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Immunomodulatory drug (IMiD)

Lenalidomide (Specialist drug)

Brand names: Revlimid

Lenalidomide is an oral specialist immunomodulatory agent used in haemato-oncology (myeloma and certain myelodysplastic syndromes and lymphomas); in rheumatology it is relevant as a comorbidity medication with significant safety constraints rather than as a routine antirheumatic therapy.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

A thalidomide analogue, it has immunomodulatory, antiangiogenic and direct antitumour actions and modulates cytokine production and T- and NK-cell activity.

Prescribing in practice

  • It is teratogenic and dispensed only under a strict Pregnancy Prevention Programme with mandatory contraception and pregnancy testing for those of childbearing potential.
  • Venous and arterial thromboembolism risk is increased, so thromboprophylaxis is generally required.
  • Myelosuppression, particularly neutropenia and thrombocytopenia, demands regular blood count monitoring.

Monitoring

Monitor full blood count regularly and ensure pregnancy testing and thrombosis vigilance under the Pregnancy Prevention Programme as set out in the SPC.

Counselling the patient

  • Strict contraception is essential; never share this medicine and report any possibility of pregnancy at once.
  • Report signs of clots such as leg swelling, chest pain or breathlessness.
  • Attend all blood tests and pregnancy tests as scheduled.

Evidence & guidelines

Randomised controlled trials in multiple myeloma and lower-risk myelodysplastic syndrome with deletion 5q establish its efficacy.

Reference: NICE TA171/TA322/TA587; UKMI; SmPC; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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