Revlimid Interactions: Alcohol, Medications, and Others

Does Revlimid interact with other drugs?

Before you start taking Revlimid, tell your doctor and pharmacist about any prescription, over-the-counter, or other drugs you take. Sharing this information with them may help prevent possible interactions. (To learn whether Revlimid interacts with herbs or vitamins and supplements, see the “Are there other interactions with Revlimid?” section.)

If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist.

The table below lists drugs that may interact with Revlimid. Keep in mind that this table does not include a full list of what drugs should not be taken with Revlimid. For more information about some of these interactions, see the “Drug interactions explained” section.

When should I avoid Revlimid?

Certain health conditions or other factors could raise your risk of harm if you take Revlimid. In such cases, your doctor may not prescribe Revlimid for you. These are known as contraindications. The list below includes contraindications of Revlimid.

If you are pregnant: Revlimid must not be used during pregnancy due to the risk of serious harm. This drug has a boxed warning about the risk of serious harm if used during pregnancy. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). To learn more, see the introduction of this article.

If you’ve had an allergic reaction: If you’ve had an allergic reaction to Revlimid or any of its ingredients, your doctor likely won’t prescribe Revlimid for you. This is because taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better options for you.

Before you start taking Revlimid, talk with your doctor if either of the factors above applies to you. Your doctor can determine whether Revlimid is safe for you to take.

Does Revlimid interact with alcohol?

Revlimid is not known to interact with alcohol. But Revlimid and alcohol can cause some similar side effects, such as diarrhea and indigestion. So you may be more likely to experience these side effects if you drink alcohol during your Revlimid treatment.

Keep in mind that Revlimid is prescribed to treat certain blood cancers. Your cancer doctor or care team may suggest limiting or avoiding alcohol consumption as part of your cancer treatment plan.

If you have questions about consuming alcohol during Revlimid treatment, talk with your doctor or pharmacist.

Drug interactions explained

Learn more about certain drug interactions that can occur with Revlimid.

Interaction with estrogens

Revlimid can interact with estrogens. Medications containing estrogens are used for a variety of purposes, including preventing pregnancy and treating certain menopausal symptoms.

Examples of medications that contain estrogen include:

• ethinyl estradiol/desogestrel (Cyclessa, others)
• ethinyl estradiol/drospirenone (Nikki, others)
• estradiol (Climara, others)
• conjugated estrogens (Premarin)
• ospemifene (Osphena)

What could happen

Taking Revlimid with estrogens can raise your risk of blood clots as a side effect of estrogens or Revlimid.

Note: Revlimid has a boxed warning about the risk of blood clots. To learn more about this warning, see the introduction of this article. To learn more about Revlimid’s side effects, check out this article.

What you can do

Before prescribing Revlimid and an estrogen together, your doctor will evaluate your risk of blood clots. Depending on your risk, they may avoid prescribing this combination together. Or they may prescribe a blood thinner for you to take during treatment. (Doctors may prescribe a blood thinner to take with Revlimid due to the risk of blood clots, even if an estrogen is not prescribed.)

It’s also possible that your doctor may recommend an alternative to the estrogen drug instead of prescribing this combination.

If you take Revlimid and a drug that contains estrogen together, seek medical attention right away if you have symptoms of a blood clot. Symptoms will vary based on where the clot is located but may include:

• sudden shortness of breath and severe chest pain, if the clot is in your lungs
• skin redness or discoloration, warmth, and swelling, if the clot is in your leg or arm

If you have questions about taking Revlimid with estrogens, talk with your doctor or pharmacist.

Interaction with clozapine

Revlimid can interact with clozapine. Clozapine is prescribed to treat schizophrenia that doesn’t respond to other treatments.

What could happen

Taking Revlimid and clozapine together can increase the risk of blood cell problems as a side effect of clozapine or Revlimid.

Revlimid has a boxed warning about the risk of blood cell problems. Specifically, Revlimid may cause serious neutropenia (low neutrophil count) and thrombocytopenia (low platelet count). See the introduction of this article to learn more about this warning.

Clozapine also has a boxed warning about the risk of blood cell problems, including serious neutropenia and agranulocytosis.

What you can do

Due to this risk, your doctor may avoid prescribing Revlimid and clozapine together. If this combination cannot be avoided, they’ll likely monitor your blood counts very closely throughout treatment.

