Revlimid (lenalidomide) can cause side effects that range from mild to serious. More common side effects include nausea, fatigue, and anemia. If side effects from Revlimid become difficult to tolerate, talk with your doctor about coping tips or other treatment options.

Revlimid is used in adults to treat certain types of blood cancers, including:

Keep reading to learn about the common, mild, and serious side effects Revlimid can cause. To learn more about this drug, including its uses, dosage, and cost, see this Revlimid overview.

Revlimid can cause certain side effects, some more common than others. These side effects may be temporary, lasting a few days to weeks. Talk with your doctor if side effects do not go away, get worse, or become too difficult for you to tolerate.

Revlimid’s commonly reported side effects include:

For more information about some of these more common Revlimid side effects, see the “Side effects specifics” section.

Mild side effects have been reported with Revlimid. These include:

  • diarrhea
  • fatigue
  • mildly decreased blood cell levels
  • constipation
  • skin rash or itchiness
  • insomnia
  • edema
  • weakness and dizziness
  • nausea or vomiting
  • fever
  • upper respiratory infection
  • stomach flu
  • cough
  • shortness of breath
  • pain in your back or joints
  • headache
  • muscle cramps
  • nose bleeds

In most cases, these side effects should be temporary, and some may be easily managed. But if you have any symptoms that are ongoing or that bother you, talk with your doctor or pharmacist. Do not stop taking Revlimid unless your doctor recommends this.

Revlimid may cause mild side effects other than the ones listed above. See Revlimid’s prescribing information for details.

For more information about some of these mild side effects of Revlimid, see the “Side effects specifics” section.

Revlimid may cause serious side effects. The following list may not include all possible serious side effects of the drug. For more information, you can refer to Revlimid’s prescribing information.

Serious side effects of Revlimid that have been reported include:

For more information about some of these serious side effects, see the “Side effects specifics” and “Warnings for Revlimid” sections.

If you develop serious side effects while taking Revlimid, call your doctor right away. If the side effects seem life threatening or if you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Allergic reaction

For some people, Revlimid can cause an allergic reaction.

But it’s not clear whether this side effect occurred in the drug’s studies.

In general, symptoms of an allergic reaction can be mild or serious.

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms and can determine whether you should keep taking Revlimid.

If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If your doctor confirms you’ve had a serious allergic reaction to Revlimid, they may have you switch to a different treatment.

Learn more about some of the side effects Revlimid may cause.

Severely decreased blood cell levels

Revlimid has a boxed warning for severely decreased levels of certain blood cells. These include platelets and white blood cells. A boxed warning is the most serious warning from the FDA.

In studies of Revlimid, these blood disorders were very common. And in many cases, the disorders were severe.

Symptoms of a blood disorder depend on which type of blood cells are affected. Revlimid may cause thrombocytopenia (low levels of platelets). It can also cause neutropenia (low levels of neutrophils, a type of white blood cell).

Thrombocytopenia can cause the following symptoms:

  • excessive bruising
  • bleeding more than usual after a minor cut or injury
  • nose bleeds
  • bleeding gums
  • blood in your mucus, vomit, or stool
  • heavy vaginal bleeding

Neutropenia itself doesn’t cause symptoms, but it raises your risk of getting infections. This is because white blood cells are part of your immune system. These cells fight germs that cause infections, such as bacteria and viruses. Without enough white blood cells, you may get infections more easily than usual.

Infection symptoms can vary, but generally include:

  • fever
  • chills
  • body aches or other flu-like symptoms

What might help

Tell your doctor if you have possible symptoms of a blood disorder with Revlimid treatment. And tell them if you have infection symptoms or if you’re getting infections frequently.

While you’re taking Revlimid, your doctor will monitor your blood cell levels using a blood test called a complete blood count (CBC). They’ll likely check your CBC weekly or monthly during treatment.

If your blood cells become low, your doctor may have you temporarily stop taking Revlimid. Taking a break from treatment may be enough for your blood cell levels to return to normal on their own. Then when you restart treatment, your doctor may lower your dose.

In some cases, your doctor may give you a blood transfusion. This is a procedure in which you receive blood cells from a donor. You may be prescribed a type of drug called a granulocyte colony-stimulating factor, such as filgrastim (Neupogen) if you develop severe neutropenia.

Talk with your doctor if you have questions about monitoring or treating blood disorders from Revlimid.

Dangerous blood clots

Revlimid has a boxed warning for dangerous blood clots. These clots include deep vein thrombosis (DVT) and pulmonary embolism (PE). DVTs are serious blood clots that form in a deep vein, often in the leg. With PE, the clot travels to your lungs.

Symptoms of blood clots can include:

  • shortness of breath
  • chest pain
  • swelling or warmth in your leg or arm

In studies, people taking Revlimid with dexamethasone for multiple myeloma had an increased risk of blood clots that led to heart attack or stroke. These conditions can be life threatening.

