Contraindicated Populations for Lenalidomide
Pregnant women are contraindicated.
Women of childbearing potential who do not fully meet contraceptive requirements are contraindicated.
Patients with hypersensitivity to the active ingredient or any excipient of the drug are contraindicated.
No clinical data are available for pediatric and adolescent patients; therefore, patients under 18 years of age are not eligible for use.
Populations Requiring Cautious Use of Lenalidomide
It is unclear whether the drug components are excreted into breast milk; breastfeeding women are advised to discontinue breastfeeding during treatment.
Lenalidomide may cause symptoms such as fatigue, dizziness, drowsiness, and blurred vision, which may affect the safety of driving or operating machinery. Careful assessment of physical condition is recommended before engaging in such activities.
Elderly patients are more prone to renal function decline; special attention should be paid to dose adjustment and regular monitoring of renal function during treatment.
Use of Lenalidomide in Special Populations
Contraindicated groups: Pregnant women, women planning pregnancy, and children.
Groups requiring caution: Breastfeeding women, elderly patients, and patients with renal impairment.
Drug Interactions of Lenalidomide
Key Interaction Considerations
For multiple myeloma patients receiving lenalidomide plus dexamethasone, concomitant use of erythropoiesis-stimulating agents or hormone replacement therapy may increase the risk of venous thromboembolism, requiring special attention.
Oral contraceptives:
No studies have confirmed that lenalidomide reduces contraceptive efficacy, but dexamethasone may weaken the activity of certain enzymes, posing a risk of contraceptive failure. Additional contraceptive methods must be used during co-administration.
Warfarin:
No significant effect was observed at standard doses, but dexamethasome may interfere with coagulation function. Regular monitoring of coagulation indicators (PT and INR) is recommended during treatment.
Digoxin:
Concomitant use with lenalidomide may lead to a slight increase in serum digoxin concentration; monitoring of drug levels is recommended during treatment.
Lipid-lowering agents (statins):
Concomitant use may increase the risk of muscle injury, especially during the initial treatment phase, requiring enhanced symptom observation and laboratory testing.
Dexamethasone:
Standard doses do not significantly affect the plasma concentration of lenalidomide.
Drug transport-related interactions:
Concomitant use with certain metabolic inhibitors (e.g., quinidine, terfenadine) does not produce a significant change in the efficacy of lenalidomide.
