Why Is Revlimid So Expensive
The two most important things to remember about the prices of drugs like Revlimid are: 1) prices are much higher than they would otherwise be thanks to a variety of poor public policies, from intellectual property protections to our insane system of health insurance and 2) very few patients pay the sticker price that …
When You Have It
You take lenalidomide every day for 3 weeks and then have a break for 1 week. This is one cycle of treatment. You then start the next cycle.
If you forget to take lenalidomide at your regular time but less than 12 hours have passed, take the capsule straight away. If more than 12 hours have passed do not take the capsule but just take your next capsule at the usual time the next day.
Side Effects Of Palbociclib
Like any drug, palbociclib can cause side effects. Everyone reacts differently to drugs and some people have more side effects than others.
Youll have regular hospital appointments with your treatment team to check whether youre experiencing side effects.
It can be helpful to keep a diary of how you feel while taking palbociclib to monitor any side effects.
Side effects can usually be controlled and those described here will not affect everyone.
Because its given alongside hormone therapy, you may have side effects from that drug as well.
If youre concerned about any side effects, regardless of whether theyre listed here, tell your treatment team.
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Increased Risk Of Getting An Infection
Increased risk of getting an infection is due to a drop in white blood cells. Symptoms include a change in temperature, aching muscles, headaches, feeling cold and shivery and generally unwell. You might have other symptoms depending on where the infection is.
Infections can sometimes be life threatening. You should contact your advice line urgently if you think you have an infection.
Effects On The Kidneys And Liver
This treatment can affect how your kidneys or liver work. This is usually mild and goes back to normal after treatment. You will have blood tests to check how well your kidneys and liver are working.
Contact your doctor straight away if you:
- find it difficult to pass urine
- are passing urine more, or less, often
- have dark urine or blood in your urine
- develop yellow skin or eyes
- have unexplained bleeding or bruising.
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Your Odds Of Surviving Have Vastly Improved
Its understandable for you to become exhausted by your treatment or its side effects. But if you can hang in there, your chances of surviving multiple myeloma are better than theyve ever been before.
Back in the 1990s, the average five-year survival for someone diagnosed with multiple myeloma was 30 percent. Today, its over 50 percent. For people who are diagnosed early, its over 70 percent.
Im Taking Revlimid With Dexamethasone For Multiple Myeloma What Might My Side Effects Be
If you take Revlimid with dexamethasone for multiple myeloma, the side effects will likely be the same as if you took Revlimid alone.* However, your risk of side effects may increase if you take both drugs.
Clinical studies looked at people who took dexamethasone in combination with Revlimid or a placebo . The group who took dexamethasone with Revlimid experienced the following conditions more frequently:
If you take Revlimid in combination with dexamethasone, your doctor may monitor you for side effects more often than usual. They can advise you on how to help prevent side effects from occurring and what to look for.
* To learn which side effects are more common in people taking Revlimid for multiple myeloma, see the More common side effects of Revlimid section above. for this side effect. This is the most serious warning from the Food and Drug Administration . For more information, see Boxed warnings in the Side effect specifics section below.
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Bringing Myeloma Under Control
The initial treatment for multiple myeloma may be either:
- non-intensive for older or less fit patients
- intensive for younger or fitter patients
Both non-intensive and intensive treatments involve taking a combination of anti-myeloma medicines.
But intensive treatment involves higher doses and is followed by a stem cell transplant.
The medicines usually include a chemotherapy medicine, a steroid medicine, and either thalidomide or bortezomib.
You Could Develop Uncomfortable Symptoms
When cancer grows, it pushes into other organs and tissues in your body. This invasion can cause body-wide symptoms.
Multiple myeloma also damages bone marrow, which is the spongy area inside bones where blood cells are made. As cancer grows inside bone marrow, it can weaken the bones to the point where they break. Fractures can be extremely painful.
Uncontrolled multiple myeloma can also lead to symptoms like:
- increased risk of infections from lowered white blood cell counts
- shortness
- bruising or bleeding from low platelets
- extreme thirst, constipation, and frequent urination from high levels of calcium in the blood
- weakness and numbness from nerve damage caused by collapsed bones in the spine
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Dosage For Myelodysplastic Syndromes
If you have myelodysplastic syndromes and red blood cell transfusion-dependent anemia, you should take 10 mg of Revlimid daily. There are no dosing cycles for this condition. Your doctor will monitor how your body reacts to Revlimid. Based on this, theyll indicate when you should stop taking Revlimid.
Side Effects Requiring Immediate Medical Attention
Along with its needed effects, lenalidomide may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur while taking lenalidomide:
More common
Applies to lenalidomide: oral capsule
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Pregnancy And Breastfeeding While Taking Revlimid
You should not take Revlimid while youre pregnant, if youre planning to become pregnant, or while youre breastfeeding.
Boxed warning. Revlimid has a boxed warning about the risk of harm or death to a fetus. This medication can cause problems with fetal development, which are commonly known as birth defects.
If youre able to become pregnant, your doctor will have you take two pregnancy tests before you start treatment. Youll also need to have regular pregnancy tests while you take Revlimid. The purpose of the tests is to confirm that youre not pregnant.
Birth control. If youre a female,* during your Revlimid treatment you should use two forms of birth control or not have sex that may cause pregnancy. You must use birth control for at least 4 weeks before starting Revlimid, and should continue using the birth control or refraining from sex for at least 4 weeks after stopping Revlimid treatment.
If youre a male,* you should use birth control, such as a condom, during sex with a partner who can become pregnant. Revlimid can pass into semen. After you stop taking Revlimid, you should continue to use condoms for up to 4 weeks.
