Lenalidomide

CLINICAL USE

Treatment of multiple myeloma in combination with dexamethasone

DOSE IN NORMAL RENAL FUNCTION

25 mg daily on days 1–21 of a 28 day cycle; reduce dose if patient has neutropenia or thrombocytopenia; see data sheet

PHARMACOKINETICS

Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :259.3

%Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :22.7–29.2

%Excreted unchanged in urine &nbsp &nbsp : 65–85

Volume of distribution (L/kg) &nbsp &nbsp &nbsp :86 litres

half-life – normal/ESRD (hrs)&nbsp &nbsp &nbsp :3.5/>9

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

30–50 10 mg daily, increasing to 15 mg after 2 cycles if patient is not responding<30 15 mg every 48 hours

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:Probably dialysed. 15 mg 2–3 times a week

HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Probably dialysed. 15 mg 3 times a week post dialysis

HDF/high flux &nbsp :Probably dialysed. 15 mg 3 times a week post dialysis

CAV/VVHD &nbsp &nbsp &nbsp:Probably dialysed. Dose as in GFR=30–50 mL/min

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugsCardiac glycosides: possibly increases concentration of digoxin

ADMINISTRATION

Reconstition

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Route

Oral

Rate of Administration

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Comments

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OTHER INFORMATION

May cause acute renal failure – monitor renal function during treatment. Patients with renal impairment are more likely to develop side effects

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