Revlimid interactions: Alcohol, medications, and other factors

Revlimid interactions with other medications  

Before you start treatment with Revlimid, tell your doctor and pharmacist which prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions. (To learn whether Revlimid interacts with supplements, herbs, or vitamins, see the “Revlimid and other interactions” section.)

If you have questions about drug interactions that may affect you, such as which drugs should not be taken with Revlimid, ask your doctor or pharmacist.

Here’s a table of drugs that can interact with Revlimid. Keep in mind that this table doesn’t include all drugs that may interact with Revlimid. Some of these interactions are described in detail in “Drug interactions in depth.”

* Revlimid has a boxed warning about the risk of blood clots. A boxed warning is the most serious warning from the FDA. For more information, see “Boxed warnings” at the beginning of this article.

When to avoid Revlimid

In some cases, factors or conditions could prevent your doctor from prescribing Revlimid due to the risk of harm. These are known as contraindications. The contraindications of Revlimid include:

Being pregnant or being able to become pregnant

Doctors won’t prescribe Revlimid while you are pregnant. They’re also unlikely to prescribe the drug for this use if you’re able to become pregnant and are not using effective birth control.

This is because Revlimid may not be safe to take during pregnancy. In fact, the drug has a boxed warning about the risk of fetal harm. A boxed warning is the most serious warning from the FDA. For details, see “Boxed warnings” at the beginning of this article.

For treating your condition during pregnancy, your doctor can recommend a different treatment that’s safe for use during this time. If you’re able to become pregnant, your doctor can advise you on birth control options to use while taking Revlimid for your condition.

Having had an allergic reaction to Revlimid or any of its ingredients

If you’ve had an allergic reaction to Revlimid or any of its ingredients, your doctor will likely not prescribe Revlimid. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.

Note: Before you start treatment with Revlimid, it’s important to tell your doctor if these contraindications apply to you. They can determine whether to prescribe Revlimid.

Revlimid interaction with alcohol

There aren’t any known interactions between Revlimid and alcohol. However, your doctor may advise you to avoid or limit alcohol consumption during Revlimid treatment.

This is because drinking alcohol while taking the drug may worsen some of Revlimid’s side effects. For example, you may experience:

• diarrhea
• fatigue
• nausea and vomiting
• dizziness
• headache

In addition, consuming large amounts of alcohol can cause liver damage. Revlimid may also cause liver damage as a side effect. This means that drinking alcohol during Revlimid treatment may increase the risk of liver problems.

If you consume alcohol during Revlimid treatment, these side effects may be more likely to occur. If you have questions about drinking alcohol while taking Revlimid, talk with your doctor.

Drug interactions in depth

Here’s a closer look at certain drug interactions of Revlimid.

Estrogens

Revlimid can interact with estrogens and medications that contain estrogens. These medications are used for birth control, hormone replacement therapy, and other uses.

Interaction result: Taking Revlimid and a medication that contains estrogen together can increase the risk of blood clots* as a side effect of Revlimid and the estrogen-containing medication.

Interaction explained: Both Revlimid and estrogen-containing medications can raise your risk of blood clots as a side effect. Taking both together further increases this risk.

Examples of medications that contain estrogen: Here are some estrogen-containing medications that may interact with Revlimid:

• estradiol (Climara, others)
• ethinyl estradiol/desogestrel (Cyclessa, others)
• conjugated estrogens (Premarin)
• esterified estrogens (Menest)

Steps you or your doctor may take: Your doctor may avoid prescribing Revlimid with a medication that contains estrogen. If there are other treatments for your condition that don’t interact with Revlimid, your doctor may prescribe those instead.

If your doctor prescribes this combination, they’ll monitor you closely for blood clots. Immediately seek medical attention if you experience symptoms of a blood clot, such as:

• skin redness or other skin discoloration
• pain or swelling in the affected limb
• sudden breathlessness
• chest pain that worsens when breathing deeply

* Revlimid has a boxed warning about the risk of blood clots. A boxed warning is the most serious warning from the FDA. For more information, see “Boxed warnings” at the beginning of this article.

ESAs

Revlimid can interact with ESAs. These medications are used for treating kidney disease, anemia, and other conditions.

Interaction result: Taking Revlimid and an ESA together can increase the risk of blood clots as a side effect of Revlimid and the ESA.

Interaction explained: When taken on their own, Revlimid and ESAs can cause blood clots as a side effect. If these medications are taken together, this risk increases further.

