Product Introduction:
Lenmid is an oral prescription medication used as part of combination chemotherapy regimens or as monotherapy in certain cancers. It is manufactured by Cipla Ltd, a leading Indian pharmaceutical company. The drug is marketed in capsule form and is classified as an immunomodulatory agent and antineoplastic agent.
Uses (Indications):
Lenmid is used in the treatment of multiple types of cancers and blood disorders, including:
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Multiple Myeloma (MM): Often used with dexamethasone as first-line or maintenance therapy
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Myelodysplastic Syndromes (MDS): Especially in patients with 5q chromosomal deletion
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Mantle Cell Lymphoma (MCL): In patients who have failed previous treatments
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Follicular and Marginal Zone Lymphomas: As second-line or salvage therapy
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Chronic Lymphocytic Leukemia (CLL): In select refractory or relapsed patients
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Off-label use: Occasionally used in other malignancies under specialist guidance
Storage Instructions:
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Store in a cool, dry place, ideally between 15°C to 30°C (59°F to 86°F)
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Keep in original packaging to protect from light and moisture
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Keep out of reach of children and pets
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Do not store in bathrooms or humid areas
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Dispose of unused capsules through hazardous waste programs — not in household trash
How It Works (Mechanism of Action):
Lenalidomide exerts its anticancer effects through multiple biological mechanisms:
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Immunomodulation: Enhances T-cell and NK cell function, boosting immune attack on malignant cells
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Inhibition of angiogenesis: Suppresses new blood vessel formation that tumors need to grow
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Direct anti-proliferative action: Blocks the cell cycle and induces apoptosis (programmed cell death) in cancer cells
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Cytokine modulation: Alters inflammatory signaling (e.g., TNF-alpha, IL-6) that supports tumor growth
This multi-pronged action makes it highly effective in hematologic malignancies like myeloma and MDS.
Side Effects:
Common Side Effects:
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Fatigue and weakness
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Nausea or vomiting
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Diarrhea or constipation
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Muscle cramps
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Mild rash or dry skin
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Dizziness or insomnia
Severe Side Effects:
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Bone marrow suppression: Neutropenia, anemia, and thrombocytopenia – may require dose adjustment
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Thromboembolism: Risk of deep vein thrombosis and pulmonary embolism (especially with steroids)
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Severe skin reactions: Stevens-Johnson Syndrome (SJS), toxic epidermal necrolysis (TEN)
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Liver injury: Elevated liver enzymes or hepatotoxicity
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Secondary malignancies: Rare, but documented risk of new cancers developing
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Birth defects: Extremely teratogenic; can cause severe fetal deformities or death
Dosage (Typical Recommended Dose):
Multiple Myeloma:
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25 mg once daily on Days 1–21 of a 28-day cycle (with dexamethasone)
Myelodysplastic Syndrome (with 5q deletion):
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10 mg once daily, continuously
Mantle Cell Lymphoma:
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25 mg once daily on Days 1–21 of a 28-day cycle
Note: Dose adjustments are required in patients with renal impairment or hematologic toxicity. The starting dose depends on indication and kidney function.
Method of Administration:
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Swallow the capsule whole with a glass of water
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Can be taken with or without food
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Do not crush, chew, or open the capsule
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Handle with care – wear gloves if you are a caregiver
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Wash hands thoroughly after handling the medicine
Precautions:
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Pregnancy Category X: Absolutely contraindicated – must not be used in pregnancy
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Females of reproductive age must use two effective forms of contraception
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Regular pregnancy tests are mandatory during treatment
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Males must use condoms if their partner is of childbearing potential
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Monitor CBC, liver, and renal function regularly
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Caution in patients with history of clotting disorders or cardiovascular disease
Drug Interactions:
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Dexamethasone: Increased risk of thrombosis, but often used together in multiple myeloma
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Erythropoietin agents: May further increase VTE risk
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Anticoagulants: Increased bleeding risk – requires close INR monitoring if on warfarin
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Live vaccines: Should be avoided due to immunosuppression
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Digoxin and other P-gp substrates: Potential increased blood levels
Allergies (Warnings for Allergic Reactions):
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Hypersensitivity reactions may include rash, itching, swelling, or fever
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Severe skin disorders like SJS/TEN may occur — seek immediate attention
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Do not take Lenmid if you’ve had an allergic reaction to Thalidomide or Lenalidomide previously
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Immediate discontinuation is necessary if signs of a serious allergic response occur
Overdose Information:
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Overdose may lead to severe cytopenias, lethargy, or other systemic toxicity
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There is no specific antidote – treatment is supportive and symptomatic
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Hospitalization may be necessary for monitoring and supportive care
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If overdose is suspected, seek emergency medical attention immediately
Missed Dose Instructions:
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If missed and remembered on the same day, take it immediately
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If it’s the next day, skip the missed dose and take the next one as scheduled
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Do not double dose to make up for missed capsules
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Inform your doctor if more than one dose is missed in a cycle
Additional Notes:
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Lenmid is a highly regulated medicine and requires enrollment in a pregnancy prevention program
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Patients must be counseled about side effects and handling precautions before starting
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Regular lab tests are essential for safe and effective treatment
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Notify your doctor if you experience bleeding, fever, numbness, or unusual bruising
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Patients should not share this medication with anyone, especially pregnant women
