Lenalidomide Zentiva

Leaflet attached to 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 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 in 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 or older or has moderate or severe kidney function impairment, the doctor will perform thorough examinations 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 abnormality del(5q)". This means that the patient's body does not produce enough healthy blood cells;
• the patient has previously used other treatments that have proven to be ineffective or insufficient.

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 reduction 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

Warnings and precautions

Before taking Lenalidomide Zentiva, you should discuss it with your doctor or pharmacist if:

• you have had blood clots in the past - this means an increased risk of blood clots in veins and arteries during treatment;
• you have any symptoms of infection, such as cough or fever; you have or have had a viral infection, especially viral hepatitis B, varicella-zoster virus, or HIV. If in doubt, consult a doctor. Taking lenalidomide may cause reactivation of viruses in previously infected patients, leading to recurrence of infection. The doctor will check if you have had hepatitis B in the past;
• you have kidney function impairment - the doctor may adjust the dose of Lenalidomide Zentiva;
• you have had a heart attack, have had a blood clot, smoke, have high blood pressure, or high cholesterol levels;
• you have had an allergic reaction after taking thalidomide (another medicine used to treat multiple myeloma), such as rash, itching, swelling, dizziness, or difficulty breathing;
• you have had a combination of any of the following symptoms in the past: rash on the face or widespread rash, redness of the skin, high fever, flu-like symptoms, increased liver enzyme activity, increased white blood cell count (eosinophilia), and swollen lymph nodes (severe skin reaction called "Drug Reaction with Eosinophilia and Systemic Symptoms", DRESS), see also "Possible side effects" in section 4). If any of the above situations apply to you, tell your doctor, pharmacist, or nurse before starting treatment.

You should immediately tell your doctor or nurse if you experience any of the following at any time during or after treatment:

• vision disturbances, loss of vision, or double vision, difficulty speaking, weakness of the arm or leg, change in gait or balance disturbances, persistent numbness, decreased sensation, or loss of sensation, memory loss, or disorientation, you should immediately tell your doctor or nurse. These may be symptoms of a severe and potentially life-threatening brain disease called progressive multifocal leukoencephalopathy (PML).
  If you have had such symptoms before treatment with lenalidomide, you should inform your doctor about any changes in them.

• shortness of breath, fatigue, dizziness, chest pain, rapid heart rate, 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, you 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).
Your doctor will order blood tests:

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

Before starting treatment with lenalidomide and during treatment, you may undergo an assessment for circulation and breathing problems.
Patients with MDS taking Lenalidomide Zentiva
If you have 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, your doctor may perform tests to better predict the risk of acute myeloid leukemia during treatment with Lenalidomide Zentiva.
Patients with MCL taking Lenalidomide Zentiva
Your doctor will ask you to have 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

Patients with FL taking Lenalidomide Zentiva
Your doctor will ask you to have 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

Your doctor may perform a test to check if you have a large amount of tumor tissue in your 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 may lead to kidney failure (a condition called "tumor lysis syndrome").
Your doctor may examine your skin to check for changes such as red spots or rash.
Your doctor may change the dose of Lenalidomide Zentiva or stop treatment based on the results of your blood tests and your overall condition. If the disease has been recently diagnosed, your doctor may also assess treatment considering your age and other existing conditions.
Blood donation
You should not donate blood during treatment and for at least 7 days after its completion.

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 you are 75 years or older or have moderate or severe kidney function impairment, your doctor will perform thorough examinations before starting treatment.

Lenalidomide Zentiva and other medicines

You should tell your doctor or nurse about all medicines you are currently taking or have recently taken, as lenalidomide and some other medicines may interact with each other.
You should especially tell your doctor or nurse if you are taking any of the following medicines or products:

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

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

Pregnancy
Information for women taking Lenalidomide Zentiva

• You should not take Lenalidomide Zentiva if you are pregnant, as it may harm the fetus.
• Women of childbearing age should not become pregnant while taking Lenalidomide Zentiva. Therefore, women of childbearing age must use effective methods of contraception (see below "Contraception").
• If you become pregnant while taking Lenalidomide Zentiva, you should stop treatment immediately and inform your doctor.

Information for men taking Lenalidomide Zentiva

• If your partner becomes pregnant, you should immediately inform your doctor. It is recommended that your partner consult a doctor.
• You should also use effective contraception (see below "Contraception").

Breastfeeding
You should not breastfeed while taking Lenalidomide Zentiva, as it is not known whether lenalidomide passes into breast milk.
Contraception
Information for women taking Lenalidomide Zentiva
Before starting treatment, you should ask your doctor if it is possible for you to become pregnant, even if you think it is unlikely.
If you are of childbearing age:

• you will have pregnancy tests under medical supervision (before each treatment, at least every 4 weeks during treatment, and at least 4 weeks after the end of treatment), unless your doctor confirms that your fallopian tubes have been cut and sealed to prevent egg cells from reaching the uterus (tubal sterilization)
  AND

you must use effective methods of contraception for 4 weeks before starting treatment, during treatment, and for at least 4 weeks after the end of treatment. Your doctor will recommend appropriate contraceptive methods.

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

Driving and using machines

If you experience dizziness, fatigue, drowsiness, a feeling of spinning, or blurred vision after taking Lenalidomide Zentiva, you should not drive or operate machinery.

