Lenalid 25mg Capsule (Lenalidomide 25mg) is the standard therapeutic dose of this immunomodulatory agent for advanced multiple myeloma management and relapsed/refractory disease. Composition: Each capsule contains 25mg Lenalidomide with pharmaceutical excipients optimized for pharmaceutical stability. Indications: This higher-dosage formulation treats newly diagnosed multiple myeloma as part of induction therapy (combined with dexamethasone or proteasome inhibitors), relapsed/refractory multiple myeloma post-treatment failure, maintenance therapy following stem cell transplantation, and advanced myelodysplastic syndromes with high disease burden. Clinical superiority demonstrated in multiple randomized trials with significantly improved remission rates and survival outcomes. Contraindications & Relative Precautions: Absolute contraindication in pregnancy, uncontrolled cardiac disease, and severe hepatorenal compromise. Relative caution required in thrombotic history, neurological disease, or baseline cytopenias. Drug Interactions: Significant interactions with anticoagulants (warfarin, DOACs), antiplatelets, cardiovascular medications, and renal-dependent drugs requiring careful co-prescribing. Dosage: Standard dosing for MM is 25mg daily on days 1-21 of 28-day cycles combined with corticosteroids or other agents. Renal adjustments mandatory for CrCl <60mL/min. Storage: 15-30°C in original protective packaging away from light and moisture. Side Effects: Neutropenia requiring G-CSF support in advanced disease, thrombocytopenia necessitating transfusion support, anemia, severe fatigue, peripheral neuropathy, cardiac complications. Serious: venous thromboembolism (10-15% requiring prophylaxis), hepatotoxicity, tumor lysis syndrome. Precautions: Weekly CBC first month, biweekly thereafter; baseline and periodic ECG; monthly pregnancy tests for females; thromboembolism prophylaxis mandatory; infection monitoring essential. Pregnancy/Lactation: Absolute contraindication; teratogenic effects documented; males require barrier contraception; females require hormonal contraception or intrauterine devices plus detailed REMS documentation. Substitutes: Second-line agents include Pomalidomide 2-4mg for lenalidomide-refractory disease; triple-agent combinations with bortezomib and dexamethasone; newer agents (ixazomib, daratumumab) for resistant MM. FAQs: Expected response time 2-4 cycles; cost significantly higher than lower doses; insurance coverage varies; side effect management requires hematology expertise; long-term toxicity monitoring essential. Expected Timeline: Month 1 tolerance assessment; Month 3 response evaluation via M-protein and free light chain reduction; Month 6 complete/partial response confirmation via bone marrow. Book Hematology-Oncology Consultation: Essential for dosing optimization, toxicity management, REMS coordination, and treatment modification strategies. Schedule Tests: Baseline CBC, liver/kidney functions, LDH, calcium; weekly CBC x 4 weeks then biweekly; monthly pregnancy testing; baseline/periodic ECG; baseline bone marrow evaluation; monthly M-protein and light chain assessment.