Lenalidomide Zentiva

Leaflet accompanying the packaging: patient information

Lenalidomide Zentiva, 5 mg, hard capsules

Lenalidomide Zentiva, 10 mg, hard capsules

Lenalidomide Zentiva, 15 mg, hard capsules

Lenalidomide Zentiva, 25 mg, hard capsules

Lenalidomide

You should carefully read the contents of the leaflet before taking the medicine, as it contains important information for the patient.

• You should keep this leaflet, so that you can read it again if you need to.
• If you have any doubts, you should consult a doctor or pharmacist.
• This medicine has been prescribed specifically for you. Do not pass it on to others. The medicine may harm another person, even if their symptoms are the same as yours.
• If the patient experiences any side effects, including any side effects not listed in this leaflet, they should tell their doctor or pharmacist. See section 4.

Table of contents of the leaflet

• 1. What is Lenalidomide Zentiva and what is it used for
• 2. Important information before taking Lenalidomide Zentiva
• 3. How to take Lenalidomide Zentiva
• 4. Possible side effects
• 5. How to store Lenalidomide Zentiva
• 6. Contents of the pack and other information

1. What is Lenalidomide Zentiva and what is it used for

Lenalidomide Zentiva contains the active substance lenalidomide and belongs to a group of medicines that affect the immune system.
Lenalidomide Zentiva is used in adults to treat:

• multiple myeloma,
• myelodysplastic syndromes,
• mantle cell lymphoma,
• follicular lymphoma.

Multiple myeloma

Multiple myeloma is a type of cancer that affects a certain type of white blood cell called plasma cells. These cells accumulate in the bone marrow and divide uncontrollably. This can lead to bone and kidney damage.
In principle, multiple myeloma is incurable. However, it is possible to temporarily significantly alleviate or eliminate the symptoms of the disease. This condition is called "remission".
Newly diagnosed multiple myeloma - in patients after bone marrow transplantation
Lenalidomide Zentiva is used alone in maintenance treatment for patients who have achieved a suitable condition after bone marrow transplantation.
Newly diagnosed multiple myeloma - in patients who are not eligible for bone marrow transplantation
Lenalidomide Zentiva is taken with other medicines:

• with a chemotherapy medicine called "bortezomib",
• with an anti-inflammatory medicine called "dexamethasone",
• with a chemotherapy medicine called "melphalan",
• with an immunosuppressive medicine called "prednisone". The patient starts treatment by taking Lenalidomide Zentiva with additional medicines, and then continues treatment with Lenalidomide Zentiva alone. If the patient is 75 years old or older, or has moderate or severe kidney function impairment, the doctor will perform thorough tests before starting treatment.

Myelodysplastic syndromes (MDS)
Myelodysplastic syndromes (MDS) are a group of different blood and bone marrow diseases. There are abnormal blood cells that do not function properly. Patients may experience various subjective and objective symptoms, including a low number of red blood cells (anemia), the need for blood transfusions, and the risk of infection.
Lenalidomide Zentiva is used alone in the treatment of adult patients with MDS, if all of the following conditions are met:

• the patient has a low number of red blood cells and needs regular blood transfusions ("transfusion-dependent anemia");
• the patient has an abnormality in bone marrow cells called "isolated cytogenetic deletion 5q". This means that the patient's body does not produce enough healthy blood cells;
• the patient has previously used other treatments that were not suitable or not effective enough.

Taking Lenalidomide Zentiva may lead to an increase in the number of healthy blood cells produced by the body, by reducing the number of abnormal cells.

• this may lead to a decrease in the number of blood transfusions required. It is possible that transfusions will no longer be needed.

Mantle cell lymphoma (MCL)
MCL is a cancer of part of the immune system (lymphoid tissue). It affects a certain type of white blood cell called B lymphocytes or B cells. Mantle cell lymphoma is a disease characterized by uncontrolled growth of B lymphocytes, resulting in their accumulation in lymphoid tissue, bone marrow, or blood.
Follicular lymphoma (FL)
FL is a slow-growing malignant tumor that affects B lymphocytes. It is a type of white blood cell that helps the body fight infections. In patients with FL, there may be an accumulation of too many B lymphocytes in the blood, bone marrow, lymph nodes, and spleen.
Lenalidomide Zentiva is taken with another medicine called "rituximab" in the treatment of adult patients with previously treated follicular lymphoma.

