Usage, dosage, and special population medication of Lenalidomide in Laos
The usage and dosage of Lenalidomide need to be adjusted according to the indications and individual patient conditions. Special attention should be paid to risks such as reproductive toxicity and differences in liver and kidney metabolism when using it for special populations. The following will explain from two aspects: standard dosing regimen and adjustment for special populations.
1. Standard usage and dosage
(1) Multiple myeloma: The recommended starting dose is 25mg/day, taken orally from day 1-21 of every 28 day cycle, in combination with dexamethasone. Maintenance therapy can be reduced to 10-15 mg/day.
(2) Myelodysplastic syndrome: 5mg/day continuous administration, evaluate efficacy for at least 4 weeks. For those who have not improved their dependence on blood transfusion, the daily dose can be increased to 10mg.
(3) Mantle cell lymphoma: 25mg/day (1-21 days), with a cycle of 28 days until disease progression or intolerable toxicity.
2. Medication adjustment for special populations
(1) Renal insufficiency
Reduce the creatinine clearance rate from 30-60mL/min to 10mg/day; <30mL/min (non dialysis) reduced to 5mg every other day; Dialysis patients need to be given 5mg/day immediately after dialysis.
(2) Liver dysfunction
Child Pugh A/B levels do not require adjustment; Child Pugh C grade requires a 50% reduction in dosage. If hepatic encephalopathy or bilirubin>3 × ULN occurs, the medication should be discontinued.
(3) Elderly patients
Patients aged 65 and above have an increased risk of thrombotic events and require enhanced anticoagulation monitoring, but there is no need to adjust dosage solely based on age.
(4) Population of childbearing age
Women need to undergo two negative pregnancy tests before treatment, and dual contraception should be used during medication and 4 weeks after discontinuation; Male patients should use condoms for 4 weeks after discontinuing medication.
(5) Children's medication
The safety and efficacy of patients under 18 years old have not been established, and existing data does not support pediatric use.
(6) Other precautions
Neutrophils<0.5 × 10 ⁹/L or platelets<30 × 10 ⁹/L require suspension of administration; After recovery, you can reduce the amount and restart. Asian patients may require lower starting doses.
Disclaimer：《Usage, dosage, and special population medication of Lenalidomide in Laos》Edited and sorted by Seagull Pharmacy's editors. Please contact us in time if there is any infringement. In addition, the suggestions for drug usage, dosage and disease mentioned in the article are only for medical staff's reference, and can not be used as any basis for medication！