Lenalidomide: uses, dosing, side effects & brands
Lenalidomide is a thalidomide analog sold in the U.S. under 2 brand and generic names, for multiple myeloma, myelodysplastic syndromes and mantle-cell lymphoma. Below: what the FDA label says, every product that contains it, what the pills look like, and its recall record.
Key facts
- Drug class
- Thalidomide Analog
- Treats
- Multiple Myeloma, Myelodysplastic Syndromes and Mantle-Cell Lymphoma
- Available as
- Capsule
- Sold as
- 2 products — Revlimid and Lenalidomide
- Prescription?
- Prescription only
- Generic available?
- Yes
- Half-life
- about 3 hours in healthy subjects, and 3 to 5 hours in patients with multiple myeloma, MDS, or mantle cell lymphoma
- Boxed warning
- Boxed warning
How lenalidomide is dosed
From the FDA label for Revlimid (application NDA021880). Other lenalidomide products — different forms, different strengths — are dosed differently. Follow the label for the one you were prescribed.
MM combination therapy: 25 mg once daily orally on Days 1-21 of repeated 28-day cycles. ( 2.1 ). • MM maintenance therapy following auto-HSCT: 10 mg once daily continuously on Days 1-28 of repeated 28-day cycles ( 2.1 ). • MDS: 10 mg once daily ( 2.2 ). • MCL: 25 mg once daily orally on Days 1-21 of repeated 28-day cycles ( 2.3 ). • FL or MZL: 20 mg once daily orally on Days 1-21 of repeated 28-day cycles for up to 12 cycles ( 2.4 ). • Renal impairment: Adjust starting dose based on the creatinine clearance value ( 2.6 ). • For concomitant therapy doses, see Full Prescribing Information ( 2.1 , 2.4 , 14.1 , 14.4 ). 2.1 Recommended Dosage for Multiple Myeloma REVLIMID Combination Therapy The recommended starting dose of REVLIMID is 25 mg orally once daily on Days 1-21 of repeated 28-day cycles in combination with dexamethasone. Refer to Section 14.1 for specific dexamethasone dosing. For patients greater than 75 years old, the starting dose of dexamethasone may be reduced [see Clinical Studies (14.1) ] . Treatment should be continued until disease progression or unacceptable toxicity. In patients who are not eligible for auto-HSCT, treatment should continue until disease progression or unacceptable toxicity. For patients who are auto-HSCT-eligible, hematopoietic stem cell mobilization should occur within 4 cycles of a REVLIMID-containing therapy [see Warnings and Precautions…
Lenalidomide side effects
The following clinically significant adverse reactions are described in detail in other sections of the prescribing information: o Embryo-Fetal Toxicity [see Boxed Warning , Warnings and Precautions (5.1 , 5.2) ] o Hematologic Toxicity [see Boxed Warning , Warnings and Precautions (5.3) ] o Venous and Arterial Thromboembolism [see Boxed Warning , Warnings and Precautions (5.4) ] o Increased Mortality in Patients with CLL [see Warnings and Precautions (5.5) ] o Second Primary Malignancies [see Warnings and Precautions (5.6) ] o Increased Mortality in Patients with MM When Pembrolizumab Is Added to a Thalidomide Analogue and Dexamethasone [see Warnings and Precautions (5.7) ] o Hepatotoxicity [see Warnings and Precautions (5.8) ] o Severe Cutaneous Reactions [see Warnings and Precautions (5.9) ] o Tumor Lysis Syndrome [see Warnings and Precautions (5.10) ] o Tumor Flare Reactions [see Warnings and Precautions (5.11) ] o Impaired Stem Cell Mobilization [see Warnings and Precautions (5.12) ] o Thyroid Disorders [see Warnings and Precautions (5.13) ] o Early Mortality in Patients with MCL [see Warnings and Precautions (5.14) ] o Hypersensitivity [see Warnings and Precautions (5.15) ] • MM: Most common adverse reactions (≥20%) include diarrhea, fatigue, anemia, constipation, neutropenia, leukopenia, peripheral edema, insomnia, muscle cramp/spasms, abdominal pain, back pain, nausea,…
Who shouldn’t take lenalidomide
Pregnancy ( Boxed Warning , 4.1 , 5.1 , 8.1 ). • Demonstrated severe hypersensitivity to lenalidomide ( 4.2 , 5.9 , 5.15 ). 4.1 Pregnancy REVLIMID can cause fetal harm when administered to a pregnant female. Limb abnormalities were seen in the offspring of monkeys that were dosed with lenalidomide during organogenesis. This effect was seen at all doses tested. Due to the results of this developmental monkey study, and lenalidomide's structural similarities to thalidomide, a known human teratogen, lenalidomide is contraindicated in females who are pregnant [see Boxed Warning ]. If this drug is used during pregnancy or if the patient becomes pregnant while taking this drug, the patient should be apprised of the potential risk to a fetus [see Warnings and Precautions (5.1 , 5.2) , Use in Special Populations (8.1 , 8.3) ] . 4.2 Severe Hypersensitivity Reactions REVLIMID is contraindicated in patients who have demonstrated severe hypersensitivity (e.g., angioedema, Stevens-Johnson syndrome, toxic epidermal necrolysis) to lenalidomide [see Warnings and Precautions (5.9 , 5.15 )].
