Revlimid (lenalidomide)

REVLIMID® (lenalidomide) is an immunomodulatory drug (IMiD). It was first approved by the U.S. Food and Drug Administration (FDA) in 2006 for use with the steroid dexamethasone in adult patients with myeloma who had received at least one prior therapy. In 2015, the FDA expanded this indication to a broad approval of Revlimid for use throughout the myeloma disease course, from diagnosis through relapse. 

How Does It Work?

Revlimid is in the drug class of immunomodulatory agents. These are drugs that can modify, enhance, or suppress the functioning of the immune system. Revlimid attacks myeloma in several ways:

• Revlimid targets and kills myeloma cells directly. It binds to cereblon (CRBN), the primary molecular target of all immunomodulatory agents. Binding cereblon triggers a protein degradation pathway that can kill myeloma cells.
• Revlimid enhances the function of the human immune system. It activates T cells (T lymphocytes) and natural killer (NK) cells that recognize and destroy myeloma cells.
• Revlimid prevents the growth of new myeloma cell by inhibiting vascular endothelial growth factor (VEGF). Revlimid can alter the levels of growth factors called cytokines and interleukins.
   

Who Can Be Treated with Revlimid? 

Revlimid is used to treat adult patients with myeloma at every point of the disease, including: 

• As combination therapy with the steroid dexamethasone, with or without additional anti-myeloma drugs.
• As maintenance therapy following autologous hematopoietic stem cell transplant (ASCT).
  • Revlimid alone as a single agent. This is called monotherapy.
  • Revlimid in combination with another drug. This 2-drug regimen is sometimes called a doublet. The combination therapy usually adds another medication from the drug class of proteasome inhibitors or monoclonal antibodies.

The U.S. Food and Drug Administration (FDA) first approved Revlimid for patients with relapsed or refractory multiple myeloma (RRMM) in 2006, then expanded the approval to treat myeloma throughout the disease course in 2015. The use of Revlimid has been studied in countless clinical trials over more than two decades.
 

Revlimid in the Frontline Setting 

The most important initial decision is when to begin treatment for your myeloma. Treatment controls myeloma bone breakdown and tumor growth. It also impacts the diverse effects caused by the monoclonal protein (myeloma protein, M-protein) and the cytokines stimulated by the M-protein. The urgency of treatment depends upon the exact problems faced by an individual patient. This is why the experience and expertise of a myeloma specialist is of such importance.  

If you are newly diagnosed with myeloma, we suggest that you read the IMF’s publication Patient Handbook (https://issuu.com/international-myeloma-foundation/docs/patient-handbook-en?fr=sM2MwYzQ2MzkwMTY). This booklet will help you to better understand this complex disease.  

Revlimid is part of many FDA-approved frontline regimens, the initial treatments used in a patient with newly diagnosed multiple myeloma (NDMM). Importantly, Revlimid is part of the two 4-drug (quadruplet) therapies currently considered the standard of care (SOC) for the newly diagnosed: 