How Lenalidomide Zentiva works

The medicine works by affecting the immune system and directly attacking cancer cells. Its mechanism of action includes:

• inhibiting the growth of cancer cells
• inhibiting the process of forming blood vessels in the tumor
• stimulating part of the immune system to attack cancer cells.

2. Important information before taking Lenalidomide Zentiva

Before starting treatment with Lenalidomide Zentiva, you should carefully read the leaflets of all medicinal products taken in combination with Lenalidomide Zentiva.

When not to take Lenalidomide Zentiva

• if the patient is pregnant or thinks she may be pregnant, or plans to become pregnant, as Lenalidomide Zentiva may harm the fetus (see "Pregnancy, breastfeeding, and contraception - information for women and men" in section 2);
• if the patient is of childbearing age, unless she follows all necessary methods to prevent pregnancy (see "Pregnancy, breastfeeding, and contraception - information for women and men" in section 2). If the patient is a woman of childbearing age, the doctor will note during each control visit that the necessary measures have been taken and will provide the patient with such confirmation.
• if the patient is allergic to lenalidomide or any of the excipients of this medicine (listed in section 6). If the patient suspects that they may be allergic, they should consult a doctor. If any of the above situations apply to the patient, they should not take Lenalidomide Zentiva. In case of doubt, the patient should consult a doctor.

Warnings and precautions

Before taking Lenalidomide Zentiva, the patient should discuss with their doctor or pharmacist if:

• the patient has had blood clots in the past - this means an increased risk of blood clots in the veins and arteries during treatment;
• the patient has any symptoms of infection, such as cough or fever; the patient has or has had a viral infection in the past, especially viral hepatitis B, varicella-zoster virus, or HIV. In case of doubt, the patient should consult a doctor. Taking lenalidomide may cause reactivation of viruses in previously infected patients, leading to recurrence of the infection. The doctor will check if the patient has had hepatitis B in the past;
• the patient has kidney function impairment - the doctor may adjust the dose of Lenalidomide Zentiva;
• the patient has had a heart attack, has had a blood clot, smokes, has high blood pressure, or high cholesterol levels;
• the patient has had an allergic reaction after taking thalidomide (another medicine used to treat multiple myeloma), such as a rash, itching, swelling, dizziness, or difficulty breathing;
• the patient has had a combination of any of the following symptoms in the past: facial rash or widespread rash, skin redness, high fever, flu-like symptoms, elevated liver enzymes, elevated white blood cell count (eosinophilia), and swollen lymph nodes (severe skin reaction called "Drug Reaction with Eosinophilia and Systemic Symptoms", DRESS). See also section 4.

The patient should immediately tell their doctor or nurse if they experience any of the following at any time during or after treatment:

• vision disturbances, loss of vision, or double vision, difficulty speaking, weakness in the arm or leg, change in gait or balance disturbances, persistent numbness, decreased sensation, or loss of sensation, memory loss, or disorientation, and should immediately tell their doctor or nurse. These may be symptoms of a severe and potentially life-threatening brain disease called progressive multifocal leukoencephalopathy (PML).

If the patient has had such symptoms before treatment with lenalidomide, they should inform their doctor about any changes in these symptoms.

• shortness of breath, fatigue, dizziness, chest pain, rapid heartbeat, or swelling of the feet or ankles. These may be symptoms of a severe condition called pulmonary hypertension (see section 4).

Tests and examinations
Before starting Lenalidomide Zentiva and during treatment, the patient will undergo regular blood tests, as lenalidomide may cause a decrease in the number of blood cells that help fight infection (white blood cells) and those that help blood clot (platelets).
The doctor will order blood tests:

• before treatment,
• every week for the first 8 weeks of treatment,
• then at least once a month.

