Celnalid, containing the active ingredient Lenalidomide, is a medication primarily used in the treatment of multiple myeloma and myelodysplastic syndromes. It belongs to a class of drugs known as immunomodulatory agents, which enhance the immune system's response to target cancer cells.

Indications

• Multiple Myeloma (in combination with dexamethasone)

• Myelodysplastic Syndromes (MDS) with deletion 5q cytogenetic abnormality

• Mantle Cell Lymphoma (after at least one prior therapy)

Mechanism of Action

Lenalidomide works by modulating the immune system, inhibiting angiogenesis (the growth of new blood vessels that tumors need to grow), and promoting the destruction of cancer cells. It affects cytokine production and enhances T-cell and natural killer cell activity.

Dosage and Administration

• Multiple Myeloma: 25 mg once daily on days 1 to 21 of repeated 28-day cycles.

• Myelodysplastic Syndromes: 10 mg once daily.

• Mantle Cell Lymphoma: 25 mg once daily on days 1 to 21 of each 28-day cycle.

Note: Doses may be adjusted based on patient tolerance and medical condition.

Onset and Duration of Action

• Onset of Action: Variable; improvement in blood counts may be seen within 4 weeks for MDS.

• Duration of Action: Depends on the indication and patient response.

Side Effects

Common side effects include:

• Fatigue

• Diarrhea

• Nausea

• Rash

• Neutropenia

• Thrombocytopenia

Serious side effects:

• Blood clots

• Tumor lysis syndrome

• Hepatotoxicity

• Hypersensitivity reactions

Precautions

• Pregnancy: Contraindicated due to severe risk of birth defects.

• Hematologic Monitoring: Regular blood tests are required to monitor for cytopenias.

• Infections: Risk of serious infections; prophylactic measures may be needed.

• Renal Impairment: Dose adjustment is required.

Contraindications

• Pregnancy

• Severe hypersensitivity to Lenalidomide or its components

Drug Interactions

• Increased risk of thrombosis when used with corticosteroids or erythropoietic agents.

• Interaction with warfarin may increase bleeding risk.

Storage

Store at room temperature (15°C to 30°C) away from moisture and direct light.