Indications and medication precautions for Lenalidomide in Laos
Lenalidomide is an immunomodulatory agent widely used in the treatment of multiple myeloma and myelodysplastic syndrome. Its medication should strictly follow the indications and pay attention to special risk management. The following provides a systematic explanation from two aspects: approved indications and core precautions.
1. Approved indications
(1) Multiple myeloma: Adult patients who have received at least one treatment in combination with dexamethasone.
(2) Myelodysplastic syndrome: Used for low/moderate risk patients with 5q deficiency and transfusion dependent anemia.
(3) Mantle cell lymphoma: treatment for recurrent or refractory cases (approved in some countries).
2. Key medication precautions
(1) Hematological toxicity
During the initial stage of treatment, blood routine should be monitored weekly. If there is grade 3-4 neutropenia, medication should be suspended and G-CSF support should be considered. If platelet count is less than 30 × 10 ⁹/L, treatment should be discontinued.
(2) Teratogenic risk
Absolute contraindications during pregnancy. Women of childbearing age should have two negative pregnancy tests before taking medication, and dual contraception measures should be taken during treatment and 4 weeks after discontinuation.
(3) Prevention of venous thrombosis
Patients with multiple myeloma should use aspirin or anticoagulants in combination according to their risk level, especially when combined with dexamethasone, which significantly increases the risk of thrombosis.
(4) Abnormal liver function
Child Pugh Class C patients need to reduce their dosage by 50%, regularly monitor transaminase levels during treatment, and discontinue medication immediately if hepatic encephalopathy or hyperbilirubinemia occurs.
(5) Renal function adjustment
The creatinine clearance rate should be reduced from 30-60mL/min to 10mg/day, and from<30mL/min (non dialysis) to 5mg every other day. Dialysis patients should receive medication after dialysis.
(6) Allergic reactions
Patients with vascular edema, Stevens Johnson syndrome, and other hypersensitivity reactions require permanent discontinuation of medication. Patients with a history of severe rash should use caution.
Disclaimer：《Indications and medication precautions for 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！