Before starting lenalidomide treatment and during treatment, the patient may undergo an assessment for circulation and breathing problems.
Patient with MDS taking Lenalidomide Zentiva
If the patient has myelodysplastic syndromes, there is an increased chance of developing a severe disease called acute myeloid leukemia. Additionally, it is not known how Lenalidomide Zentiva affects the likelihood of developing acute myeloid leukemia. Therefore, the doctor may perform tests to better predict the risk of acute myeloid leukemia during treatment with Lenalidomide Zentiva.
Patient with MCL taking Lenalidomide Zentiva
The doctor will ask for a blood test:

• before treatment,
• every week for the first 8 weeks (2 cycles) of treatment,
• then every 2 weeks in cycles 3 and 4 (more information is provided in section 3 "Treatment cycle"),
• then at the beginning of each cycle and
• at least once a month

Patient with FL taking Lenalidomide Zentiva
The doctor will ask for a blood test:

• before treatment
• every week for the first 3 weeks (1 cycle) of treatment
• then every 2 weeks in cycles 2 to 4 (more information is provided in section 3 "Treatment cycle")
• then at the beginning of each cycle
• at least once a month

The doctor may perform a test to check if the patient has a large amount of tumor tissue in the body, including in the bone marrow. This may lead to a condition in which the tumor tissue breaks down, causing an abnormal increase in the levels of various chemicals in the blood and potentially leading to kidney failure (a condition called "tumor lysis syndrome").
The doctor may examine the patient's skin to check for changes, such as red spots or rash.
The doctor may change the dose of Lenalidomide Zentiva or interrupt treatment based on the results of the patient's blood tests and overall condition. If the disease has been recently diagnosed, the doctor may also assess treatment considering the patient's age and other existing conditions.
Blood donation
Do not donate blood during treatment and for at least 7 days after treatment has ended.

Children and adolescents

Lenalidomide Zentiva is not recommended for use in children and adolescents under 18 years of age.

Elderly and patients with renal impairment

If the patient is 75 years old or older, or has moderate or severe kidney function impairment, the doctor will perform thorough tests before starting treatment.

Lenalidomide Zentiva and other medicines

The patient should tell their doctor or nurse about all medicines they are currently taking or have recently taken, as lenalidomide and some other medicines may affect each other's action.
The patient should especially tell their doctor or nurse if they are taking any of the following medicines or products:

• certain contraceptives, such as oral contraceptives, as they may lose their effectiveness
• certain heart medicines, such as digoxin
• certain blood-thinning medicines, such as warfarin

Pregnancy, breastfeeding, and contraception - information for women and men

Pregnancy
Information for women taking Lenalidomide Zentiva

• Lenalidomide Zentiva must not be taken if the patient is pregnant, as it may harm the fetus.
• Women must not become pregnant while taking Lenalidomide Zentiva. Therefore, women of childbearing age must use effective methods of contraception (see below "Contraception").
• If the patient becomes pregnant while taking Lenalidomide Zentiva, she must stop treatment immediately and inform her doctor.

Information for men taking Lenalidomide Zentiva

• If the partner of a man taking Lenalidomide Zentiva becomes pregnant, the man should immediately inform his doctor. It is recommended that the partner consult a doctor.
• The patient must also use effective contraception methods (see below "Contraception").

Breastfeeding
Lenalidomide Zentiva must not be taken during breastfeeding, as it is not known whether lenalidomide passes into breast milk.
Contraception
Information for women taking Lenalidomide Zentiva
Before starting treatment, the patient should ask her doctor if she can become pregnant, even if she thinks it is unlikely.
If the patient is of childbearing age:

• she will have pregnancy tests under medical supervision (before each treatment, at least every 4 weeks during treatment, and at least 4 weeks after treatment has ended), unless the doctor confirms that her fallopian tubes have been cut and blocked to prevent egg cells from reaching the uterus (tubal sterilization)

AND

• she must use effective methods of contraception for 4 weeks before starting treatment, during treatment, and for at least 4 weeks after treatment has ended. The doctor will recommend suitable contraception methods to the patient.

Information for men taking Lenalidomide Zentiva
Lenalidomide is present in human semen. If the patient's partner is pregnant or may become pregnant and is not using effective contraception, the patient must use condoms during treatment and for at least 7 days after treatment has ended. This also applies to men who have had a vasectomy. During treatment and for at least 7 days after treatment has ended, the patient must not donate semen.

