| Lymphoma, Follicular

Revlimid vs Rituxan Hycela

Side-by-side clinical, coverage, and cost comparison for lymphoma, follicular.

Deep comparison between: Revlimid vs Rituxan Hycela with Prescriber.AI

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Safety signalsRituxan Hycela has a higher rate of injection site reactions vs Revlimid based on FDA-approved prescribing information

Coverage gaps3 major payers require step therapy for Rituxan Hycela but not Revlimid, including UnitedHealthcare

Category

Revlimid

Rituxan Hycela

At A Glance

RouteOral

FrequencyDaily on Days 1-21 of repeated 28-day cycles

ClassImmunomodulatory agent targeting cereblon

RouteSC injection

FrequencyEvery 3-4 weeks

ClassCD20-directed antibody

Indications

Multiple Myeloma
Myelodysplastic Syndrome with Isolated del(5q)
Mantle cell lymphoma
Lymphoma, Follicular
Marginal Zone B-Cell Lymphoma

Lymphoma, Follicular
Diffuse Large B-Cell Lymphoma
Chronic Lymphocytic Leukemia

Dosing

Multiple Myeloma (combination therapy) 25 mg orally once daily on Days 1-21 of repeated 28-day cycles, in combination with dexamethasone

Multiple Myeloma (maintenance therapy following auto-HSCT) 10 mg orally once daily continuously on Days 1-28 of repeated 28-day cycles

Myelodysplastic Syndrome with Isolated del(5q) 10 mg orally once daily

Mantle cell lymphoma 25 mg orally once daily on Days 1-21 of repeated 28-day cycles

Follicular Lymphoma 20 mg orally once daily on Days 1-21 of repeated 28-day cycles for up to 12 cycles, in combination with a rituximab-product

Marginal Zone B-Cell Lymphoma 20 mg orally once daily on Days 1-21 of repeated 28-day cycles for up to 12 cycles, in combination with a rituximab-product

Lymphoma, Follicular 1,400 mg/23,400 Units SC; for relapsed/refractory FL, once weekly for 3 or 7 weeks following an initial IV rituximab dose (4 or 8 weeks total); for previously untreated FL, on Day 1 of Cycles 2-8 of chemotherapy every 21 days, then maintenance every 8 weeks for 12 doses; for non-progressing FL after CVP, once weekly for 3 weeks every 6 months to a maximum of 16 doses.

Diffuse Large B-Cell Lymphoma 1,400 mg/23,400 Units SC on Day 1 of Cycles 2-8 of CHOP chemotherapy every 21 days for up to 7 cycles following an initial IV rituximab dose at Day 1, Cycle 1 (up to 6-8 cycles total).

Chronic Lymphocytic Leukemia 1,600 mg/26,800 Units SC on Day 1 of Cycles 2-6 in combination with fludarabine and cyclophosphamide every 28 days for 5 cycles following an initial IV rituximab dose at Day 1, Cycle 1 (6 cycles total).

Contraindications

Pregnancy
Severe hypersensitivity to lenalidomide including angioedema, Stevens-Johnson syndrome, toxic epidermal necrolysis

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Drug Interactions

1200View drug interactions

636View drug interactions

Adverse Reactions

Most common (>=20%) - Multiple Myeloma combination therapy Diarrhea, anemia, constipation, peripheral edema, neutropenia, fatigue, back pain, nausea, asthenia, insomnia

Most common (>=20%) - Multiple Myeloma maintenance therapy Neutropenia, thrombocytopenia, leukopenia, anemia, upper respiratory tract infection, bronchitis, diarrhea, rash, fatigue

Most common (>=20%) - Myelodysplastic Syndromes Thrombocytopenia, neutropenia, pruritus, rash, diarrhea, constipation, nausea, nasopharyngitis, cough, dyspnea, pharyngitis, epistaxis, fatigue, pyrexia, peripheral edema, asthenia, arthralgia, back pain, muscle cramp

Most common (>=20%) - Mantle Cell Lymphoma Neutropenia, thrombocytopenia, anemia, fatigue, diarrhea, nausea, cough, dyspnea, rash, pruritus

Most common (>=20%) - Follicular and Marginal Zone Lymphoma Neutropenia, fatigue, diarrhea, constipation, nausea, cough

Serious Venous thromboembolism, arterial thromboembolism, infections including pneumonia, second primary malignancies, hepatotoxicity, severe cutaneous reactions, tumor lysis syndrome, tumor flare reactions

Postmarketing Hypothyroidism, hyperthyroidism, hepatic failure, toxic hepatitis, angioedema, anaphylaxis, acute graft-versus-host disease, viral reactivation, progressive multifocal leukoencephalopathy, pneumonitis, Stevens-Johnson Syndrome, toxic epidermal necrolysis, drug reaction with eosinophilia and systemic symptoms

Most common (>=20%) Infections, neutropenia, nausea, constipation, cough, fatigue (FL); infections, neutropenia, alopecia, nausea, anemia (DLBCL); infections, neutropenia, nausea, thrombocytopenia, pyrexia, vomiting, injection site erythema (CLL).

Serious Mucocutaneous reactions, hepatitis B reactivation, progressive multifocal leukoencephalopathy, hypersensitivity and administration reactions, tumor lysis syndrome, infections, cardiac arrhythmias, renal toxicity, bowel obstruction and perforation.

Postmarketing Prolonged pancytopenia, fatal cardiac failure, uveitis, viral infections including PML, Kaposi's sarcoma progression, severe mucocutaneous reactions, pyoderma gangrenosum, bowel obstruction and perforation, fatal bronchiolitis obliterans, fatal interstitial lung disease.

Pharmacology

Lenalidomide is an immunomodulatory agent that mediates cellular activities through binding to cereblon, a component of a cullin ring E3 ubiquitin ligase enzyme complex, leading to degradation of substrate proteins and resulting in direct cytotoxic and immunomodulatory effects.

Anti-CD20 chimeric murine/human IgG1 monoclonal antibody that binds the CD20 antigen on pre-B and mature B-lymphocytes, mediating B-cell lysis via complement dependent cytotoxicity (CDC) and antibody dependent cell mediated cytotoxicity (ADCC); combined with hyaluronidase human, which transiently depolymerizes subcutaneous hyaluronan to enhance rituximab absorption into systemic circulation.

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Most Common Insurance

Anthem BCBS

Revlimid