• Darzalex Faspro® (daratumumab + hyaluronidase-fihj) + Velcade® (bortezomib), Revlimid, and dexamethasone (DVRd) for patients who are eligible for autologous stem cell transplantation (ASCT). 
  • The DVRd regimen was approved by the FDA in July 2024 based on data from the PERSEUS phase 3 clinical trial (https://www.myeloma.org/videos/phase-3-randomized-study-daratumumab-dara-bortezomib-lenalidomide-dexamethasone-vrd-versus) of DVRd vs. VRd. Patients were 70 years or younger and had a performance status of 0 to 2 based on the scale by the Eastern Cooperative Oncology Group (ECOG), now part of the ECOG-ACRIN Cancer Research Group. The PERSEUS study demonstrated a 60% reduction in risk of disease progression or death with the use of DVRd. Further, there was a significant advantage in overall minimal residual disease (MRD) negativity rate in the DVRd study arm (57.5%) vs. the VRd study arm (32.5%). Additionally, MRD negativity among those who also achieved a complete response (CR) or better was 76.6% in the DVRd study arm vs. 58.5% in the VRd study arm.
• Sarclisa® (isatuximab), Velcade, Revlimid, and dexamethasone (Isa-VRd) for patients who are ineligible for autologous stem cell transplant (ASCT) (https://www.myeloma.org/autologous-stem-cell-transplant). 
  • The Isa-VRd regimen was approved by the FDA on September 2024 based on data from the IMROZ phase 3 clinical trial, which compared the efficacy and safety of Isa-VRd vs. VRd for transplant-ineligible patients. The results showed that Isa-VRd reduced the risk of disease progression or death by 40.4% compared to VRd. Isa-VRd also led to deep and sustained responses, with higher rates of complete response (CR), MRD-negativity, and sustained MRD-negativity for at least 12 months. The safety profile of Isa-VRd was consistent with the addition of Sarclisa to VRd.
• Darzalex Faspro® (daratumumab and hyaluronidase-fihj), Revlimid, and dexamethasone (DRd) for patients who are ineligible for ASCT.  
• Velcade® (bortezomib), Revlimid, and dexamethasone (VRd), a highly effective and well-tolerated combination therapy that is still used in some regions while research data continues to emerge in support of therapies that add a fourth drug to VRd combination therapy.

For more information about the drugs that are part of Revlimid-containing frontline combination therapies, read the following IMF publications from our Understanding series: 

• Understanding Dexamethasone in the Treatment of Myeloma   (https://www.myeloma.org/resource-library/understanding-dexamethasone)
• Understanding DARZALEX® (daratumumab) and DARZALEX FASPRO® (daratumumab + hyaluronidase-fihj (https://www.myeloma.org/resource-library/understanding-darzalex-faspro))  
• Understanding VELCADE® (bortezomib) (https://www.myeloma.org/resource-library/understanding-velcade)
• Understanding the VRd Regimen for Newly Diagnosed Myeloma (https://www.myeloma.org/resource-library/understanding-vrd-regimen)  
• Understanding Stem Cell Transplant in Myeloma (https://www.myeloma.org/resource-library/understanding-stem-cell-transplant-myeloma)
• The VRd Regimen Tip Card (https://www.myeloma.org/resource-library/tip-card-vrd-regimen)

If a particular frontline therapy is not working for you, many other treatment options are available. Discuss your options with the doctor. However, it is not advisable to rapidly skip from one treatment regimen to another. 

Revlimid in the Relapsed or Refractory Setting 

Revlimid is part of many FDA-approved regimens for the treatment of patients with myeloma whose disease was treated previously. Regimens for patients with RRMM include the following:

• Darzalex (daratumumab), Revlimid (lenalidomide), and dexamethasone (DRd) for myeloma patients who have received at least one prior therapy 
• Empliciti® (elotuzumab), Revlimid, and dexamethasone (ERd) for patients who have had one to three prior therapies 
• Kyprolis® (carfilzomib), Revlimid, and dexamethasone (KRd) for patients who have received one to three prior lines of therapy 
• Ninlaro® (ixazomib), Revlimid, and dexamethasone (IRd) for patients who have had at least one prior therapy.  

For more information about Revlimid-containing therapies for patients with RRMM, read the following IMF booklets, listed in alphabetical order: 

• Understanding EMPLICITI® (elotuzumab)  (https://www.myeloma.org/resource-library/understanding-empliciti) 
• Understanding KYPROLIS® (carfilzomib) (https://www.myeloma.org/resource-library/understanding-kyprolis) 
• Understanding NINLARO® (ixazomib) (https://www.myeloma.org/resource-library/understanding-ninlaro) 

If You Are Planning to Proceed to Stem Cell Transplant 

In December 2023, a plenary session at the annual meeting of the American Society of Hematology (ASH) presented the results from the IsKia phase III clinical trial (https://www.myeloma.org/videos/results-phase-iii-randomized-iskia-trial-isatuximab-carfilzomib-lenalidomide-dexamethasone)of 302 patients with NDMM who were eligible for ASCT. 

