Cancer drugs A to Z list
Lenalidomide and dexamethasone is the name of a cancer drug combination.
You pronounce these drug names as:
lenalidomide (len-uh-lid-oh-mide)
dexamethasone (deks-ah-meth-uh-zone)
This combination is a treatment for myeloma. You may have this combination with other cancer drugs.
Go to the A to Z list of cancer drugs
Lenalidomide works in different ways. It:
interferes with chemicals that cells use to signal to each other to grow
helps the to attack the cancer cells
blocks the growth of new blood vessels, which cancer cells need to be able to grow
Dexamethasone is a . It helps lenalidomide to work better and kills myeloma cells.
You take lenalidomide as capsules and dexamethasone as tablets. You swallow these drugs whole with a glass of water.
You can take lenalidomide with or without food.
You should take dexamethasone tablets after a meal or with milk as they can irritate your stomach. Taking them in the morning might help to stop difficulty in sleeping (insomnia).
Whether you have a full or empty stomach can affect how much of a drug gets into your bloodstream.
You should take the right dose, not more or less.
Talk to your healthcare team before you stop taking a cancer drug, or if you have missed a dose.
You have lenalidomide and dexamethasone as cycles of treatment. This means that you have the drugs and then a rest to allow your body to recover.
Each cycle of treatment lasts 28 days (4 weeks).
You take lenalidomide every day for 3 weeks and then have a break for 1 week.
You take dexamethasone on certain days of your cycle. Your doctor, nurse or pharmacist will tell you exactly what days to take your tablets on.
You continue lenalidomide treatment for as long as it is working and you are not experiencing too many side effects.
Dexamethasone may stop after a few cycles of treatment depending how well the treatment is working and if you are not experiencing too many side effects.
You have blood tests before and during your treatment. They check your levels of and other substances in the blood. They also check how well your liver and kidneys are working.
Before treatment starts you may have a blood test to check for viruses such as hepatitis B, hepatitis C, and HIV. This is called a viral screen.
It’s important for your doctor to know if you have had any of these viruses. This is because this treatment can weaken your and can cause the virus to become active again (reactivation).
Side effects can vary from person to person. They also depend on what other treatments you're having.
Your doctor, nurse or pharmacist will go through the possible side effects. They will monitor you during treatment and check how you are at your appointments. Contact your advice line as soon as possible if:
you have severe side effects
your side effects aren’t getting any better
your side effects are getting worse
Early treatment can help manage side effects better.
We haven't listed all the side effects here. Talk to your healthcare team if you have any new symptoms that you think might be a side effect of your treatment.
Remember it is very unlikely that you will have all of these side effects. But you might have some of them at the same time.
These side effects happen in more than 10 in 100 people (more than 10%). You might have one or more of them. They include:
Increased risk of getting an infection is due to a drop in . Symptoms include a change in temperature, aching muscles, cough, headaches, feeling cold and shivery, pain or a burning feeling when peeing or generally feeling unwell. You might have other symptoms depending on where the infection is.
Infections can sometimes be life threatening. You should contact your advice line urgently if you think you have an infection.
Blood clots can develop in the deep veins of your body, usually the leg. This is called deep vein thrombosis (DVT). A blood clot can be very serious if it travels to your lungs (pulmonary embolism), although this isn’t common.
Symptoms of a blood clot include:
pain, redness and swelling around the area where the clot is and may feel warm to touch
breathlessness
pain in your chest or upper back – dial 999 if you have chest pain
coughing up blood
You might be breathless and look pale due to a drop in . This is called anaemia.
This is due to a drop in the number of platelets in your blood. These blood cells help the blood to clot when we cut ourselves. You may have nosebleeds or bleeding gums after brushing your teeth. Or you may have lots of tiny red spots or bruises on your arms or legs. This is known as petechiae.
You might feel very tired and as though you lack energy.
Various things can help you to reduce tiredness and cope with it, for example exercise. Some research has shown that taking gentle exercise can give you more energy. It is important to balance exercise with resting.
