[chthonianmachine]

Dangers of Revlimid for sex partners?

by chthonianmachine on Mon Apr 13, 2015 9:04 pm

Hi, everyone.

I think this is a fantastic forum. Although i don't personally have myeloma, the man in my life does, so i have some questions (about sex) that the manufacturer doesn't seem equipped to answer. I am hoping someone can offer me some insight here. Please forgive me if I'm over­stepping a boundary on this forum. Just set me straight and I'll shut up.

My partner had been on Revlimid for 3+ years (every single day) when we met, so from the beginning we used condoms. I was concerned about whether I was exposed to the Revlimid through kissing and other bodily fluids (like his sweat), but I just kind of swept that concern under the rug in favor of being intimate with him. (I'd appreciate a better understanding of the risk posed to me by those things, though.)

Anyway, about 4 months ago, he stopped taking the Revlimid completely, which was won­der­ful. So, our intimacy has had no boundaries. But today, he and his doctor decided that he will go back ON the Revlimid for maintenance, starting immediately.

I'm wondering whether any dangers to me (from drug exposure) are greatest right when the Revlimid is starting up in his system again, or whether the levels and risk to me are equal, whether we're intimate right when he resumes taking it or a few months in (after the levels have stabilized in his blood). I would greatly appreciate any expertise that can be offered on the matter.

I wish you all the best of luck and have enormous respect for the difficult journey you're on. Please accept my thanks in advance,

T

[Cheryl G]

Re: Dangers of Revlimid for sex partners?

by Cheryl G on Tue Apr 14, 2015 7:21 pm

Hello T,

You've raised an important question and there is absolutely nothing wrong with asking it.

As I understand it, the key question in this case is whether you are still able to have children. This is because the reason there are warnings about sexual activity among people taking Revlimid is that it may cause birth defects in a fetus is exposed to the drug. The FDA-approved "prescribing information" for Revlimid, whose generic name is "lenalidomide", carries the following warning right at the beginning of the document in a bold, boxed warning:

Lenalidomide, a thalidomide analogue, caused limb abnormalities in a developmental monkey study similar to birth defects caused by thalidomide in humans. If lenalidomide is used during pregnancy, it may cause birth defects or embryo-fetal death."

Now, if you are past the age of being able to have children, or if you have had, for example, a hysterectomy, then this primary source of concern related to sexual activity with someone taking Revlimid is not relevant in your case.

If, on the other hand, you are still able to have children, then you definitely want to make certain you are not pregnant, or possibly pregnant, during any intimacy with your partner when he is being treated with Revlimid, and it also would be advisable to start using a condom again.

Once again, this is a topic addressed in Revlimid's prescribing information, where it says:

Lenalidomide is present in the semen of patients receiving the drug. Therefore, males must always use a latex or synthetic condom during any sexual contact with females of reproductive potential while taking Revlimid and for up to 28 days after discontinuing Revlimid, even if they have undergone a successful vasectomy. Male patients taking Revlimid must not donate sperm."

Since Revlimid can be found in the sperm of male patients taking the drug, I assume it's also possible that you could experience some of the side effects associated with the drug if you were to have unprotected sex. On the other hand, I suspect the amount of the drug that might be transferred to you might not be so significant to cause any concern. It's a personal decision you'll have to think about, and perhaps have your partner discuss with his doctor, if not using a condom is an option for the two of you give your "reproductive potential" (what a phrase!).

I hope this helps some. Please let us know if you have any other questions we might be able to answer.

[blair77]

Re: Dangers of Revlimid for sex partners?

by blair77 on Wed Apr 15, 2015 12:14 am

I was 2 months pregnant when my husband was diagnosed with multiple myeloma. He started on Revlimid while I was pregnant and, other then making sure I did not handle the pills directly, the Revlimid being in his system was not of concern.

We questioned both my OB and his oncologist, and they said that, to be on the safe side, wear a condom during intercourse, but nothing about us kissing, etc. posing any harm. I believe the only concern is conceiving a child while taking Revlimid (either partner).

[EF11]

Re: Dangers of Revlimid for sex partners?

by EF11 on Wed Apr 15, 2015 1:34 pm

I have asked our doctors this question and as a "woman of childbearing age", it is very difficult to get a straight answer. I understand the need to stress the importance of the harm Revlimid would have on a fetus, but that is a different concern and a different question. The round-about responses I have received seem to be that any residual Revlimid in my husband's sperm would not be harmful to me. My gynecologist (who happens to be a long-time supporter of myeloma research and friends with some of the local myeloma specialists) was actually the most helpful. He was not alarmed that my husband on Revlimid and I continue to use other forms of birth control other than condoms. I do however wear gloves to handle the Revlimid pills.

I plan to ask our myeloma specialist again for good measure when my husband goes back on Revlimid after he recovers from his ASCT.

[Madrigal]

Re: Dangers of Revlimid for sex partners?

by Madrigal on Fri Apr 17, 2015 2:54 pm

Greetings T:
Is it possible that you and your partner are a same-sex couple? If so than the issues of reproductive potential are not an issue. Basically as Cheryl G mentioned, some of the drug may be passed in the seminal fluid and therefore you may experience some side effects. Regardless of the scant amount of drug passed along, it may be safest to use a condom as the Revlimid could interact with some drugs you are taking as well as cause side effects. Obviously if you're concerned about passing on Revlimid than I won't bore you with safer sex practices. I am a myeloma patient for 9 years married 3 years to my partner of 34 years. Be well and be happy.
Phil (aka Madrigal)