Patients were randomized to two study arms, with 151 patients in each arm. One arm received Kyprolis® (carfilzomib) and Revlimid® (lenalidomide) plus dexamethasone (KRd), and the other arm received Sarclisa and KRd (Isa-KRd). 

The study assessed the efficacy and safety of Isa-KRd as pre-ASCT induction and post-ASCT consolidation. Compared to KRd alone, the addition of Sarclisa to KRd (Isa-KRd) induction and consolidation significantly increased the rates of MRD-negativity in every treatment phase and with no new safety concerns, including in patients with high-risk multiple myeloma (HRMM).

Newly diagnosed myeloma patients who are eligible for autologous stem cell transplant (ASCT) (https://www.myeloma.org/autologous-stem-cell-transplant) should know that longer-term use of Revlimid can affect their blood-making stem cells.

The collection of stem cells for use in ASCT should occur within 4 cycles of a Revlimid-containing therapy. For more information, read the IMF publication Understanding Stem Cell Transplant in Myeloma (https://www.myeloma.org/resource-library/understanding-stem-cell-transplant-myeloma). 

Revlimid in the Post-ASCT Maintenance Setting 

To prolong remission, some patients receive maintenance therapy after their ASCT. 

Studies show that maintenance therapy with Revlimid received after ASCT significantly increases both progression-free survival (PFS) and overall survival (OS). This is also true for patients who have high-risk multiple myeloma (HRMM). The proportion of patients who achieve MRD-negative status with Revlimid maintenance is also increased.

• PFS: This is the length of time during and after the treatment that a patient lives with myeloma, but it does not get worse. In a clinical trial, PFS is one way to measure how well the treatment is working.
• OS: This is the amount of time measured from diagnosis or start of treatment until death from any cause. In past clinical trials, OS was used to assess if a treatment extended a patient’s life. However, the length of OS duration has increased significantly as myeloma therapies have become more effective; current clinical trials use faster endpoints to validate their outcomes.
• HRMM: Approximately 20% of myeloma patients have a more aggressive form of myeloma that is more likely to be resistant to treatment, to relapse more quickly, and to feature specific genetic chromosomal abnormalities.
• Minimal residual disease (MRD): The presence of residual tumor cells after treatment has been completed. 
• MRD-negative: Highly sensitive testing methods are able to detect 1 myeloma cell among 1,000,000 sampled cells in blood or bone marrow. MRD-negativity is associated with significantly prolonged PFS and OS, including in patients with HRMM.

For more information, read the IMF booklet Understanding Stem Cell Transplant in Myeloma (https://www.myeloma.org/resource-library/understanding-stem-cell-transplant-myeloma).
  

Revlimid in the Setting of Smoldering Myeloma 

Currently, several active and recruiting clinical trials are bringing Revlimid to a new treatment setting in myeloma, intermediate-risk and high-risk smoldering multiple myeloma (SMM). These clinical trials are investigating several approaches to treating SMM, and the data being gathered will help assess the possible benefits and risks of treating SMM with these different strategies. If you are diagnosed with SMM and have an interest in clinical trial participation, please have a discussion with your treating doctor and contact the IMF InfoLine at 1.818.487.7455 or [email protected] (mailto:[email protected]).

Possible Risk of Secondary Primary Malignancy 

Maintenance therapy with Revlimid after ASCT can increase the risk of a second primary malignancy (SPM), a new cancer that is unrelated to the diagnosis of myeloma. Secondary cancers that are a consequence of treatment for myeloma may occur months or years later.

An SPM can occur in a patient who has been exposed to both Revlimid and melphalan, which is used in the ASCT process. Studies show that second hematologic (blood) cancers occurred in 7.5% of patients who received Revlimid maintenance compared to 3.3% of patients who did not receive Revlimid maintenance.

At a follow-up of almost 10 years later, the incidence of SPMs with a hematologic plus a solid tumor cancer was 14.9% compared to 8.8% patients who received no maintenance. 