Examples of ESAs: Here are some ESAs that may interact with Revlimid:

• darbopoetin alfa (Aranesp)
• epoetin alfa (Procrit) and its biosimilar, epoetin alfa-epbx (Retacrit)

Steps you or your doctor may take: Your doctor may avoid prescribing Revlimid and an ESA together. If there are alternatives to an ESA that can treat your condition and don’t interact with Revlimid, your doctor may recommend those treatments instead.

If your doctor prescribes this combination, they’ll monitor you closely for blood clots. You should seek immediate medical attention if you experience symptoms of a blood clot, such as:

• pain or swelling in the affected limb
• skin redness or other skin discoloration
• chest pain that worsens when breathing deeply
• sudden breathlessness

Revlimid and other interactions

Revlimid may have other interactions, such as with supplements, foods, vaccines, or even lab tests. You’ll find details below. Keep in mind that the following information does not include all other possible interactions with Revlimid.

Revlimid and supplements

It’s possible for drugs to interact with supplements such as vitamins and herbs.

Revlimid and herbs

There are no specific reports of herbs interacting with Revlimid. However, that doesn’t mean herbal interactions won’t occur or be recognized in the future. Because of this, it’s important to check with your doctor or pharmacist before taking any of these products during Revlimid treatment.

Revlimid and vitamins

There are no specific reports of vitamins interacting with Revlimid. However, that doesn’t mean vitamin interactions won’t occur or be recognized in the future. Because of this, you should talk with your doctor or pharmacist before taking any vitamin product with Revlimid.

Revlimid and food

There were no reports of food interactions with Revlimid. If you’d like to learn more about eating certain foods during treatment with Revlimid, talk with your doctor.

Revlimid interactions with vaccines

Revlimid may interact with live vaccines. A live vaccine contains live but weakened pieces of the virus or bacterium it’s meant to defend against. When your immune system is healthy, live vaccines usually won’t cause infection.

But Revlimid works by affecting your immune system. So if you get a live vaccine, your immune system may not be able to fight the virus or bacterium. This may cause you to become sick or develop symptoms of the illness the vaccine is meant to prevent. And you may not develop long-term protection against the virus or bacterium in the vaccine.

Examples of live vaccines that your doctor may suggest avoiding during Revlimid treatment include:

• measles, mumps, rubella (MMR) vaccine
• chickenpox vaccine
• the nasal spray form of the flu vaccine

Before starting Revlimid, talk with your doctor or pharmacist about any vaccines you may need. And during your treatment with Revlimid, talk with your doctor or pharmacist before receiving a vaccine. They can advise on whether it’s safe for you to receive.

Revlimid and lab tests

Revlimid isn’t known to interact with any lab tests. If you have concerns about this medication interacting with lab tests, talk with your doctor.

REVLIMID AND CANNABIS OR CBD

Cannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have not been specifically reported to interact with Revlimid. However, as with any drug or supplement, talk with your doctor before using cannabis in combination with Revlimid. The impact of cannabis may affect how well you stick to your Revlimid treatment plan.

Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.

Revlimid and health-related interactions

Certain medical conditions and other factors may increase the risk of interactions with Revlimid. Before you take this drug, be sure to talk with your doctor about your health history. Revlimid may not be the right treatment option if you have certain medical conditions or other factors affecting your health.

Health conditions or factors that might interact with Revlimid include:

