In combination w/ lenalidomide & dexamethasone for adult patient w/ multiple myeloma who have received at least 1 prior therapy Initially 4 mg once wkly on days 1, 8, & 15 of a 28-day treatment cycle. Starting dose of lenalidomide: 25 mg daily on days 1-21 of a 28-day treatment cycle. Starting dose of dexamethasone 40 mg on days 1, 8, 15, & 22 of a 28-day treatment cycle. Dose reduction steps: Starting dose: 4 mg. 1st reduction: 3 mg. 2nd reduction: 2.3 mg.
Maintenance therapy w/ multiple myeloma following autologous stem cell transplant & those not treated w/ stem cell transplantation Cycle 1-4: 3 mg. Cycle 5 onwards: 4 mg. Administer once wkly for 3 wk on days 1, 8, & 15 followed by 13 days rest period (days 16-28). Dose reduction steps: Step 1: Cycle 1-4: 2.3 mg. Cycle 5 onwards: 3 mg. Step 2: Cycle 1-4: Discontinue. Cycle 5 onwards: 2.3 mg. Step 3: None. Cycle 5: Discontinue.
Moderate or severe hepatic impairment, severe renal impairment (CrCl <30 mL/min) or ESRD requiring dialysis Reduced dose to 3 mg.
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