The Educational Health Care Professional’s Kit shall contain the following elements: • Brief background on lenalidomide and its licensed indication • Posology • The need to avoid foetal exposure due to teratogenicity of lenalidomide in animals and the expected teratogenic effect of lenalidomide in humans including a summary of the interim results of study CC-5013-TOX-004 • Obligations of the health care professional in relation to the prescribing of Revlimid o Need to provide comprehensive advice and counselling to patients o That patients should be capable of complying with the requirements for the safe use of Revlimid o Need to provide patients with appropriate patient educational brochure and patient card • Safety advice relevant to all patients o Description and management of neutropenia and thrombocytopenia including incidence rates from clinical trials o Description and management of thromboembolic risk including incidence rates from clinical trials o Use in patients with hepatic and/or renal impairment o Disposal of unwanted medicine o Local country specific arrangements for a prescription for Revlimid to be dispensed o Description of risk of hypothyroidism o Explanation of unknown risk of neuropathy with long term use • Description of the PPP and categorisation of patients based on sex and childbearing potential o Algorithm for implementation of PPP o Definition of women of childbearing potential (WCBP) and actions the physician should take if unsure • Safety advice for women of childbearing potential o The need to avoid foetal exposure o Description of the PPP o Need for adequate contraception (even if woman has amenorrhoea) and definition of adequate contraception o Pregnancy test regime Advice on suitable tests Before commencing treatment During treatment based on method of contraception After finishing treatment o Need to stop Revlimid immediately upon suspicion of pregnancy o Need to tell treating doctor immediately upon suspicion of pregnancy • Safety advice for men o The need to avoid foetal exposure o The need to use condoms if sexual partner is a WCBP (even if man has had a vasectomy) During Revlimid treatment For one week following final dose. o That if his partner becomes pregnant whilst he is taking Revlimid or shortly after he has stopped taking Revlimid he should inform his treating doctor immediately • Requirements in the event of pregnancy o Instructions to stop Revlimid immediately upon suspicion of pregnancy o Need to refer to physician specialised or experienced in dealing with teratology and its diagnosis for evaluation and advice o Local contact details for reporting of any suspected pregnancy 64 o Pregnancy reporting form • Check list for physicians ensuring that patients receive the appropriate counselling concerning the treatment, contraceptive methods and pregnancy prevention appropriate for their sex and childbearing status • Adverse event reporting forms
72 • Conseils de sécurité pour les hommes o Nécessité de prévenir l’ exposition fœ tale o Nécessité d’ utiliser des préservatifs si leur partenaire est susceptible de procréer (même si l’ homme est vasectomisé) Pendant le traitement par Revlimid Pendant une semaine après la prise de la dernière dose. o Si la partenaire du patient découvre une grossesse alors qu’ il prend Revlimid ou immédiatement après l'arrêt du traitement par Revlimid, il doit en informer immédiatement son médecin traitant • Exigences en cas de grossesse o Instructions d’ arrêter immédiatement Revlimid en cas de suspicion de grossesse o Nécessité d’ orienter la patiente vers un médecin spécialisé ou expérimenté en tératologie et en diagnostic prénatal pour évaluation et conseil o Coordonnées locales permettant de signaler une suspicion de grossesse o Formulaire de signalement de grossesse • Liste de vérification pour les médecins permettant de s’ assurer que les patients ont reçu des informations appropriées concernant le traitement, les méthodes de contraception et la prévention des grossesses, adaptés à leur sexe et à leur potentiel de procréation • Formulaires de signalement d’ effets indésirables