Lenalidomide Zentiva contains lactose and sodium

If you have been told that you have an intolerance to some sugars, you should consult your doctor before taking this medicine.
The medicine contains less than 1 mmol (23 mg) of sodium per capsule, which means it is essentially "sodium-free".

3. How to take Lenalidomide Zentiva

Lenalidomide Zentiva must be administered by medical personnel with experience in the treatment of 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 who 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 your doctor. If you are unsure, consult your doctor or pharmacist.
If you are taking Lenalidomide Zentiva with other medicines, you should read the leaflets of those medicines to learn about their use and effects.

Treatment cycle

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

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

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

How much Lenalidomide Zentiva to take

Before starting treatment, your doctor will inform you:

• 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 your skin, wash the skin 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, wash your hands 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 your doctor recommends stopping it.

Taking more Lenalidomide Zentiva than prescribed

If you have taken more capsules than you should, you should immediately consult your doctor.

Missing a dose of Lenalidomide Zentiva

If you miss a dose of Lenalidomide Zentiva at the usual time:

• and it has been less than 12 hours since then, you should take the capsule immediately,
• and it has been more than 12 hours since then, do not take the missed capsule. Take the next dose at the usual time the next day.

If you have any further doubts about taking this medicine, consult your doctor or pharmacist.

4. Possible side effects

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

If you experience any of the following serious side effects, stop taking Lenalidomide Zentiva and immediately consult your doctor - you may need urgent medical attention:

• 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 can start as a rash in one area and spread to the entire body, accompanied by a significant loss of skin (Stevens-Johnson syndrome and/or toxic epidermal necrolysis);
• widespread rash, high fever, increased liver enzyme activity, 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.

You should immediately inform your 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 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. For this reason, before prescribing this medicine, your 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, pain, muscle tenderness, bone pain, joint pain, back pain, limb pain; ● generalized swelling, 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, calcium, or sodium levels in the blood ● abnormal thyroid function ● low blood cell count ● 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 ● increased liver enzyme activity ● changes in blood proteins leading to blood vessel inflammation (vasculitis) ● high blood sugar levels (diabetes) ● low blood sugar levels ● headache ● nosebleeds ● dry skin ● depression, mood changes, sleep disturbances; ● cough ● low blood pressure ● general feeling of physical discomfort, malaise ● painful mouth inflammation, dry mouth● dehydration.
  Common(may affect up to 1 in 10 people)
  • red blood cell breakdown (hemolytic anemia) ● certain types of skin tumors
  • bleeding from the gums, stomach, or intestines ● high blood pressure, slow, fast, or irregular heart rhythm ● increased levels of a substance produced by the breakdown of red and abnormal blood cells ● increased 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 ● high uric acid levels in the blood ● skin rashes, redness of the skin, peeling, cracking, or flaking of the skin, hives ● itching, increased sweating, night sweats ● difficulty swallowing, sore throat, voice changes, or voice alterations
  • runny nose ● urinating much more or much less than usual or inability to control urination ● 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 disturbances causing a spinning sensation), loss of consciousness ● muscle weakness, lack of energy ● neck pain, chest pain
  • chills ● joint swelling ● slowed or blocked bile flow 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 up to 1 in 100 people)

  • bleeding in the brain ● circulation problems ● vision loss ● loss of libido ● excessive urine production, accompanied by bone pain and weakness, which may be a sign of kidney disease (Fanconi syndrome) ● yellowing of the skin, mucous membranes, or eyes (jaundice), pale stools, dark urine, itching of the skin, rash, pain, or swelling of the abdomen - may be signs of liver damage (liver failure);
  • abdominal pain, bloating, or diarrhea, which may be symptoms of colon inflammation (colitis) ● breakdown of the stomach or intestine wall, which can lead to a serious infection. You should tell your doctor if you 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 causing painful skin rash with blisters) and hepatitis B virus reactivation (which may cause yellowing of the skin and eyes, dark urine, abdominal pain, fever, and nausea) ● transplant rejection of a transplanted organ (e.g., kidney, heart).

  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 heart rate - these symptoms may occur in association with pancreatitis ● wheezing, shortness of breath, or dry cough, which may be due to pneumonia ● rare cases of muscle breakdown (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, characterized by joint pain and fever (leukocytoclastic vasculitis) ● breakdown of the stomach or intestine wall, which can lead to a serious infection. You should tell your doctor if you experience severe abdominal pain, fever, nausea, vomiting, blood in the stool, or changes in bowel movements.

  infections, including varicella-zoster virus (a viral disease causing painful skin rash with blisters) and hepatitis B virus reactivation (which may cause yellowing of the skin and eyes, dark urine, abdominal pain, fever, and nausea) ● organ transplant rejection.

  Reporting side effects

  If you experience any side effects, including any side effects not listed in this leaflet, you should tell your 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, you can help provide 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 stated.
  There are no special storage instructions for this medicine.
  Do not use the medicine if it is damaged or if there are signs of blister pack damage.
  Medicines should not be disposed of via wastewater or household waste. You should ask your 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), yellow iron oxide (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 Member States of 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.

  To obtain more detailed information, please contact the representative of the marketing authorization holder in Poland:

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