Driving and using machines

If the patient experiences dizziness, fatigue, drowsiness, a feeling of spinning, or blurred vision after taking Lenalidomide Zentiva, they should not drive or operate machinery.

Lenalidomide Zentiva contains lactose and sodium

If the patient has been diagnosed with intolerance to some sugars, they should consult their doctor before taking this medicine.
The medicine contains less than 1 mmol (23 mg) of sodium per capsule, which means that the medicine is considered "sodium-free".

3. How to take Lenalidomide Zentiva

Lenalidomide Zentiva must be administered by medical personnel with experience in treating multiple myeloma, MDS, MCL, or FL.

• If Lenalidomide Zentiva is used to treat multiple myeloma in patients who are not eligible for bone marrow transplantation or have received previous treatment, the medicine is taken with other medicines (see section 1 "What is Lenalidomide Zentiva and what is it used for").
• If Lenalidomide Zentiva is used to treat multiple myeloma in patients after bone marrow transplantation or to treat patients with MDS or MCL, the medicine is taken alone (as monotherapy).
• When Lenalidomide Zentiva is used to treat follicular lymphoma, it is taken with another medicine called "rituximab".

This medicine should always be taken as directed by the doctor. In case of doubt, the patient should consult their doctor or pharmacist.
If the patient is taking Lenalidomide Zentiva with other medicines, they should read the leaflets of those medicines to get information about their use and action.

Treatment cycle

Lenalidomide Zentiva is taken on specific days for 3 weeks (21 days).

• Each 21-day period is called a "treatment cycle".
• Depending on the day of the cycle, the patient will take one or more medicines. However, on some days, the patient will not take any medicines.
• After completing each 21-day cycle, the patient should start a new cycle lasting 21 days.
  OR
  Lenalidomide Zentiva is taken on specific days for 4 weeks (28 days).

Each 28-day period is called a "treatment cycle".
Depending on the day of the cycle, the patient will take one or more medicines. However, on some days, the patient will not take any medicines.
After completing each 28-day cycle, the patient should start a new cycle lasting 28 days.

How much Lenalidomide Zentiva to take

Before starting treatment, the doctor will inform the patient:

• how much Lenalidomide Zentiva to take;
• how many other medicines (if any) to take with Lenalidomide Zentiva;
• on which days of the cycle to take each of these medicines.

How and when to take Lenalidomide Zentiva

• The capsule should be swallowed whole, preferably with water.
• The capsule should not be broken, opened, or chewed. If the powder from a damaged Lenalidomide Zentiva capsule comes into contact with the skin, the skin should be washed immediately with soap and water.
• Healthcare professionals, caregivers, and family members should wear disposable gloves when handling the blister or capsule. The gloves should then be carefully removed to avoid skin exposure, placed in a sealed plastic bag, and disposed of in accordance with local regulations. Then, the hands should be washed thoroughly with soap and water. Pregnant or potentially pregnant women should not touch the blister or capsule.
• The capsules can be taken with or without food.
• The medicine should be taken on the designated days at approximately the same time.

Taking this medicine

To remove a capsule from the blister:

• press the capsule only on one side and push it through the foil,
• do not press on the center of the capsule, as this may damage it.

Duration of treatment with Lenalidomide Zentiva

Lenalidomide Zentiva is taken in treatment cycles, each lasting 21 or 28 days (see above "Treatment cycle"). Treatment should be continued until the doctor recommends stopping it.

Taking more Lenalidomide Zentiva than prescribed

If the patient has taken more capsules than they should, they should immediately consult their doctor.

Missing a dose of Lenalidomide Zentiva

If the patient forgets to take Lenalidomide Zentiva at the usual time:

• and it has been less than 12 hours since then, the patient should take the capsule immediately,
• and it has been more than 12 hours since then, the patient should not take the missed capsule. The next dose of Lenalidomide Zentiva should be taken at the usual time on the next day.

In case of any further doubts about taking this medicine, the patient should consult their doctor or pharmacist.

