Recommended dose of Ninlaro: 4 mg once a wk (on the same day of the wk) for the 1st 3 wk of the 4-wk treatment cycle. Recommended dose of lenalidomide: 25 mg daily for the 1st 3 wk of the 4-wk treatment cycle. Recommended dose of dexamethasone: 40 mg once a wk on the same day for all 4 wk of the cycle. Patient w/ liver or kidney problems 3 mg.
Patients w/ history of bleeding; persistent nausea, vomiting or diarrhoea; history of nerve problems (including tingling & numbness); history of swelling; persistent rash or SJS; present or history of liver or kidney problems; present or history of thrombotic microangiopathy or TTP. Perform blood tests before starting & during treatment. May affect ability to drive or use machines. Women of childbearing potential & men who can father a child must use effective contraception during & for 90 days after treatment. May cause fetal harm. Not recommended during pregnancy. Discontinue breast-feeding during treatment. Not recommended in childn & adolescents <18 yr.
Thrombocytopenia; nausea, vomiting, diarrhoea; peripheral neuropathy; peripheral oedema; skin rash that may be itchy & in a few areas or all over the body; bronchitis; constipation; back pain; URTI; fatigue; neutropenia; decreased appetite; arrhythmia; vision conditions including blurred vision, dry eye & conjunctivitis. Herpes zoster; hypotension; heart failure; jaundice; hypokalaemia.
Drug Interactions
Reduced effectiveness w/ carbamazepine, phenytoin, rifampicin & St. John's wort.
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