Each patient must discuss with their myeloma doctor both the advantages and the potential risks of post-ASCT maintenance therapy with Revlimid. Be sure to discuss and evaluate your individual risk factors and your response to transplant before deciding to receive Revlimid maintenance therapy. If you decide to proceed with maintenance therapy, you must be carefully monitored.
 

How Is Revlimid Taken? 

Revlimid is taken by mouth (orally) in capsule form. Since you do not need to be at the doctor’s office or in a clinic or hospital to receive Revlimid, it is your responsibility to take Revlimid as directed by your doctor.  

• Make sure to read the booklet Understanding Revlimid (https://www.myeloma.org/resource-library/understanding-revlimid).  
• Follow any other materials your doctor provides.  
• Read and download/order the IMF Tip Card: Adherence to Oral Cancer Therapy. (https://www.myeloma.org/resource-library/tip-card-adherence) 
• Both brand-name and generic capsules come in the following dosages: 
  • 2.5 mg
  • 5 mg
  • 10 mg
  • 15 mg
  • 20 mg
  • 25 mg
     

A capsule of 7.5 mg strength is available only as brand-name Revlimid, not as a generic version.

You do not need to be at a doctor’s office or in a clinic or hospital to receive Revlimid. This makes it your responsibility to take Revlimid as directed by your doctor. You must read and understand the written materials your doctor gives you. Please also review the notes below:

• Do not open, break, or chew your capsules.
• Do not handle the capsules any more than needed. 
• Swallow capsules whole. 
• Take capsules with water, with or without food.
• Take capsules at about the same time each day.
• If you touch a broken capsule or the medicine inside, immediately wash the contact area of your skin with soap and water.
• If you miss a dose, and it has been less than 12 hours since your regular time to take this medication, take it as soon as possible. 
• If you miss a dose, and it has been more than 12 hours since your regular time to take this medication, contact your myeloma doctor for instructions.

NOTE: If you have renal (kidney) disease, your dosage of Revlimid may be adjusted in accordance with your level of kidney function. The drug manufacturer’s prescribing information includes the recommended dosage for patients with kidney disease, which your doctor must follow.

Dose and Schedule

The standard dose for Revlimid is one capsule, taken daily on Days 1 through 21 of a 28-day cycle. It is important to follow the Revlimid dose and schedule prescribed by your myeloma doctor.

Clinical trials show that if the dose of Revlimid is reduced after 12 months or longer, treatment benefit is retained. Your myeloma doctor will determine if it is appropriate to change your dose and/or schedule. Your doctor may lower your dose to a level determined to be appropriate for you, possibly down to as low as 2.5mg. 
 

Dose Reductions with Revlimid  

The standard treatment dose for Revlimid is one 25 mg capsule each day for 21 days of a 28-day cycle. Your physician may consider reducing the dose due to lowered blood cell counts. In addition, there may be cumulative side effects such as fatigue or slight neuropathy. Your physician may decide that dose reduction is appropriate, lowering first to 20 mg, then to 15 mg, then to 10 mg, and even to 5 mg or 2.5 mg if necessary.  

Results from clinical trials show that with dose reductions after 12 months or longer of Revlimid therapy, treatment benefit is retained. Long remissions following dose reduction were reported in two clinical trials, MM009 and MM010 (https://ashpublications.org/blood/article/108/11/3547/126940/Lenalidomide-Plus-High-Dose-Dexamethasone-Provides). In these two clinical trials, Revlimid and dexamethasone were compared to dexamethasone alone in myeloma patients who had relapsed after 1 to 3 prior lines of therapy. Patients who had dose reductions after 12 months or more of Revlimid had significantly longer PFS than those who had never had dose reductions at all. These patients were better able to remain on therapy. 

The dose of Revlimid is also reduced as part of maintenance therapy, commonly dosed at 10 mg daily on a 28-day schedule.

It is important to  

• communicate openly with your doctor or healthcare professional, 
• follow your prescribed dose and schedule of medication, and  
• keep regular appointments to maintain your Revlimid treatment schedule. 

Clinical Trial Experience with Revlimid

A clinical trial is a medical research study with people who volunteer to test scientific approaches to a new treatment or a new combination therapy. Each clinical trial is designed to find better ways to prevent, detect, diagnose, or treat a medical condition, or to answer scientific questions.