What might help

If you develop any symptoms that could be caused by a blood clot, tell your doctor or seek emergency medical care right away.

Your doctor may prescribe a blood thinner medication to help prevent blood clots. They may also recommend ways to reduce other risk factors for blood clots. These may include managing high blood pressure and high cholesterol, and quitting smoking.

If you have questions about your risk of blood clots from Revlimid, talk with your doctor.

Eye problems

Revlimid may cause eye problems. In studies, blurred vision and cataracts were reported. Eye problems were less common than other side effects.

Rarely, other eye problems have been reported in studies of Revlimid treatment for multiple myeloma. These include vision loss and high pressure inside the eye.

What might help

Tell your doctor right away if you notice any changes in your vision.

It’s important to have regular eye exams during Revlimid treatment. If you develop cataracts, your eye doctor may suggest cataract surgery. If you develop severe vision problems, they may recommend switching to a different treatment.

Neuropathy

Revlimid may cause neuropathy (nerve damage).

Healthy nerves work by delivering signals between your body and your brain. Neuropathy occurs when your nerves become damaged and no longer work as they should. This can lead to your nerves sending inaccurate signals to your brain, such as pain signals without a cause.

Specifically, Revlimid may cause peripheral neuropathy. This causes symptoms that mainly occur in your hands, arms, legs, and feet. These may include:

  • prickling or tingling sensations
  • numbness
  • pain
  • muscle cramping, twitching, or weakness

What might help

If you develop symptoms of neuropathy while taking Revlimid, talk with your doctor. They may recommend physical therapy or medication to help manage this side effect. Or they may suggest other ways to treat neuropathy.

If you have questions about neuropathy from Revlimid, talk with your doctor or pharmacist.

Constipation

Constipation is a common side effect of Revlimid.

With constipation, you have bowel movements less often than usual or fewer than three a week. Your stools may be hard and difficult to pass.

Revlimid commonly causes other digestive side effects besides constipation. These include diarrhea, nausea, vomiting, and belly pain.

What might help

You may be able to ease constipation from Revlimid with certain diet and lifestyle changes. These include:

  • increasing your intake of fiber and foods that are high in fiber
  • drinking more water and fluids
  • exercising regularly

As long as your doctor says this is safe for you, over-the-counter (OTC) laxatives or stool softeners might also help with constipation.

If constipation from Revlimid becomes severe or doesn’t go away, talk with your doctor. They may suggest other ways to relieve constipation.

Keeping track of side effects

During Revlimid treatment, consider keeping notes on any side effects you’re having. Then, you can share this information with your doctor. This is especially helpful to do when you first start taking new drugs or using a combination of treatments.

Your side effect notes can include things such as:

  • what dose of drug you were taking when you had the side effect
  • how soon after starting that dose you had the side effect
  • what your symptoms were from the side effect
  • how it affected your daily activities
  • what other medications you were also taking
  • any other information you feel is important

Keeping notes and sharing them with your doctor will help your doctor learn more about how Revlimid affects you. And your doctor can use this information to adjust your treatment plan if needed.

Here are answers to some frequently asked questions about Revlimid’s side effects.

Can the stronger doses of Revlimid (10 mg, 15 mg, 20 mg, and 25 mg) increase my risk of side effects?

Yes, it’s possible that taking higher doses of Revlimid can make certain side effects more likely. These can include:

If you develop these side effects while taking a higher dose, your doctor may have you stop treatment until the side effect eases. Then, they’ll likely restart your Revlimid treatment with a lower dose.

Where can I see pictures of skin rashes caused by Revlimid?

A skin rash and itchiness are common side effects of Revlimid. For more pictures, you can see this study of rashes that occurred in people who took Revlimid along with rituximab (Rituxan).

Does taking Revlimid lead to hair loss?

No, Revlimid isn’t known to cause hair loss. This side effect wasn’t seen in people who took the drug in studies.

But hair loss could be caused by other cancer treatments you may be taking. Talk with your doctor if you’re concerned about hair loss during Revlimid treatment.

Are certain side effects more likely when Revlimid is taken with dexamethasone to treat multiple myeloma?

Revlimid is taken with dexamethasone (DexPak) to treat multiple myeloma (MM) in most adults. Taking these drugs together may increase your risk of certain serious side effects, such as:

Revlimid can be prescribed by itself (without dexamethasone or other drugs) to treat MM in people who’ve had a type of stem cell transplant called auto-HSCT. This use of Revlimid is known as maintenance therapy. You can talk with your doctor to discuss if a stem cell transplant or Revlimid maintenance therapy could be options for you.

Can stopping Revlimid cause withdrawal symptoms?

No, stopping Revlimid shouldn’t cause withdrawal symptoms. These are effects that can happen if you stop taking a drug your body has become dependent on.

Revlimid stays in your system for up to 4 weeks after stopping treatment. So it’s possible that you could still experience side effects of the drug after your last dose.