Contact your advice line if you have diarrhoea. For example, in one day you have 2 or more loose bowel movements than usual. If you have a , you might have more output than normal. Your doctor may give you anti diarrhoea medicine to take home with you after treatment.
Try to eat small meals and snacks regularly. It’s best to try to have a healthy balanced diet if you can. You don’t necessarily need to stop eating foods that contain . But if your diet is normally very high in fibre, it might help to cut back on high fibre foods such as beans, nuts, seeds, dried fruit, bran and raw vegetables.
Drink plenty to try and replace the fluid lost. Aim for 8 to 10 glasses per day.
is easier to sort out if you treat it early. Drink plenty and eat as much fresh fruit and vegetables as you can. Try to take gentle exercise, such as walking. Tell your healthcare team if you think you are constipated. They can give you a if needed.
This treatment might cause changes to your muscles. This can include pain in your muscles or spasms. You may feel weaker and lack strength. So for example walking or climbing stairs may be more difficult.
Let your treatment team know and they may be able to give you medicines to help.
You may experience pain while on treatment. This can be in your arms, legs, joints or other parts of your body.
Let your treatment team know and they can give you painkillers to help.
Your kidneys may stop working. Symptoms might include not peeing enough, breathlessness, feeling tired and weak, feeling confused, feeling sick and you might have swelling in your legs, ankles and feet.
You have regular blood tests to check how well your kidneys are working. Let your healthcare team know if you have any of these symptoms.
This treatment may cause itchy skin.
Less commonly you may have hives, dry skin, areas of your skin might get lighter or darker, eczema or redness.
Rarely this treatment can cause your skin to change colour. It can also have an abnormal reaction to sunlight known as photosensitivity reaction. This can cause a rash, itchy skin or a burning sensation. On white skin this may look red on black or brown skin the skin may go darker than surrounding skin.
There are other skin problems you may have. There isn’t enough information to work out how often these happen. These side effects include thinning of the skin, tiny red and purple spots on the skin, stretchmarks, acne and swelling.
With this treatment you can get nerve changes such as changes in sensation to the skin such as numbness, burning and tingling. Less commonly you might get nerve pain or an unpleasant or abnormal feeling, especially when touched.
Tell your healthcare team if you are having any of these symptoms.
You may develop shaking (a tremor) with this treatment.
Feeling sick is usually well controlled with anti sickness medicines. Avoiding fatty or fried foods, eating small meals and snacks, drinking plenty of water, and relaxation techniques can all help.
It is important to take anti sickness medicines as directed by your doctor or pharmacist, even if you don’t feel sick. It is easier to prevent sickness rather than treating it once it has started.
You may have changes in levels of minerals and salts in your blood, including low levels of sodium, calcium or potassium. Less commonly you might have low levels of magnesium and high levels of calcium or (causing gout).
You have regular blood tests during treatment to check this.
You might have liver changes that are usually mild and unlikely to cause symptoms. They usually go back to normal when treatment finishes.
Rarely your liver may stop working. Symptoms can include yellowing of the skin and whites of the eyes, itchy skin, rash, tummy pain and swelling, feeling or being sick, your poo may be pale in colour and your pee might be dark in colour.
You have regular blood tests to check for any changes in the way your liver is working. Let your healthcare team know straight away if you develop these symptoms.
You might have changes to your blood sugar levels. Symptoms of high blood sugar levels are feeling very thirsty, a dry mouth and peeing very often.
Or you might have low blood sugar levels. These symptoms include sweating, feeling hungry, shaky or trembling.
If you have you may need to check your blood sugar levels more often than usual. You may need to change the dose of medication.
Contact your healthcare team or advice line if you have any of these symptoms. You will have regular blood sugar tests to check these levels.
You might develop a cough or breathing problems. This could be due to infection, such as pneumonia and bronchitis.
You may develop a dry mouth while on treatment.
You might lose weight while having this treatment. Let your doctor or nurse know and they can recommend ways of maintaining your weight. Or they can refer you to a dietitian.