A clinical trial is launched only after laboratory studies have shown the potential of a treatment or procedure to be more effective and/or less harmful than previous methods. For patients with myeloma, clinical trials can be part of normal care that may provide earlier access to new drugs and therapies that are not yet available outside of a study.

The ISKIA clinical trial

The ISKIA phase 3 clinical trial enrolled 302 transplant-eligible patients with NDMM to assess efficacy and safety of Sarclisa, Kyprolis, Revlimid, and dexamethasone (Isa-KRd) as induction therapy before ASCT and consolidation therapy after ASCT. Isa-KRd is being compared to KRd.

Results published in Nature Medicine in April 2026 (https://www.nature.com/articles/s41591-026-04282-0) show significant improvement in MRD-negativity rates at 10^⁻5 after consolidation therapy in the Isa-KRd group (77%) vs. the KRd group (67%). At the deeper threshold of 10^⁻⁶, MRD-negativity was 68% with Isa-KRd vs. 48% with KRd. At 1-year, sustained MRD-negativity at 10^⁻⁶ was higher with Isa-KRd at 52% vs. with KRd at 38%.

The MRD benefit of Isa-KRd was consistent across subgroups, including patients with HRMM.

The MIDAS clinical trial

Published in the New England Journal of Medicine in June 2025 (https://www.nejm.org/doi/abs/10.1056/NEJMoa2505133), the phase 3 MIDAS clinical trial showed that a quadruplet regimen can achieve high rates of MRD-negativity and that some patients may not require ASCT when MRD-negativity is achieved. Longer follow up is still needed.

In addition, the MIDAS study showed that tandem (two) ASCT procedures do not seem to provide a significant additional benefit for patients who remain MRD-positive after induction therapy.

Finding a clinical trial to match your needs

Myeloma clinical research is very exciting, with many studies enrolling patients. To help you with personalized support for identifying clinical trial options across the U.S., the IMF has partnered with SparkCures. Visit myeloma.org/sparkcures (https://www.myeloma.org/sparkcures) or contact the IMF (https://www.myeloma.org/infoline) for more information.

If you would like to explore possible participation in a clinical trial, ask your myeloma doctor if a study may be right for you and about the potential risks and benefits that may apply to you. For more information about what’s involved in study participation, read the IMF booklet Understanding Clinical Trials in Myeloma (https://www.myeloma.org/resource-library/understanding-clinical-trials-myeloma).

Special Precautions When Taking Revlimid

All medications come with a risk of side effects. You must promptly report to your doctor any changes in your health, including all new or worsening side effects that you experience.

Most side effects associated with Revlimid are manageable. Some potential side effects of Revlimid are serious enough to require an FDA-mandated Boxed Warning, the strictest warning in the labeling of prescription drugs.

Revlimid and blood-making stem cells

Newly diagnosed patients who are eligible for ASCT should know that the collection of stem cells for use in ASCT should occur within 4 to 6 Cycles of a Revlimid-containing regimen. This is because longer use of Revlimid can affect blood-making stem cells. 

Risk Evaluation and Mitigation Strategy (REMS)

REMS programs are required by the FDA for treatments that may have serious safety concerns. REMS programs support the use of treatment and help ensure that the potential benefits outweigh the risks. Revlimid is available only through a REMS program. 

Embryo-fetal toxicity 

Revlimid may cause birth defects or embryo-fetal death.

Women of reproductive potential and males with female partners of reproductive potential must use two reliable methods of contraception during treatment with Revlimid. Pregnancy must be excluded before the start of treatment and prevented during treatment with Revlimid. 

Thrombocytopenia 

A low number of platelets (thrombocytes) in the blood is called thrombocytopenia. Platelets help blood to clot. Fewer platelets can lead to easier bruising, bleeding, and slower healing. 

The “normal” level of platelets varies from laboratory to laboratory but is approximately 150,000 or more platelets per microliter of circulating blood. Bleeding problems could occur if the count is less than 50,000 platelets. Major bleeding is usually associated with a reduction to less than 10,000 platelets. 