4. Possible side effects

Like all medicines, Lenalidomide Zentiva can cause side effects, although not everybody gets them.

If any of the following serious side effects occur, the patient should stop taking Lenalidomide Zentiva and immediately consult their doctor - immediate treatment may be necessary:

• hives, rash, swelling of the eyes, lips, or face, difficulty breathing, or itching, which may be symptoms of severe allergic reactions called angioedema and anaphylaxis;
• severe allergic reaction that starts as a rash in one area and spreads to the entire body, accompanied by a significant loss of skin (Stevens-Johnson syndrome and/or toxic epidermal necrolysis);
• widespread rash, high fever, elevated liver enzymes, blood abnormalities (eosinophilia), swollen lymph nodes, and involvement of other organs (drug reaction with eosinophilia and systemic symptoms, also known as DRESS). See also section 2.

The patient should immediately inform their doctor about any of the following serious side effects:

• fever, chills, sore throat, cough, mouth sores, or any other signs of infection (including blood infection - sepsis);
• bleeding or bruising without injury;
• chest pain or leg pain;
• shortness of breath;
• bone pain, muscle weakness, confusion, or fatigue that may be due to high calcium levels in the blood.

Lenalidomide may decrease the number of white blood cells that fight infection and the number of blood cells that help blood clot (platelets), which can lead to bleeding disorders, such as nosebleeds and bruising. Lenalidomide may also cause blood clots in the veins (thrombosis).

Other side effects

In a small number of patients, another type of cancer may develop, and it is possible that the risk of its development is higher during lenalidomide treatment. Therefore, before prescribing this medicine, the doctor will carefully weigh the benefits and risks of treatment.
Very common(may affect more than 1 in 10 people)

• decrease in red blood cell count, which may cause anemia leading to fatigue and weakness ● rash, itching ● muscle spasms, muscle weakness, fatigue, muscle pain, bone pain, joint pain, back pain, limb pain ● generalized edema, including swelling of the hands and feet; ● weakness, fatigue ● fever and flu-like symptoms, including fever, muscle pain, headache, ear pain, cough, and chills ● numbness, tingling, or burning sensation of the skin, pain in the hands or feet, dizziness, tremors ● decreased appetite, altered taste ● worsening of pain, increase in tumor size, or redness around the tumor ● weight loss ● constipation, diarrhea, nausea, vomiting, abdominal pain, heartburn ● low potassium or calcium and/or sodium levels in the blood ● abnormal thyroid function ● leg pain (which may be a sign of thrombosis), chest pain, or shortness of breath (which may be a sign of blood clots in the lungs, called pulmonary embolism); ● all types of infections, including sinusitis, pneumonia, and upper respiratory tract infections ● shortness of breath ● blurred vision ● blurred vision (cataract) ● kidney problems, including abnormal kidney function or inability to maintain normal kidney function ● abnormal liver test results ● elevated liver enzyme values ● changes in blood protein levels, leading to blood vessel inflammation (vasculitis) ● elevated blood sugar levels (diabetes) ● low blood sugar levels ● headache ● nosebleeds ● dry skin ● depression, mood changes, sleep disturbances;

Common(may affect less than 1 in 10 people)

• breakdown of red blood cells (hemolytic anemia) ● certain types of skin tumors
• bleeding from the gums, stomach, or intestines ● elevated blood pressure, slow, fast, or irregular heartbeat ● elevated levels of a substance produced by the breakdown of red blood cells ● elevated levels of a protein indicating inflammation in the body ● skin darkening; skin discoloration due to bleeding under the skin, usually caused by bruising; skin swelling filled with blood, bruising ● elevated uric acid levels in the blood ● skin rashes, skin redness, peeling, cracking, or shedding of the skin, hives ● itching, increased sweating, night sweats ● difficulty swallowing, sore throat, voice changes, or hoarseness
• nasal congestion ● passing much more or much less urine than normal or inability to control urination ● passing blood in the urine ● shortness of breath, especially when lying down (which may be a sign of heart failure) ● erectile dysfunction
• stroke, fainting, dizziness (inner ear disorders causing a feeling of spinning), loss of consciousness ● muscle weakness, lack of energy ● neck pain, chest pain
• chills ● joint swelling ● slowing or blocking the flow of bile from the liver ● low phosphate or magnesium levels in the blood ● speech difficulties ● liver damage ● balance disturbances, difficulty walking ● hearing loss, ringing in the ears (tinnitus)
• nerve pain, unpleasant abnormal sensations, especially in response to touch ● excessive iron in the body ● thirst ● confusion ● toothache ● falls that can lead to injury.