Blood cell problems often don’t cause symptoms, and blood tests can detect these side effects even when they’re not causing symptoms. Based on the results of these tests, your doctor may reduce your Revlimid or clozapine dosage or pause treatment with either drug.

Interaction with warfarin

Revlimid may interact with warfarin (Jantoven), which is prescribed to prevent and treat blood clots.

What could happen

Taking Revlimid and warfarin together can increase or decrease the effect of warfarin. Increasing the effect could raise your risk of side effects caused by warfarin, such as bleeding. Decreasing the effect would cause warfarin not to work as well as expected.

Taking warfarin doesn’t appear to increase the risk of side effects caused by Revlimid. But certain side effects of Revlimid could be worsened by warfarin. For example, Revlimid has a boxed warning about the risk of blood cell problems.

Specifically, Revlimid may cause serious thrombocytopenia (low platelet count). This condition raises your risk of bleeding. Taking warfarin can also increase your risk of bleeding. So if you develop thrombocytopenia from taking Revlimid, warfarin could worsen your risk of bleeding due to it.

What you can do

If your doctor prescribes Revlimid and warfarin together, they’ll use blood tests to closely monitor your platelet counts. They’ll also use blood tests to monitor how well warfarin is working. Your doctor can provide more information on these tests and how often they’ll order them if you take Revlimid and warfarin together.

Are there other interactions with Revlimid?

Revlimid may have other interactions. They could occur with supplements, foods, vaccines, or even lab tests. See below for details. Note that this information does not include all other possible interactions with Revlimid.

Does Revlimid interact with supplements?

Before you start taking Revlimid, talk with your doctor and pharmacist about any herbs or vitamins and supplements you take. Sharing this information with them may help you avoid possible interactions.

If you have questions about interactions that may affect you, talk with your doctor or pharmacist.

Revlimid and herbs

There are currently no reports of Revlimid interacting with herbs. But this doesn’t mean that interactions with herbs won’t be recognized in the future.

For this reason, it’s still important to check with your doctor or pharmacist before taking any of these products while taking Revlimid.

Revlimid and vitamins

There are currently no reports of Revlimid interacting with vitamins. But this doesn’t mean that vitamin interactions won’t be recognized in the future.

For this reason, it’s still important to check with your doctor or pharmacist before taking any of these products while taking Revlimid.

Does Revlimid interact with food?

There are currently no reports of Revlimid interacting with food. If you have questions about eating certain foods during your treatment with Revlimid, talk with your doctor.

Does Revlimid interact with vaccines?

You should not receive live vaccines* during your Revlimid treatment. This is because getting a live vaccine while you’re taking Revlimid increases your risk of infection. Examples of live vaccines include measles, mumps, rubella (MMR); rotavirus; and chickenpox. If you need to receive a vaccine, talk with your doctor first to make sure it’s safe.

* Live vaccines contain weakened versions of the bacteria or virus that they’re meant to protect against.

Does Revlimid interact with lab tests?

There are currently no reports of Revlimid interacting with lab tests. If you have questions about having certain lab tests during your treatment with Revlimid, talk with the healthcare professional ordering the test.

Does Revlimid interact with cannabis or CBD?

There are currently no reports of Revlimid interacting with cannabis (commonly called marijuana) or cannabis products such as cannabidiol (CBD). But, as with any drug or supplement, talk with your doctor before using cannabis with Revlimid.

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

Does my health history affect whether I should take Revlimid?

Certain medical conditions or other health factors may raise the risk of interactions with Revlimid. Before taking Revlimid, talk with your doctor about your health history. They’ll determine whether Revlimid is right for you.

Health conditions or other factors that might interact with Revlimid include:

Blood cell problems, such as neutropenia (low neutrophil count): Revlimid has a boxed warning about the risk of blood cell problems, including neutropenia and thrombocytopenia (low platelet count). You may be at higher risk if you have an existing blood cell problem. To learn more about this warning, see the introduction of this article.

Current or past blood clot: Revlimid has a boxed warning about the risk of blood clots as a side effect. You may be at higher risk if you’ve had a blood clot in the past. To learn more, see the introduction of this article.

Increased risk of blood clots: Certain conditions can raise your risk of blood clots as a side effect of Revlimid. These conditions include high blood pressure and hyperlipidemia (a high level of fats in your blood). Revlimid has a boxed warning about the risk of blood clots as a side effect. To learn more, see the introduction of this article.

