[Jean Ruth Howard]

Revlimid and blood clots

by Jean Ruth Howard on Thu Sep 18, 2014 9:08 pm

My husband is on a clinical trial that includes Revlimid. The starting dose was 25 mg, although his specialist lowered the dose to 5 mg due to high creatinine levels.

This week, my husband was diagnosed with a blood clot in his left calf. He started Xarelto (rivaroxaban) to treat it (at a lower dosage than normal, again due to kidney issues). The specialist will keep him on Xarelto as long as he still remains on Revlimid.

I guess my question is has anyone else experienced a blood clot due to taking Revlimid (the trial drug has been ruled out as the cause of blood clot)? How long did it take to heal? Should we use compression hose?

I read that if you use compression hose, you have a lower risk for complications in the future, but none of the medical professionals have mentioned this.

I just don't want my husband to have future problems with pain, internal scarring etc.

I would appreciate hearing any/all stories pertaining to this. Navigating on an unknown path is hard sometimes!! Thank you!

[Chris M.]

Re: Revlimid and blood clots

by Chris M. on Thu Sep 18, 2014 10:15 pm

Hi Jean,

My husband also had a DVT (deep vein thrombosis / blood clot) early in his treatment while on Kyprolis, Revlimid, and dex. He had to give himself Lovenox injections twice daily for about a year, if I recall correctly.

While the Revlimid can cause DVTs, I believe they can also be caused by the multiple myeloma itself. His multiple myeloma doctor said the DVT would take 6 months or so to go away. It was painful for him at first, but not for very long. Now he only takes a baby aspirin each day.

Because my husband travels for work a great deal, his multiple myeloma doctor wrote him a prescription for compression stockings and he still wears them faithfully if he has to fly or drive long distances. He also gets out and walks a while if he's driving on long trips.

Best wishes to you and your husband.
Chris M.

[Jean Ruth Howard]

Re: Revlimid and blood clots

by Jean Ruth Howard on Fri Sep 19, 2014 12:42 pm

Thanks Chris M. Your post is very helpful!

All the best to you and yours,
Jeannie

[Rneb]

Re: Revlimid and blood clots

by Rneb on Fri Sep 19, 2014 3:33 pm

With Revlimid, a mild blood thinner is strongly suggested.
I take an 81 grain, enteric coated, baby aspirin with Revlimid.

BTW--I keep seeing TV ads for Xarelto complications by Lawyers seeking class action status--side effects, etc.
I took it post Hip Arthoplasty--but only for two weeks.
My Orthopod at 2 week post-op checkup, also asked that I DQ Xarelto.

BTW--what is your husbands Platelet status ?? ( Review serial labs)

[Jean Ruth Howard]

Re: Revlimid and blood clots

by Jean Ruth Howard on Fri Sep 19, 2014 7:54 pm

Hi Rneb,

My husband took baby aspirin when he started Revlimid. He is no longer taking it, though, because he is on the Xarelto. I saw the ad last night on TV. Made me uncomfortable, of course, but what to do? His platelets are within normal range.

Chris M. Is your husband still on Revlimid?

Best,
Jeannie

[Dr. Heather Landau]

Re: Revlimid and blood clots

by Dr. Heather Landau on Sat Sep 20, 2014 11:52 am

Hi Jean,

Indeed having multiple myeloma as well as being treated with Revlimid (especially in com­bi­na­tion with dex) can increase the risk of blood clots. Patients are recommended to take an aspirin when receiving this combination of treatment.

If a blood clot develops, we can treat with blood thinners, which prevent the clot from extending and new clots from forming. It is actually your own body that breaks down the clot that has already formed, and that happens over time. Xarelto is a newer oral (by mouth) blood thinner that has been very useful.

Your husband will need to remain on Xarelto for as long as he is on Revlimid and no longer requires aspirin. Compression stockings, while initially uncomfortable, can reduce com­pli­ca­tions of blood clots, which are rare but can happen. I am a big fan of compression hose, but patients are often reluctant.

The good news is that most clots heal very well!

Hope this helps!
Heather Landau

[Chris M.]

Re: Revlimid and blood clots

by Chris M. on Sat Sep 20, 2014 7:47 pm

Hi Jeannie,

Yes, my husband is still on Revlimid maintenance, 15 mg 21 days a month. Fortunately, he hasn't had any further DVT problems since only taking the baby aspirin and wearing the com­pres­sion stockings when traveling.

Best wishes,
Chris M.

[Jean Ruth Howard]

Re: Revlimid and blood clots

by Jean Ruth Howard on Sun Sep 21, 2014 4:04 am

Thanks Dr. Landau and Chris. Very helpful information. We were able to get some com­pres­sion hose yesterday and my husband feels that they are already helping.

Thanks again to everybody.

Best,
Jeannie

[hopeful27]

Re: Revlimid and blood clots

by hopeful27 on Mon Sep 22, 2014 8:25 am

Hello,

My mom gets blood clots easily (before she was diagnosed), including deep ones that are dangerous.

The week she started on Revlimid, she came down with one immediately even though she was on Coumadin (warfarin). She was quickly changed to shots in legs with Lovenox (enoxaparin).

They work great so far-no more blood clots, and my mom is on 25 mg of Revlimid.

[Al-Nawas]

Re: Revlimid and blood clots

by Al-Nawas on Mon Sep 22, 2014 8:37 am

As long as I take Revlimid, I do take daily Innohep (tinzaparin) injection to avoid blood clots.