Lenalidomide drug interactions
Digoxin: Monitor digoxin plasma levels periodically due to increased C max and AUC with concomitant REVLIMID therapy ( 7.1 ). • Concomitant use of erythropoietin stimulating agents or estrogen containing therapies with REVLIMID may increase the risk of thrombosis ( 7.2 ). 7.1 Digoxin When digoxin was co-administered with multiple doses of REVLIMID (10 mg/day) the digoxin C max and AUC inf were increased by 14%. Periodically monitor digoxin plasma levels, in accordance with clinical judgment and based on standard clinical practice in patients receiving this medication, during administration of REVLIMID. 7.2 Concomitant Therapies That May Increase the Risk of Thrombosis Erythropoietic agents, or other agents that may increase the risk of thrombosis, such as estrogen containing therapies, should be used with caution after making a benefit-risk assessment in patients receiving REVLIMID [see Warnings and Precautions (5.4) ] . 7.3 Warfarin Co-administration of multiple doses of REVLIMID (10 mg/day) with a single dose of warfarin (25 mg) had no effect on the pharmacokinetics of lenalidomide or R- and S-warfarin. Expected changes in laboratory assessments of PT and INR were observed after warfarin administration, but these changes were not affected by concomitant REVLIMID administration. It is not known whether there is an interaction between dexamethasone and warfarin. Close monitoring of PT and INR is recommended in patients with MM taking concomitant warfarin.
Every lenalidomide product we track (2)
Same active ingredient — different manufacturer, form, price and FDA recall record. That last one is what our independent score measures.
| # | Drug | Rating | Type | Form | Generic? | Pharmacy pays | |
|---|---|---|---|---|---|---|---|
| 1 | 72/100 | Prescription | Capsule | No data | — | View → | |
| 2 | 70/100 | Prescription | Capsule | No data | — | View → |
What lenalidomide pills look like
Imprint codes, colour and shape from the FDA’s labelling data. Match the imprint on your pill — or search any imprint.
| Imprint | Strength | Colour | Shape | Maker |
|---|---|---|---|---|
| 25mg | 25 mg | white | capsule | — |
| NAT;2;5mg | 2.5 mg | white | capsule | — |
| NAT;5mg | 5 mg | white | capsule | — |
| NAT;10mg | 10 mg | white | capsule | — |
| NAT;15mg | 15 mg | white | capsule | — |
| NAT;20mg | 20 mg | green, blue | capsule | — |
| NAT;25mg | 25 mg | white | capsule | — |
| AA17A | 2.5 mg | blue, white | capsule | — |
| AA18A | 5 mg | white, white | capsule | — |
| AA19A | 10 mg | blue, yellow | capsule | — |
| AA20A | 15 mg | blue, white | capsule | — |
| AA21A | 20 mg | blue, blue | capsule | — |
Can you crush or split lenalidomide?
At least one lenalidomideproduct is labelled to be swallowed whole — crushing an extended-release tablet releases the whole day’s dose at once. Which applies depends on the form you were given.
What each lenalidomide label says about crushing, splitting and chewingHow long lenalidomide keeps
No lenalidomide label we read sets a separate limit for after opening, but they do specify how it must be stored — and the stability behind any date assumes those conditions.
Does lenalidomide expire? The in-use limits and storage rules from its labelsWhat people report to the FDA about lenalidomide
The FDA Adverse Event Reporting System (FAERS) collects reports from patients and clinicians. It holds 74,809 reports naming lenalidomide, and the FDA flagged 78% of those reports as serious. The effects reported most often — leaving out reports about overdose, misuse or the condition being treated, which dominate the raw list for common medicines:
- diarrhoea4,798 reports
- pneumonia3,962 reports
- fatigue3,941 reports
- plasma cell myeloma3,811 reports
- neutropenia2,998 reports
- rash2,861 reports
- thrombocytopenia2,308 reports
- neuropathy peripheral2,123 reports
Read these as a signal, not a rate. A report does not mean lenalidomide caused the effect — anyone can file one, and many describe people taking several medicines for several conditions. Crucially there is no denominator: FAERS does not record how many people took the drug, so these counts cannot be turned into “X% of patients” — a bigger number often just means a more widely used or more talked-about drug. Duplicates exist, and publicity drives reporting. For what is actually established, read the FDA label section above.