• Blood cell problems: Treatment with Revlimid may cause blood cell problems as a side effect. Examples include low white blood cell count and low platelet count. If you have an existing blood cell problem, taking Revlimid could worsen your condition.
• Blood clots in the past: Taking Revlimid increases your risk of developing a blood clot.* If you’ve had a blood clot in the past, be sure to let your doctor know before you start taking Revlimid. Most people who are prescribed Revlimid are also prescribed a blood thinner to help lower this risk.
• High blood pressure or hyperlipidemia: Taking Revlimid increases your risk of developing a blood clot.* High blood pressure or hyperlipidemia also raises the risk of blood clots. So if you have either or both of these conditions, you have a higher risk of experiencing this side effect if you take Revlimid.
• Kidney problems: If you have a kidney problem, such as chronic kidney disease, your doctor may prescribe a lower Revlimid dosage to start treatment. Kidney problems can cause issues with how well your body gets rid of Revlimid and can cause drug levels in your system to become too high. This can increase the risk of side effects of Revlimid.
• Liver problems: Revlimid can cause liver damage as a side effect. If you have an existing liver problem, such as fatty liver disease, taking Revlimid could worsen your condition.
• Thyroid problems: Taking Revlimid can cause problems with thyroid function as a side effect, including hyperthyroidism and hypothyroidism. If you have an existing thyroid problem, taking Revlimid could worsen your condition. Your doctor will likely order tests to check your thyroid function before prescribing Revlimid. If they prescribe the drug, they’ll reorder these tests throughout your treatment.
• Lactose intolerant: Revlimid capsules contain lactose. Be sure to tell your doctor if you have lactose intolerance, as they may prescribe a different treatment instead.
• Cigarette smoking: Smoking cigarettes increases your risk of blood clots.* Treatment with Revlimid can cause blood clots as a side effect, and cigarette smoking can further raise this risk. Most people who are prescribed Revlimid are also prescribed a blood thinner to lower this risk. Your doctor may also talk with you about quitting smoking before they prescribe Revlimid.
• Allergic reaction to thalidomide: Revlimid is very similar to the medication thalidomide. If you’ve had an allergic reaction after taking thalidomide, you’re likely to have a similar reaction if you take Revlimid.
• Allergic reaction: If you’ve had an allergic reaction to Revlimid or any of its ingredients, your doctor will likely not prescribe Revlimid. Taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better choices for you.
• Breastfeeding: It’s not known whether Revlimid is safe to take while breastfeeding. There isn’t enough information to determine whether the drug passes into breast milk or what effects Revlimid may have on a child who is breastfed. If you’re breastfeeding or planning to, talk with your doctor before taking Revlimid. They can talk with you about treatment options and ways to feed your child.
• Pregnancy: Revlimid should not be used during pregnancy. Animal studies show that the drug may cause congenital anomalies (commonly known as birth defects) or pregnancy loss. Revlimid has a boxed warning about the risk of severe harm if used during pregnancy. For more details, see “Boxed warnings” at the beginning of this article. If you’re pregnant or planning to become pregnant, tell your doctor before starting Revlimid. They can advise on the right treatment plan for you.

* Revlimid has a boxed warning about the risk of blood clots. For more information, see “Boxed warnings” at the beginning of this article.

FAQs about Revlimid and interactions

Here are some frequently asked questions about Revlimid and possible interactions.

Is Revlimid a type of chemotherapy or immunotherapy? Is it safe to take with chemotherapy or immunotherapy?

Revlimid is a type of immunotherapy, specifically an immunomodulator. Immunotherapy is a treatment that activates your immune system. Immunomodulators specifically help your immune system respond to cancer cells. Revlimid is not a chemotherapy medication.

Chemotherapy works to kill fast-growing cells in your body. This includes cancer cells, but it also includes many healthy cells, such as cells that cause hair growth and cells inside your mouth. Immunotherapy medications can still affect healthy cells, but their actions are more targeted to your immune system than the actions of chemotherapy are. So, for example, hair loss is much more common with chemotherapy than with immunotherapy.

Revlimid is approved for use with rituximab (Rituxan) to treat certain cancers. Rituximab is a type of targeted immunotherapy. It’s designed to find specific targets in cancer cells to stop the cells from growing and spreading.

Talk with your doctor if you have more questions about how Revlimid is used, including other types of cancer treatments it may be used with. While Revlimid’s approved uses don’t include chemotherapy, cancer treatment can vary on a case-by-case basis. Your doctor can provide more information about your treatment plan and whether it’s safe to take Revlimid with other drugs.

Is there an interaction between Revlimid and acyclovir?

No, there isn’t a known interaction between Revlimid and acyclovir. These medications are typically safe to take together if your doctor prescribes them for you.

Acyclovir is an antiviral medication. It’s used to treat infections caused by certain viruses. Examples include genital herpes, chickenpox, and varicella-zoster (also known as shingles).

Talk with your doctor if you have additional questions about taking these medications together.

Preventing interactions

You can take certain steps to help prevent interactions with Revlimid. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan to do the following:

• Let them know if you drink alcohol or use cannabis.
• Tell them about any other medications you take, as well as any supplements, herbs, and vitamins.
• Create a medication list, which your doctor and pharmacist can help you fill out.

It’s also important to read the Revlimid label and other paperwork that may come with the drug. The label may have colored stickers that mention an interaction. And the paperwork, sometimes called the medication guide or patient package insert, may contain details about interactions.

If Revlimid doesn’t come with paperwork, you can ask your pharmacist to print a copy. If you need help reading or understanding this information, ask your doctor or pharmacist.

You can also help prevent interactions with Revlimid by taking it exactly as your doctor prescribes.

Disclaimer: Medical News Today 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.