Uncommon(may affect less than 1 in 100 people)

• bleeding in the brain ● circulation problems ● loss of vision ● loss of libido ● passing large amounts of urine, with accompanying bone pain and weakness, which may be a sign of kidney disease (Fanconi syndrome) ● liver disease causing yellowing of the skin, mucous membranes, or eyes (jaundice), pale stools, dark urine, itching, rash, or abdominal pain or swelling - may be signs of liver damage (liver failure);
• abdominal pain, bloating, or diarrhea, which may be signs of colon inflammation (colitis) ● kidney cell damage (renal tubular necrosis) ● changes in skin color, sensitivity to sunlight ● skin rashes, skin redness, peeling, cracking, or shedding of the skin, hives ● itching, increased sweating, night sweats ● difficulty swallowing, sore throat, voice changes, or hoarseness
• nasal congestion ● passing much more or much less urine than normal or inability to control urination ● passing blood in the urine ● shortness of breath, especially when lying down (which may be a sign of heart failure) ● erectile dysfunction
• stroke, fainting, dizziness (inner ear disorders causing a feeling of spinning), loss of consciousness ● muscle weakness, lack of energy ● neck pain, chest pain
• chills ● joint swelling ● slowing or blocking the flow of bile from the liver ● low phosphate or magnesium levels in the blood ● speech difficulties ● liver damage ● balance disturbances, difficulty walking ● hearing loss, ringing in the ears (tinnitus)
• nerve pain, unpleasant abnormal sensations, especially in response to touch ● excessive iron in the body ● thirst ● confusion ● toothache ● falls that can lead to injury.

Frequency not known(cannot be estimated from the available data)

• sudden or gradual, but worsening, pain in the upper abdomen and/or back, lasting for several days, usually accompanied by nausea, vomiting, fever, and rapid heartbeat - these symptoms may occur in association with pancreatitis ● wheezing, shortness of breath, or dry cough, which may be caused by lung inflammation ● breakdown of muscle tissue (pain, weakness, or swelling of the muscles) that can lead to kidney problems (rhabdomyolysis), some of which occurred when lenalidomide was taken with a statin (a type of cholesterol-lowering medicine) ● a skin disease caused by inflammation of small blood vessels, accompanied by joint pain and fever (leukocytoclastic vasculitis) ● breakdown of the stomach or intestine wall, which can lead to a serious infection. The patient should tell their doctor if they experience severe abdominal pain, fever, nausea, vomiting, blood in the stool, or changes in bowel movements. ● viral infections, including varicella-zoster virus (a viral disease that causes a painful rash with blisters) and hepatitis B virus reactivation (which may cause yellowing of the skin and eyes, dark urine, abdominal pain, fever, nausea, and vomiting) ● transplant rejection (e.g., kidney, heart, or liver transplant).

Reporting side effects

If the patient experiences any side effects, including any side effects not listed in this leaflet, they should tell their doctor or pharmacist, or nurse. Side effects can be reported directly to the Department of Drug Safety Monitoring of the Office for Registration of Medicinal Products, Medical Devices, and Biocidal Products: Al. Jerozolimskie 181C, 02-222 Warsaw, tel.: +48 22 49 21 301, fax: +48 22 49 21 309, website: https://smz.ezdrowie.gov.pl
Side effects can also be reported to the marketing authorization holder or its representative in Poland.
By reporting side effects, it is possible to gather more information on the safety of this medicine.