You may have difficulty falling asleep or staying sleeping. We have some tips for coping with insomnia. This information also includes possible treatments.
Talk to your healthcare team if you have insomnia. They might be able to prescribe some medicines to help.
Mood changes can include feeling very sad and depressed. Tell your doctor or nurse if you’re feeling depressed. They can arrange for you to talk to someone and give treatment if necessary.
Tell your healthcare team if you keep getting headaches. They can give you painkillers to help.
Taste changes may make you go off certain foods and drinks. You may also find that some foods taste different from usual or that you prefer to eat spicier foods. Your taste gradually returns to normal a few weeks after your treatment finishes.
You might have eye problems such as blurred vision or a clouding of the lens of the eye (cataracts). Less commonly, you may find your vision become less sharp.
Let your healthcare team know straight away if you have any problems with your eyes.
Mouth sores and ulcers can be painful. It helps to keep your mouth and teeth clean, drink plenty of fluids and avoid acidic foods such as lemons. Chewing gum can help to keep your mouth moist. Tell your doctor or nurse if you have ulcers.
Contact your doctor or pharmacist if you have indigestion or heartburn. They can prescribe medicines to help.
You may have swelling of your hands, feet and legs due to a build up of fluid (oedema).
These side effects happen in between 1 and 10 out of every 100 people (between 1 and 10%). You might have one or more of them. They include:
a serious reaction to an infection (sepsis). Signs can include feeling very unwell, not passing urine, slurred speech or confusion, breathlessness, mottled or discoloured skin, extreme shivering or muscle pain. Call 999 or go to accident and emergency (A&E) immediately if you have any of these symptoms
blood in your pee
being unable to completely empty bladder
a low level of hormones - you may feel tired or cold, gain weight, feel sad or depressed, or your voice may deepen
a disorder which affects your co-ordination, balance and speech
ear problems such as full or partial loss of hearing or a ringing in the ear (tinnitus)
heart problems such as slow or fast heartbeat. Rarely, it may become irregular, you may have changes to the heart muscle or rhythm that are picked up on an , or both. Other rare changes can include palpitations and shortness of breath
high blood pressure - tell your doctor or nurse if you have headaches, nosebleeds, blurred or double vision or shortness of breath. You have your blood pressure checked regularly
a hoarse voice
difficulty swallowing
joint swelling
painful sensations for no known reason such as a burning, tingling or crawling type of pain
difficulty with getting or keeping an (impotence)
chest pain - call 999 or go to A&E straight away if you develop this
a fall
sweating more than usual
a high level of in the blood that’s shows in the body
These side effects happen in fewer than 1 in 100 people (less than 1%). You might have one or more of them. They include:
an allergic reaction – symptoms can include a rash, shortness of breath, redness or swelling of the face and dizziness - some allergic reactions can be life threatening
an increased risk of and – these are non melanoma skin cancers
a loss of interest in sex (low libido)
inflammation of the – symptoms can include tummy pain, diarrhoea, fever and feeling tired
a condition that affects your kidneys (acquired Fanconi syndrome) – symptoms can include feeling weak, tired, painful bones, dehydration, feeling thirsty and peeing more than usual
your get destroyed faster than they can be made
There isn't enough information to work out how often these side effects might happen. You might have one or more of them. They include:
steroid withdrawal syndrome – this is when you stop taking dexamethasone too quickly after taking it for a long time. It can be life threatening and cause low blood pressure. Symptoms include fever, muscle and joint pain, runny nose, irritated eyes, lumps on skin, weight loss and feeling weak
weight gain
hiccups
passing wind
thinning hair
vertigo – a condition which makes you feel like you’re spinning even when standing still, causing loss of balance and feeling or being sick
slow wound healing
feeling generally unwell
bone problems including thinning bones (osteoporosis), bone tissue losing blood supply in the hip and shoulder, fractures in the spine and long bones
Cushing's syndrome - where your make too much of a steroid hormone (cortisol) in your body – you may gain weight and notice your skin bruises easily
low cortisol in your body – you may feel tired, weak, lose weight and have low blood pressure
irregular or no periods
increased appetite
high levels of certain fats in your blood
sodium (salt) and water retention – a condition which causes swelling in the body, weight gain, puffiness in the face and high blood pressure
problems with your food pipe, such as infections or ulcers
problems with your stomach, such as bloating, sores, bleeding and a hole in the stomach wall which causes severe pain
inflammation of the – you may feel or be sick, have severe tummy pain and diarrhoea
a tear in the heart muscle after a
sudden worsening of a previous heart condition
heart failure – you may have shortness of breath, feel very tired, sudden weight gain and swollen legs or ankles
inflamed
a weakened immune system can cause vaccines and skin tests to not produce an accurate response – vaccines may not give full immunity and skin tests may not show full reaction
a tendon tear - tendons attach muscles to bones, you might hear a snap when it tears and it can be very painful. There may be swelling or bruising around the area. Dial 999 or go straight to accident and emergency (A&E) if this happens
being sick
your blood not clotting as normally so you may bleed more easily
If you have side effects that aren’t listed on this page, you can look at the individual drug page on dexamethasone.