REMS program. Due to Revlimids possible risks to a fetus, the drug is part of a Risk Evaluation and Mitigation Strategy program. The program requires you to answer questions before you can receive the medication. This is done to help prevent harm to a fetus. To learn more, visit the programs website or talk with your doctor.
Make Every Dose Everyone’s Responsibility
The good news is that your healthcare team, caregivers, and loved ones can all help with adherence. This way, the responsibility doesn’t fall entirely on you. Talk with your care team about the importance of adherence and how you can work together to stay on treatment. When talking with your healthcare team specifically, consider the following suggestions for your adherence conversation.
- Ask questions to fully understand your treatment and clarify anything that’s confusing
- Ask for information about potential side effects of treatment
- Always talk to your doctor, as there are changes that can be made to your dose for certain side effects
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Darzalex Can Also Cause:
Changes in blood testsDARZALEX® can affect the results of blood tests to match your blood type. These changes can last for up to 6 months after your final dose of DARZALEX®. Your healthcare provider will do blood tests to match your blood type before you start treatment with DARZALEX®. Tell all of your healthcare providers that you are being treated with DARZALEX® before receiving blood transfusions.
DARZALEX® can decrease white blood cell counts, which help fight infections, and blood cells called platelets, which help to clot blood. Tell your healthcare professionals if you develop fever or have signs of bruising or bleeding.
Questions to ask before and after treatment
Here are a few things you may want to ask your doctor so you can be better prepared for treatment with DARZALEX®:
- What side effects should I watch for?
- Do I need to make any changes to my diet during or after treatment?
- What kind of exercise can or should I do while being treated?
- What type of follow-up will I need after treatment and when?
- How will we know if the cancer has come back? What should I watch for?
DARZALEX® is a prescription medicine used to treat adults with multiple myeloma:
It is not known if DARZALEX® is safe and effective in children.
Do not receive DARZALEX® if you have a history of a severe allergic reaction to daratumumab or any of the ingredients in DARZALEX®. See below for a complete list of ingredients.
How will I receive DARZALEX®?
DARZALEX® may cause serious reactions, including:
What If I Miss A Dose
If you notice you missed a dose and its within 12 hours of when you shouldve taken it, take the dose immediately. However, dont take the dose if its 12 hours or more after when you shouldve taken it. In this case, you should skip that dose of Revlimid.
To help make sure that you dont miss a dose, try setting a reminder on your phone. A medication timer may be useful, too.
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What Is Myelodysplastic Syndrome
Myelodysplastic syndrome is a type of cancer in the blood. Some people with myelodysplastic syndrome also have anemia . Red blood cells are important because they carry oxygen through your blood to the rest of your body.
People with red blood cell transfusion-dependent anemia may need to have a red blood cell transfusion, a procedure in which they receive donated blood.
Who Might Be Offered Palbociclib
Palbociclib is used to treat breast cancer thats oestrogen receptor positive and HER2 negative.
You may be offered palbociclib if your breast cancer has:
- Spread to the tissues and lymph nodes around the chest, neck and under the breastbone
- Spread to another part of the body such as the bones, lungs, liver or brain
Palbociclib is not currently given for early breast cancer, though clinical trials are looking at whether this may be useful.
Find out more about availability.
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How Should This Medicine Be Used
Lenalidomide comes as a capsule to take by mouth. When lenalidomide is used to treat myelodysplastic syndrome, it is usually taken with or without food once daily. When lenalidomide is used to treat multiple myeloma or mantle cell lymphoma, it is usually taken with or without food once daily for the first 21 days of a 28-day cycle. When lenalidomide is used to treat multiple myeloma after HSCT, it is usually taken with or without food once daily for 28 days of a 28-day cycle. The 28-day cycle regimen may be repeated as recommended by your doctor based on your body’s response to this medication. Take lenalidomide at around the same time of day every day that you take it. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take lenalidomide exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
Swallow the capsules whole with plenty of water do not break, chew, or open them. Handle the capsules as little as possible. If you touch a broken lenalidomide capsule or the medicine in the capsule, wash that area of your body with soap and water. If the medicine in the capsule gets into your mouth, nose, or eyes, wash it away with plenty of water.
Your doctor may need to interrupt your treatment or reduce your dose if you experience certain side effects. Be sure to tell your doctor how you are feeling during your treatment with lenalidomide.
Numb Or Tingling Hands Or Feet
This treatment affects the nerves, which can cause numb, tingling or painful hands or feet. You may find it hard to fasten buttons or do other fiddly tasks.
Tell your doctor if you have these symptoms. They sometimes need to lower the dose of the drug. The symptoms usually improve slowly after treatment finishes, but for some people they may never go away. Talk to your doctor if you are worried about this.
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What Do I Need To Tell My Doctor Before I Take This Drug
- If you are allergic to this drug any part of this drug or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had.
- If you are lactose intolerant.
- If you have a type of leukemia called chronic lymphocytic leukemia . In people with CLL, more deaths happened with this drug than with a certain other drug. Very bad heart problems also happened more often.
- If you are taking pembrolizumab or nivolumab.
- If you are breast-feeding. Do not breast-feed while you take this drug.
This is not a list of all drugs or health problems that interact with this drug.
Tell your doctor and pharmacist about all of your drugs and health problems. You must check to make sure that it is safe for you to take this drug with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.
What Side Effects Are Possible With This Medication
Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.
The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.
The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.
Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.
- back pain
- swelling of feet or legs
- symptoms of anemia
- signs of sodium or potassium levels being too high or too low
- symptoms of a chest/lung infection
- symptoms of hypothyroidism
- symptoms of liver problems
- symptoms of over active thyroid
- tingling or numbness in the hands and feet or muscle weakness that interferes with daily activities
- vision changes
Stop taking the medication and seek immediate medical attention if any of the following occur:
Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.
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