Myelodysplastic Syndromes
- PO (Adults ): 10 mg once daily.
Renal Impairment
- PO (Adults ): CCr 30–60 mL/min: 5 mg once daily; CCr <30 mL/min (not on dialysis): 2.5 mg once daily; CCr <30 mL/min (requiring dialysis): 2.5 mg once daily (give after dialysis on dialysis days).
Multiple Myeloma
- PO (Adults ): 25 mg once daily on Days 1–21 of repeated 28-day cycles (with dexamethasone); if patients not eligible for auto-hematopoietic stem-cell transplantation (HSCT), continue treatment until disease progression or unacceptable toxicity; for patients eligible for auto-HSCT, hematopoietic stem cell mobilization should take place within 4 cycles.
Renal Impairment
- PO (Adults ): CCr 30–60 mL/min: 10 mg once daily; if patient tolerates initial dose, may ↑ to 15 mg once daily after 2 cycles; CCr <30 mL/min (not on dialysis): 15 mg every 48 hr; CCr <30 mL/min (requiring dialysis): 5 mg once daily (give after dialysis on dialysis days).
Maintenance Therapy for Multiple Myeloma Following Autologous Hematopoietic Stem Cell Transplantation
- PO (Adults ): After adequate hematologic recovery (ANC ≥1000/mcL and/or platelet counts ≥75,000/mcL), initiate therapy with 10 mg once daily continuously on Days 1–28 of repeated 28-day cycles; after 3 cycles, dose may be ↑ to 15 mg once daily, if tolerated; continue treatment until disease progression or unacceptable toxicity.
Renal Impairment
- PO (Adults ): CCr 30–60 mL/min: 5 mg once daily; CCr <30 mL/min (not on dialysis): 2.5 mg once daily; CCr <30 mL/min (requiring dialysis): 2.5 mg once daily (give after dialysis on dialysis days).
Mantle Cell Lymphoma
- PO (Adults ): 25 mg once daily on Days 1–21 of repeated 28-day cycles; continue treatment until disease relapse or unacceptable toxicity develops.
Renal Impairment
- PO (Adults ): CCr 30–60 mL/min: 10 mg once daily; CCr <30 mL/min (not on dialysis): 15 mg every 48 hr; CCr <30 mL/min (requiring dialysis): 5 mg once daily (give after dialysis on dialysis days).
Follicular Lymphoma or Marginal Zone Lymphoma
- PO (Adults ): 20 mg once daily on Days 1–21 of repeated 28-day cycles for up to 12 cycles.
Renal Impairment
- PO (Adults ): CCr 30–60 mL/min: 10 mg once daily; if patient tolerates initial dose, may ↑ to 15 mg once daily after 2 cycles; CCr <30 mL/min (not on dialysis): 5 mg once daily; CCr <30 mL/min (requiring dialysis): 5 mg once daily (give after dialysis on dialysis days).
Therapeutic Classification: antineoplastics
Pharmacologic Classification: immunomodulatory agents
Absorption: Well absorbed following oral administration. Levels are higher in patients with multiple myeloma.
Distribution: Unknown.
Metabolism/Excretion: 66% excreted unchanged in urine, some renal excretion involves active secretion.
Half-Life: 3 hr.