Promptly alert your doctor of excessive bruising or bleeding. At the discretion of your doctor, management can include platelet growth-stimulating medication or transfusion. 

Neutropenia 

White blood cells (WBC) help to fight infection. A low level of white blood cells called neutrophils can lead to infection. 
Alert your doctor immediately if you have a fever, sore throat, or any other sign of an infection. Fever is often the first symptom of infection. Your doctor will determine how to best manage your infection. 

Treatment of neutropenia depends on its cause and severity. Neutropenia accompanying viral infections (such as influenza or flu) may go away after the infection has cleared. Mild neutropenia generally has no symptoms and may not need treatment. In some cases, treatment may include medication to stimulate the growth of neutrophils. 
 

Venous thromboembolism 

Venous thromboembolism (VTE) is a condition that includes both deep vein thrombosis (DVT) and pulmonary embolism (PE). Signs or symptoms of VTE may include difficulty breathing and/or warmth, swelling, redness, and/or pain in an extremity.

• DVT occurs when a blood clot (thrombus) forms in one or more of the deep veins in the body, usually in the lower extremities. A blood clot from a DVT can break loose (embolize) and travel to the heart or lungs. An embolus is potentially life-threatening. DVT can occur without any symptoms or can cause leg pain or swelling.
• PE occurs when a blood clot in the vein breaks loose, travels through the bloodstream, and lodges in a lung, blocking blood flow.

Blood clots in the arteries, veins, and lungs occur more often in people who take Revlimid than in the healthy population. The risk of blood clots is even higher for people with myeloma who take Revlimid together with dexamethasone. 

Myocardial infarctions (heart attacks) are more frequent in people who take Revlimid together with dexamethasone. Signs or symptoms may include the following:

• Chest pain, which may spread to the arms, neck, jaw, back, or abdomen (belly area)
• Breaking out in a sweat
• Shortness of breath
• Feeling sick to your stomach or vomiting

Strokes are more frequent in people who take Revlimid together with dexamethasone. Signs or symptoms may include the following:

• Sudden numbness or weakness, especially on one side of the body
• Severe headache
• Confusion
• Problems with vision, speech, or balance

A doctor will diagnose your condition and determine whether or not treatment is needed. Treatment depends upon both the location of the VTE and the underlying cause.

Preventive therapy with a blood thinner is required. The type and dose of blood thinner you will receive is determined by your personal risk factors. Before taking Revlimid, tell your doctor:

• if you had a blood clot in the past.
• if you have high blood pressure, if you smoke, or if you have hyperlipidemia (high level of fat in your blood).
• about all the medicines you take, because some medications can increase the risk for blood clots.

Seek urgent medical care if you experience any of the above signs or symptoms.

Liver injury (hepatotoxicity)

Revlimid may be associated with liver injury. Risk factors may include pre-existing viral liver disease, elevated baseline liver enzymes, and other medications that a patient may be taking. Liver failure, including fatal cases, has occurred in patients treated with Revlimid in combination with dexamethasone.

Your doctor will monitor your liver enzymes. Your treatment with Revlimid will be stopped if your liver enzymes are higher than normal. After the enzymes return to your normal baseline levels, treatment at a lower dose may be considered.
 

Possible Common Side Effects of Revlimid

Diarrhea

Diarrhea is a common side effect of long-term Revlimid therapy.  Diarrhea is defined as 3 or more loose stools per day. Severe diarrhea is defined as 7 or more loose stools per day. 

Revlimid activates the immune system throughout the body. This includes the immune system in the gut, which absorbs bile acids.

When the intestines cannot process bile acids properly, bile acid malabsorption (BAM) can lead to diarrhea.

Diarrhea can have a negative impact on quality of life. Your doctor can determine if your diarrhea is caused by BAM or by other medical problems. Treatment with intravenous (IV) fluids may be required. If not managed well, diarrhea may lead to pausing or stopping treatment with Revlimid.