Source: openFDA drug/event (FAERS), retrieved August 25, 2026.
How long lenalidomide stays in your system
The elimination half-life of lenalidomide is about 3 hours in healthy subjects, and 3 to 5 hours in patients with multiple myeloma, MDS, or mantle cell lymphoma. This is the mean elimination half-life reported under "Elimination" in §12.3; the label reports a single terminal value, not separate distribution and terminal phases. No active metabolite outlasts the parent: lenalidomide undergoes limited metabolism, unchanged drug is the predominant circulating component, and the two identified metabolites (5-hydroxy- and N-acetyl-lenalidomide) each make up less than 5% of parent levels. Not a prodrug. Elimination is primarily renal, so half-life lengthens markedly with kidney impairment: the label reports about a 3-fold increase in patients with moderate or severe renal impairment, and about a 4.5-fold increase in patients on hemodialysis; the starting dose must be adjusted by creatinine clearance. Mild hepatic impairment did not affect disposition and there are no data for moderate-to-severe impairment. Age (studied 39 to 85 years) had no clinically relevant effect on clearance.
Lenalidomide capsules — DailyMed FDA label, §12.3 Pharmacokinetics ↗Half-life is how long the body takes to clear half a dose. It is not the same as how long a drug test can detect it, and it varies with age, kidney and liver function.
Related calculators
Frequently asked questions
What is lenalidomide?
REVLIMID, a thalidomide analogue, is an immunomodulatory agent with antiangiogenic and antineoplastic properties.
What kind of drug is lenalidomide?
The FDA classifies lenalidomide as a thalidomide analog. If you are checking whether it is safe to combine with something else, the class is what matters — two drugs from the same class usually should not be stacked.
How long does lenalidomide stay in your system?
The elimination half-life of lenalidomide is about 3 hours in healthy subjects, and 3 to 5 hours in patients with multiple myeloma, MDS, or mantle cell lymphoma — that is how long the body takes to clear half of a dose. This is the mean elimination half-life reported under "Elimination" in §12.3; the label reports a single terminal value, not separate distribution and terminal phases. No active metabolite outlasts the parent: lenalidomide undergoes limited metabolism, unchanged drug is the predominant circulating component, and the two identified metabolites (5-hydroxy- and N-acetyl-lenalidomide) each make up less than 5% of parent levels. Not a prodrug. Elimination is primarily renal, so half-life lengthens markedly with kidney impairment: the label reports about a 3-fold increase in patients with moderate or severe renal impairment, and about a 4.5-fold increase in patients on hemodialysis; the starting dose must be adjusted by creatinine clearance. Mild hepatic impairment did not affect disposition and there are no data for moderate-to-severe impairment. Age (studied 39 to 85 years) had no clinically relevant effect on clearance. Half-life is not the same as how long a drug test can detect the drug, and it varies with age, kidney and liver function.
Can you take lenalidomide with other medicines?
It depends on the medicine. We check it against the FDA labels rather than guessing: our interaction checker searches each drug's own label for the other and quotes what it says, naming the section it came from. Run lenalidomide against whatever else you take — and remember that a label not naming a drug is not the same as that combination being safe.
What brand names is lenalidomide sold under?
We track 2 lenalidomide-containing products in the U.S.: Revlimid and Lenalidomide. They are the same active ingredient; they differ in form, manufacturer, price and FDA recall record.
What forms does lenalidomide come in?
Across the brands we track, lenalidomide is currently marketed as capsule, per the FDA's National Drug Code Directory. Each form is dosed differently — follow the label for the exact product you were prescribed.
Is there a generic lenalidomide?
Yes. Our catalog lists 1 generic lenalidomide product alongside the brand versions. A generic has the same active ingredient and must meet the FDA's bioequivalence standard; it usually costs less. Ask your pharmacist which one your plan covers.
Cite this page
- APA
- pharmaranks. (2026, July 24). Lenalidomide: uses, dosing, side effects & brands. https://pharmaranks.com/drugs/lenalidomide
- MLA
- “Lenalidomide: uses, dosing, side effects & brands.” pharmaranks, 24 July 2026, https://pharmaranks.com/drugs/lenalidomide.
We summarise public FDA and NIH sources — for a clinical claim, cite the primary source we link to as well.
Sources: FDA openFDA drug label, National Drug Code Directory, and Enforcement (recall) database. This page reproduces public FDA data and is not medical advice. Dosing is set by your prescriber.
Read the full FDA label for lenalidomide on DailyMed (NIH) ↗ — including its boxed warning in full.