Stopping Revlimid may lead to your cancer progressing (getting worse). So you shouldn’t stop taking Revlimid without first discussing it with your doctor. They may suggest a different treatment plan for you.

Revlimid comes with several warnings.

Boxed warnings

Revlimid has three boxed warnings. Boxed warnings are the most serious warnings from the Food and Drug Administration (FDA).

  • Fetal harm: Revlimid may cause life threatening problems in a fetus (commonly called birth defects) or pregnancy loss. See “Pregnancy and breastfeeding while taking Revlimid” below for details.
  • Severely decreased blood cell levels: Revlimid may cause severely decreased levels of certain blood cells. These include platelets and certain white blood cells. These blood disorders can cause symptoms such as bruising and bleeding and can increase your risk of infection.
  • Dangerous blood clots: Taking Revlimid can increase your risk of developing serious blood clots. These include deep vein thrombosis (DVT) and pulmonary embolism (PE). These conditions can be life threatening and require immediate medical attention.

To learn more about severely decreased blood cell levels and dangerous blood clots, see the “Side effects specifics” section.

Other warnings

Revlimid may not be right for you if you have certain medical conditions or other factors that affect your health. Talk with your doctor about your health history before you take Revlimid. The list below includes factors to consider.

  • Chronic lymphocytic leukemia (CLL): If you have CLL, your doctor will likely not prescribe Revlimid. According to studies, taking Revlimid may increase your risk of death if you have CLL.
  • Pembrolizumab treatment: Taking Revlimid with pembrolizumab (Keytruda) for multiple myeloma may increase the risk of death. Be sure to tell your doctor about all of your current medications before taking Revlimid. If your medications include Keytruda, they’ll discuss your treatment plan and its risks and benefits.
  • Severe skin reaction to thalidomide: The drug thalidomide is very similar to lenalidomide (the active drug in Revlimid). If you’ve had a severe skin reaction to thalidomide in the past, your doctor will likely not prescribe Revlimid for you.
  • Liver or kidney problems: The liver and kidneys help to remove medications, including Revlimid, from your body. If you have liver problems or kidney problems, the drug may stay in your body longer than usual. This could increase your risk of side effects.

If you have liver or kidney problems, your doctor may not prescribe Revlimid. If they do, they’ll likely prescribe a lower dosage for you than usual.

  • Allergic reaction: If you’ve had an allergic reaction to Revlimid or any of its ingredients, your doctor will likely not prescribe Revlimid. Ask your doctor what other medications are better options for you.
  • Lactose intolerance: If you’re lactose intolerant, tell your doctor. They likely won’t prescribe Revlimid for you because it contains lactose. Ask your doctor about other medication options.

Alcohol and Revlimid

It’s usually safe to drink alcohol with Revlimid, if your doctor says this is safe for you.

But alcohol may cause some of the same side effects as Revlimid. These include nausea, vomiting, fatigue, and liver failure. Drinking alcohol while taking Revlimid could worsen these side effects.

If you drink alcohol, talk with your doctor about how much is safe to drink while taking Revlimid.

Pregnancy and breastfeeding while taking Revlimid

You should not take Revlimid during pregnancy. If you or your sexual partner can become pregnant, you should avoid pregnancy:

  • while taking Revlimid,
  • during any breaks in your treatment, and
  • for at least 4 weeks after your last dose

Females* should also avoid pregnancy starting at least 4 weeks before Revlimid treatment.

Revlimid is not considered safe to take while breastfeeding. The effects of Revlimid on a child who is breastfed are unknown.

If you’re pregnant or breastfeeding, or planning either, talk with your doctor. They can guide you on the safest options for you and your child.

Fetal harm

Revlimid has a boxed warning for fetal harm. If taken during pregnancy, it can cause severe developmental problems in a fetus (commonly known as birth defects). It can also cause pregnancy loss.

Due to the risk of fetal harm:

  • Before starting this medication, you must enroll in the Revlimid Risk Evaluation and Mitigation Strategy program. With this program, you must meet certain requirements before your doctor may prescribe Revlimid for you. As part of this program, females must have regular pregnancy testing.
  • Females should avoid becoming pregnant while taking Revlimid and for at least 4 weeks before and after treatment. You should use at least two methods of birth control starting 4 weeks before Revlimid treatment. Continue using these methods to help prevent pregnancy during treatment, any time your treatment is paused, and for at least 4 weeks after your last dose. You must have two negative pregnancy test results before starting treatment. And you’ll have pregnancy tests while taking Revlimid.
  • Males* taking Revlimid should use a condom during sexual contact. This should be used during treatment and for at least 4 weeks after stopping treatment. This is because Revlimid passes into sperm.

This warning is based on information about the drug thalidomide. Thalidomide is very similar to lenalidomide (the active drug in Revlimid).

If you have questions about fetal harm from Revlimid, birth control, or the REMS program, talk with your doctor or pharmacist.

* In this article, we use the terms “female” and “male” to refer to someone’s sex assigned at birth. Learn more about the difference between sex and gender.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.