How long is Revlimid administered?
Revlimid® (lenalidomide, Celgene) is administered orally. Revlimid is a capsule that is taken every day for 3 weeks with a 1 week rest period. Each 4 weeks of therapy is known a treatment cycle. There are several available Revlimid doses (2.5 mg, 5 mg, 10 mg, 15 mg, 20 mg, and 25 mg capsules). The typical starting dose is 25 mg once a day. The minimum dose is 2.5 mg daily.
Revlimid is taken along with a pill called dexamethasone. The dose of dexamethasone is usually 40 mg and may be given in two different ways — on a high-dose schedule or on a low-dose schedule.
The initial studies with Revlimid-dex used dexamethasone in a high-dose schedule (considered to be the “standard” dose). However, more recent studies have shown that the combination of Revlimid and low-dose dexamethasone in newly diagnosed or untreated patients significantly improves survival with fewer side effects as compared with Revlimid and high-dose dexamethasone. Therefore, low-dose dexamethasone has increasingly become the standard approach.
Your doctor will recommend the right dose for you.
High-dose dexamethasone is typically taken only on certain days of the month, at a starting dose of 40 mg. For the first four months, it is taken on days 1-4, 9-12, and 17-20 of each month. Starting at month 5, dexamethasone is only taken on days 1-4 of each month.
Low-dose dexamethasone is given once a week. The starting dose of dexamethasone is 40 mg.
In addition, a blood thinner such as aspirin is typically taken along with Revlimid-dex to reduce the chance of developing a blood clot.
Your dose may be changed depending upon your response to therapy and side effects. Patients who have reduced kidney function that is moderate to severe are usually started on a lower dose of Revlimid, sometimes on an every-other-day schedule.
How long is the treatment with Revlimid-dex?
The length of treatment with Revlimid-dex is determined on an individual basis and may depend on a number of factors including:
- Response to therapy
- Side effects
- Whether the treatment plan includes high-dose chemotherapy and stem cell transplant (following Revlimid-dex)
- Patient preference
Patients who expect to proceed to high-dose chemotherapy and stem cell transplant may only receive a few cycles of Revlimid-dex, until they achieve a response. In this case, patients will also have their stem cells collected (harvested) within the first 4 cycles of treatment. Other patients may continue to receive Revlimid-dex indefinitely, as long as the treatment is working and side effects are manageable. You and your doctor will discuss the length of treatment that is right for you.