We have more information about side effects and tips on how to cope with them.
Cancer drugs can interact with medicines, herbal products, and some food and drinks. We do not list these interactions on this page. An example is grapefruit or grapefruit juice which can increase the side effects of certain drugs.
Tell your healthcare team about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies. Also let them know if you have any other medical conditions or allergies.
It is important not to become pregnant or get anyone pregnant whilst you are taking this treatment.
Lenalidomide can be harmful to a baby developing in the womb and can cause severe abnormalities. Some people may worry about taking lenalidomide, but it doesn’t cause physical defects in adults.
Because lenalidomide can be harmful to the developing baby, your doctor will talk to you before you start treatment. They will make sure that you understand the risks of this treatment and agree to use contraception.
Women should continue to use effective contraception for at 4 weeks after the end of treatment. Men should continue to use effective contraception for at least 7 days after treatment.
Let your doctor know straight away if you or your partner becomes pregnant.
It is not known whether this treatment affects in people. Talk to your doctor before starting treatment if you think you may want to have a baby in the future.
It is not known whether these drugs come through into the breast milk. Doctors usually advise that you don’t breastfeed during this treatment.
If you are having tests or treatment for anything else, always mention your cancer treatment. For example, if you are visiting your dentist.
Do not have live vaccines while you’re having treatment and for up to 12 months afterwards. For some people, it may be longer than this. The length of time you need to avoid live vaccines depends on the treatment you’ve had.
Ask your doctor or pharmacist how long you should avoid live vaccinations.
In the UK, live vaccines include rubella, mumps, measles, chickenpox, BCG, and yellow fever. You can usually have non-live vaccines. But they might not give you as much protection as usual. These include the:
flu vaccine, as an injection
coronavirus (COVID-19) vaccine
Talk to your doctor or pharmacist about the best time to have a vaccine in relation to your cancer treatment.
You can be in contact with other people who have had live vaccines as injections. If someone has had a live vaccine by mouth or nasal spray there may be a small risk the vaccine virus can be passed onto you if your is weakened.
Your healthcare team will let you know if you need to take any precautions if you are in close contact with someone who has had a live vaccine.
For further information about each drug and the possible side effects go to the electronic medicines compendium (emc) website. You can find patient information leaflets for each drug on this website.
You can report any side effect you have to the Medicines and Healthcare Regulatory Agency (MHRA) as part of their Yellow Card Scheme.
Last reviewed: 20 Oct 2026
Next review due: 20 Oct 2029
Find out about the symptoms, causes, tests to diagnose and treatment for myeloma. This includes chemotherapy, targeted treatments, stem cell transplant (intensive treatment), and current research.
Steroids are used in different ways during cancer treatment. Find out about how you might have them, possible side effects and other important information.
Cancer drugs have side effects and these can vary from person to person. But there are things that you can do to help you cope.
Coping with cancer can be difficult. There is help and support available. Find out about the emotional, physical and practical effects of cancer and how to manage them.
