Product Introduction:
Lenakast is a prescription-only anticancer medication manufactured by Aprazer Healthcare Pvt. Ltd., formulated for oral use in capsule form. It is primarily used in the treatment of multiple myeloma, myelodysplastic syndromes, and certain types of lymphomas, especially in adults who are either newly diagnosed or have relapsed disease.
Uses (Indications):
Lenakast is indicated in the treatment of multiple blood-related cancers and disorders:
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Multiple Myeloma (MM) – In combination with dexamethasone for newly diagnosed or relapsed patients
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Myelodysplastic Syndromes (MDS) – Especially with deletion 5q cytogenetic abnormality
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Mantle Cell Lymphoma (MCL) – In patients whose disease has relapsed or progressed
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Follicular and Marginal Zone Lymphomas – As a second-line or later therapy
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Chronic Lymphocytic Leukemia (CLL) – In select patients with specific cytogenetic profiles
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Primary Cutaneous T-cell Lymphomas (off-label) – In certain refractory cases
Storage Instructions:
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Store at 15°C to 30°C (59°F to 86°F).
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Protect from light, moisture, and heat.
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Keep out of reach of children and pets.
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Do not use beyond expiry date.
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Dispose of unused capsules safely – do not flush or throw in regular trash.
How It Works (Mechanism of Action):
Lenalidomide works through multiple mechanisms:
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Anti-proliferative: Inhibits the growth of abnormal blood cells by halting cell division.
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Immunomodulation: Enhances the function of T-cells and natural killer (NK) cells, aiding immune destruction of tumor cells.
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Anti-angiogenic: Prevents the formation of new blood vessels required for tumor growth.
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Cytokine modulation: Alters inflammatory signaling pathways that contribute to cancer progression.
These combined effects reduce tumor burden and prolong survival in hematological malignancies.
Side Effects:
Common Side Effects:
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Fatigue and weakness
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Constipation or diarrhea
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Decreased appetite
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Skin rash, dry skin
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Headache
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Muscle cramps or pain
Serious Side Effects:
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Myelosuppression: Decrease in white blood cells, platelets, or red cells (risk of infection, bleeding, or anemia)
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Venous thromboembolism (VTE): Deep vein thrombosis or pulmonary embolism – especially when combined with steroids
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Hepatotoxicity: Elevated liver enzymes or liver injury
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Second Primary Malignancies: Slight increased risk of developing other cancers
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Severe skin reactions: Stevens-Johnson Syndrome (rare but life-threatening)
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Birth defects: Extremely high risk of fetal harm or death if taken during pregnancy
Dosage (Typical Recommended Dose):
Multiple Myeloma (in combination with dexamethasone):
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25 mg orally once daily on days 1–21 of a 28-day cycle
Myelodysplastic Syndrome (del 5q):
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10 mg orally once daily, continuously
Mantle Cell Lymphoma (relapsed/refractory):
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25 mg orally once daily on days 1–21 of a 28-day cycle
Dose adjustments are frequently required based on kidney function, blood counts, and tolerance. Patients with renal impairment need dose reduction.
Method of Administration:
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Take orally with or without food, ideally at the same time each day
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Swallow capsule whole with water – do not crush, open, or chew
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Wash hands before and after handling capsules
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If handling by a caregiver: wear gloves, especially if pregnant or breastfeeding
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Adherence to prescribed schedule is crucial for effectiveness
Precautions:
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Pregnancy Warning: Absolutely contraindicated in pregnancy – causes severe birth defects or fetal death
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Women of childbearing potential must use two forms of contraception and undergo regular pregnancy tests
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Men taking Lenakast must use condoms if their partner is pregnant or of childbearing potential
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Increased clot risk: Prophylactic aspirin or anticoagulation may be needed
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Monitor blood counts, kidney, and liver function regularly
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Avoid driving or machinery if dizziness or blurred vision occurs
Drug Interactions:
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Dexamethasone: Synergistic effect in myeloma, but increases VTE risk
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Warfarin/Anticoagulants: May increase bleeding risk
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Erythropoietin-stimulating agents: Combined use may further elevate thrombosis risk
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Live vaccines: Should be avoided during therapy
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CYP enzyme modulators (minimal interaction) – Lenalidomide is not significantly metabolized by CYP pathways, reducing interaction risks compared to other agents
Allergies (Warnings for Allergic Reactions):
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Hypersensitivity reactions can include rash, itching, swelling, and fever
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Severe skin conditions like Stevens-Johnson Syndrome or Toxic Epidermal Necrolysis (rare but life-threatening)
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Patients with known allergy to Thalidomide or Lenalidomide should not take Lenakast
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Immediate medical attention is required if allergic symptoms appear
Overdose Information:
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Overdose may result in severe bone marrow suppression, fatigue, nausea, and dizziness
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There is no specific antidote – management is supportive and may involve hospitalization
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Blood transfusions, hydration, and close monitoring may be required
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Contact Poison Control Center or emergency medical services immediately in case of overdose
Missed Dose Instructions:
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If a dose is missed, take it as soon as remembered on the same day
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If it's the next day already, skip the missed dose and continue the regular schedule
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Do not take a double dose to make up for a missed one
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Inform your oncologist if doses are frequently missed
Additional Notes:
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Lenakast is a powerful and life-extending therapy for multiple cancers when used correctly
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The drug is dispensed under strict risk-management programs (e.g., RevAid / REMS) to prevent pregnancy-related risks
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Regular blood monitoring and clinical review are mandatory throughout treatment
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Patients should receive educational counseling on safe handling and risks before starting
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Notify your doctor of any new symptoms or side effects, including mood changes, nerve pain, or infection signs