5. How to store Lenalidomide Zentiva

The medicine should be stored out of sight and reach of children.
Do not use this medicine after the expiry date stated on the blister and carton after EXP. The expiry date refers to the last day of the month.
There are no special storage instructions for this medicine.
Do not use the medicine if it is damaged or if the packaging is broken.
Medicines should not be disposed of via wastewater or household waste. The patient should ask their pharmacist how to dispose of medicines that are no longer needed. This will help protect the environment.

6. Contents of the pack and other information

What Lenalidomide Zentiva contains

Lenalidomide Zentiva 5 mg, hard capsules:

• The active substance is lenalidomide. Each capsule contains 5 mg of lenalidomide.
• Other ingredients are:
• capsule contents: lactose, microcrystalline cellulose, sodium croscarmellose, magnesium stearate
• capsule shell: gelatin, titanium dioxide (E171)
• printing ink: shellac, propylene glycol, potassium hydroxide, iron oxide black (E172). Lenalidomide Zentiva 10 mg, hard capsules:
• The active substance is lenalidomide. Each capsule contains 10 mg of lenalidomide.
• Other ingredients are:
• capsule contents: lactose, microcrystalline cellulose, sodium croscarmellose, magnesium stearate
• capsule shell: gelatin, titanium dioxide (E171), indigo carmine (E132), iron oxide yellow (E172)
• printing ink: shellac, propylene glycol, potassium hydroxide, iron oxide black (E172). Lenalidomide Zentiva 15 mg, hard capsules:
• The active substance is lenalidomide. Each capsule contains 15 mg of lenalidomide.
• Other ingredients are:
• capsule contents: lactose, microcrystalline cellulose, sodium croscarmellose, magnesium stearate
• capsule shell: gelatin, titanium dioxide (E171), indigo carmine (E132)
• printing ink: shellac, propylene glycol, potassium hydroxide, iron oxide black (E172). Lenalidomide Zentiva 25 mg, hard capsules:
• The active substance is lenalidomide. Each capsule contains 25 mg of lenalidomide.
• Other ingredients are:
• capsule contents: lactose, microcrystalline cellulose, sodium croscarmellose, magnesium stearate
• capsule shell: gelatin, titanium dioxide (E171)
• printing ink: shellac, propylene glycol, potassium hydroxide, iron oxide black (E172).

What Lenalidomide Zentiva looks like and contents of the pack

Lenalidomide Zentiva 5 mg: hard capsule with a non-transparent white body and a non-transparent white cap, approximately 18.0 mm in length, marked with "L9NL" and "5".
Lenalidomide Zentiva 10 mg: hard capsule with a non-transparent yellow body and a non-transparent green to light green cap, approximately 21.7 mm in length, marked with "L9NL" and "10".
Lenalidomide Zentiva 15 mg: hard capsule with a non-transparent white body and a non-transparent blue to light blue cap, approximately 21.7 mm in length, marked with "L9NL" and "15".
Lenalidomide Zentiva 25 mg: hard capsule with a non-transparent white body and a non-transparent white cap, approximately 21.7 mm in length, marked with "L9NL" and "25".
Lenalidomide Zentiva hard capsules are available in cartons containing 7 or 21 capsules in OPA/Aluminum/PVC/Aluminum blisters.
Not all pack sizes may be marketed.

Marketing authorization holder

Zentiva k.s., U kabelovny 130, Dolni Mĕcholupy, 102 37 Prague 10, Czech Republic

Manufacturer/Importer

Synthon Hispania S.L.
C/ Castelló 1, Pol. Las Salinas
Sant Boi de Llobregat
08830 Barcelona, Spain
Synthon B.V.
Microweg 22
6545 CM Nijmegen, Netherlands
This medicine is authorized in the European Economic Area and the United Kingdom (Northern Ireland) under the following names:
Lenalidomide Zentiva: Austria, Czech Republic, Denmark, Estonia, Finland, Germany, Norway, Sweden, United Kingdom (Northern Ireland).
Lenalidomide Zentiva: France, Italy, Poland.
Lenalidomida Zentiva Portugal.

For more information, please contact the representative of the marketing authorization holder in Poland:

Zentiva Polska Sp. z o. o.
ul. Bonifraterska 17
00-203 Warsaw
tel.: +48 22 375 92 00
Date of last revision of the leaflet:February 2024