Cycle length: 28 days. | |||
Drug | Dose and route | Administration | Given on days |
Lenalidomide* | 25 mg¶ by mouth | Administer with water. Swallow capsule whole; do not break, open, or chew. | Take once daily on days 1 through 21 |
Dexamethasone | 40 mg¶ by mouth | Take with food (after meals or with food or milk) in the morning. | Take once daily on days 1, 8, 15, and 22 |
Pretreatment considerations: | |||
Emesis risk |
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Infection prophylaxis |
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Antithrombotic prophylaxis |
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Dose adjustment for baseline liver or kidney dysfunction |
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Monitoring parameters: | |||
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Suggested dose modifications for toxicity: | |||
Myelotoxicity |
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Nonhematologic toxicity |
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ANC: absolute neutrophil count; CBC: complete blood count; CrCl: creatinine clearance; G-CSF: granulocyte colony-stimulating factors.
* In the United States, the use of lenalidomide is subject to the REVLIMID REMS program (www.REVLIMIDREMS.com) developed in an attempt to minimize the potential for pregnancy and associated birth defects among patients taking this medication.
¶ For frail older adult patients, we decrease the starting doses of lenalidomide (to 15 mg) and dexamethasone (to 20 mg). Following 9 cycles of lenalidomide plus dexamethasone in this population, we discontinue the dexamethasone and continue with lenalidomide maintenance alone.
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