Kidney problems or receiving kidney dialysis: Your doctor may prescribe a different Revlimid dosage for you if you have a kidney problem, including if you receive kidney dialysis. Your body relies on your kidneys to help get rid of Revlimid. Kidney problems can slow this process and may cause the level of Revlimid in your system to build up. This can increase your risk of side effects of Revlimid.

Lactose intolerance: Revlimid capsules contain lactose. Be sure to let your doctor know if you have lactose intolerance before you start treatment.

Liver problems, such as cirrhosis: Revlimid can cause liver-related side effects, including liver failure. If you have an existing liver problem, such as cirrhosis, taking Revlimid could worsen your condition. You may also be at higher risk of liver-related side effects that Revlimid can cause.

Thyroid condition: Treatment with Revlimid can affect your thyroid function. The drug can cause either hypothyroidism (underactive thyroid) or hyperthyroidism (overactive thyroid) as a side effect. If you have an existing thyroid condition, your doctor may use blood tests to closely monitor your thyroid function while you’re taking Revlimid.

Pregnancy: Revlimid must not be used during pregnancy due to the risk of harm. Revlimid has a boxed warning about the risk of serious harm if it’s used during pregnancy. For more information, see the introduction to this article.

Breastfeeding: The drugmaker of Revlimid advises against breastfeeding while you’re taking the drug. If you’re breastfeeding or planning to breastfeed, talk with your doctor about your options.

Allergic reaction: If you’ve had an allergic reaction to Revlimid or any of its ingredients, your doctor will likely not prescribe Revlimid. This is because taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better choices for you. You should also let your doctor know if you’ve had a serious skin rash as a reaction to taking the drug thalidomide. You may have a similar or worse reaction from taking Revlimid, because Revlimid and thalidomide are very similar.

Common questions about Revlimid and interactions

Find answers to some frequently asked questions about Revlimid and possible interactions.

Does Revlimid interact with acyclovir? Is it safe to take these medications together?

It’s likely safe to take Revlimid with acyclovir. There are no reports of interactions between these two medications.

But there is one important note to keep in mind about taking Revlimid and acyclovir. Revlimid can cause blood cell problems, such as thrombocytopenia (low platelet count), as a side effect. This is a common side effect with Revlimid.

There are also very rare reports of blood cell problems, including thrombocytopenia, in people using acyclovir. In fact, these reports are so rare with acyclovir that it’s not fully clear whether the blood cell problems are caused by acyclovir or another factor. This also means it’s not clear whether taking Revlimid and acyclovir together would increase the risk of experiencing blood cell problems as a side effect.

If your doctor decides to prescribe both Revlimid and acyclovir for you, they may want to monitor your blood cell counts closely during treatment. They can provide more information on these blood tests and how often you’ll receive them.

Is it safe to take Revlimid with over-the-counter pain relievers?

Maybe. Talk with your doctor before you take Revlimid with over-the-counter pain relievers such as acetaminophen (Tylenol) or ibuprofen (Motrin, Advil).

In rare cases, acetaminophen can cause liver-related side effects, including liver damage. Revlimid can also rarely cause liver-related side effects. If you have an existing liver condition, your doctor may recommend against taking acetaminophen while you’re taking Revlimid. But if you do not, this combination may be safe to take.

Ibuprofen and other nonsteroidal anti-inflammatory drugs (NSAIDs) can cause kidney-related side effects in rare cases. Revlimid isn’t known to cause kidney-related side effects, but your body relies on your kidneys to get rid of Revlimid. If ibuprofen causes kidney-related side effects, they could affect how well your body gets rid of Revlimid. This could raise your risk of side effects of Revlimid. But this isn’t common, and your doctor can help determine whether it’s safe for you to take Revlimid with ibuprofen or another NSAID.

How can I prevent interactions?

Taking certain steps can help you avoid interactions with Revlimid. Before starting treatment, talk with your doctor and pharmacist. Things to discuss with them include:

• whether you drink alcohol or use cannabis
• other medications you take, as well as any vitamins, supplements, and herbs (they can also help you fill out a medication list)
• what to do if you start taking a new drug during your Revlimid treatment

It’s also important to understand Revlimid’s label and other paperwork that may come with the drug. Colored stickers that describe interactions may be on the label. And the paperwork (sometimes called the patient package insert or medication guide) may have other details about interactions. (If you did not get paperwork with Revlimid, ask your pharmacist to print a copy for you.)

If you have trouble reading or understanding this information, your doctor or pharmacist can help.

Taking Revlimid exactly as prescribed can also help prevent interactions.

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.