• Revlimid-related diarrhea can be significantly improved or resolved by the following:
  Reducing intake of dietary fat.
• Taking a bile acid medication such as cholestyramine, colesevelam, or colestipol. These medications are available under several brand names.
• Other medications may also be used to manage diarrhea. If these medications are not sufficient to control your diarrhea, ask your doctor if a lower dose of Revlimid is acceptable in your case. In some cases, Revlimid may have to be discontinued.

Fatigue

Fatigue is associated with cancer and with cancer therapy, including Revlimid.

Fatigue that is related to cancer and its treatments tend to be more severe, last longer, and include a feeling of overall weakness (this is called asthenia). The effects of fatigue may be minimized by:

• A moderate level of activity.
• A healthy diet and proper fluid intake.
•  A consistent sleeping schedule.
• Monitoring your red blood cell count (RBC) by your doctor.
• Review of the side effects of any other medications you are taking.

For more information, read the IMF booklet Understanding Fatigue in Myeloma (https://www.myeloma.org/resource-library/understanding-fatigue)

Anemia

Red blood cells contain hemoglobin. This is a protein that contains iron and transports oxygen from the lungs to the body’s organs and tissues. A low level of red blood cells results in low levels of oxygen in the body, which may cause shortness of breath and feelings of exhaustion. The following are options for treatment of anemia:

• Revlimid dose interruption, reduction, or discontinuation.
• Erythropoietic (RBC-making) medication.
• Blood transfusion.

Rash

Most Revlimid-related rash is mild to moderate. A rash may look like patchy, raised spots on the skin, with or without hives. The rash might be itchy. Mild rash may be treated with an oral antihistamine or steroids, either topical or by mouth. 

Revlimid may be paused for a period of time, then restarted at the same or lower dose.  Repeated rash is not common, and this may lead to stopping treatment with Revlimid. In rare cases, Revlimid-related rashes can become severe or life-threatening. 
 

Decreased appetite

Decreased appetite occurred in 23% of the newly diagnosed study patients. But only 3% of patients experienced decreased appetite that led to weight loss or malnutrition. Access the National Cancer Institute’s Eating Hints: Before, During, and After Cancer Treatment here (https://www.cancer.gov/publications/patient-education/eating-hints). It includes the following helpful suggestions to maintain body weight and meet your nutritional needs:

• Eat plenty of protein and calories when you can.
• Eat at the time of the day when you have some appetite.
• Eat what appeals to you, even if it’s the same thing repeatedly.
• Drink liquid meal replacements for extra nutrition.
• If you can’t eat at all some days, tell your healthcare team.
• Drink 8 to 12 cups of non-alcoholic liquids each day, especially on days when you cannot eat. 

Other Possible Side Effects of Revlimid

Other common side effects of Revlimid include the following:

• constipation
• peripheral edema (swelling of the ankles and feet)
• insomnia
• muscle cramps and/or spasms
• abdominal pain
• back pain
• fever
• respiratory tract infection
• gastroenteritis ("stomach flu")
• tremors or trembling
   

Revlimid prescribing information, including updated renal dosing guidelines

Dosing guidelines from the FDA (https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/021880s049lbl.pdf) and the EMA (https://www.ema.europa.eu/en/medicines/human/EPAR/revlimid).

Patient Assistance

BMS Access Support (https://www.bmsaccesssupport.com/patient)

Bristol-Myers Squibb (BMS) offers "coverage and access assistance, co-pay and financial support options for eligible patients, help identifying local support resources, and educational guides and videos."

Uninsured patients or those who are experiencing financial difficulties can apply for assistance through the BMS Patient Assistance Foundation. Call 1.800.736.0003 or go to bmspaf.org (https://www.bmspaf.org/).

Patients with Medicare, Medicaid, or other U.S. government insurance are not eligible for co-pay assistance but can be connected to support specialists for help identifying charitable foundations that offer grants.

Teva U.S.A. has been manufacturing generic lenalidomide since 2022. For information, call 1.888.838.2872 or go to tevausa.com (https://www.tevausa.com/).