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Lenalidomide refers to antitumor immunomodulators. The mechanism of action is based on changes in the body’s immune system. The main task of the immune system is to fight infection. The principle of the action of immunomodulators differs from the principle of classical chemotherapy, this is an important feature, since they can be used in parallel with chemotherapy remedies or separately if the chemotherapy remedies cease to function.
Treatment with Lenalidomide 25 mg should be carried out under the supervision of a doctor who has experience in the using of antitumor remedies.
Lenalidomide is prescribed in capsules for oral administration, usually a course of 21 days, followed by a 7-day break. Thus, a 28-day treatment cycle is formed. The appointment and duration of treatment is determined by the doctor. The optimal dose, duration of treatment depends largely on the clinical picture of the disease, as well as on the individual characteristics of the patient. However, for comparison, leading clinical studies used a dose of 25 mg daily, for 21 days, a break for 7 days. Patients were treated until the progression of myeloma began.
Treatment of myeloma in most cases becomes more effective if two or more remedies with different but synergistic (reinforcing each other) mechanisms of action are used. In the treatment of myeloma, Lenalidomide 25 mg is used in combination with a steroid hormone dexamethasone. If treatment is ineffective, it may be necessary to increase the dose or introduce another remedy into the scheme. When the maximum effect is achieved, the dose of remedies can be reduced. If the disease progresses, despite the increase in dosages or the introduction of additional remedies, the doctor will usually change the therapy and switch to alternative treatment regimens.
– in combination with dexamethasone for the treatment of patients with multiple myeloma who have received at least one line of therapy.
Lenalidomide 25 mg is intended only for oral administration.
Capsules of Lenalidomide cannot be broken or chewed. It is recommended to take the remedy every day at the same time before or after eating, squeezed with water.
Interactions of the remedy Analogue Revlimid
Erythropoietic agents, as well as other agents that may increase the risk of thrombosis, such as hormone replacement therapy, should be used with caution in patients with multiple myeloma who take Lenalidomide in combination with dexamethasone.
Mutual influence on the metabolism of Lenalidomide and other remedies is unlikely in connection with the fact that Lenalidomide is not metabolized by the cytochrome P450 system.
Simultaneous administration of Lenalidomide with Digoxin is accompanied by an increase in the plasma concentration of Digoxin (Cmax Digoxin was 114%, and AUC0-∞ 108%). Thus, against the background of Lenalidomide treatment, it is recommended to monitor the concentration of Digoxin.
Dexamethasone, which is an obligatory component of the treatment regimen with Revlimid, can reduce the effectiveness of oral contraceptives. To effectively prevent pregnancy, use the remedies indicated in the Pregnancy Protection Program.
There was no mutual influence on the pharmacokinetic parameters of Lenalidomide and Warfarin. Taking into account the using of dexamethasone in combination with Lenalidomide, one cannot exclude the influence of the latter on the effects of Warfarin. Thus, against a background of combined therapy with Lenalidomide and dexamethasone, careful monitoring of the concentration of Warfarin is recommended.