ERd

Say it: E R D

Elotuzumab, lenalidomide and dexamethasone

ERd is a three medicine plan for multiple myeloma that has come back, combining an antibody (elotuzumab), daily pills (lenalidomide) and a steroid (dexamethasone).

Also called: ERD, Elo-Rd, Elo-Len-Dex, elotuzumab lenalidomide dexamethasone, Empliciti Revlimid dexamethasone

What it is

Elotuzumab attaches to a protein (SLAMF7) on myeloma cells and helps natural killer cells, a type of immune cell, attack them. Lenalidomide boosts the immune system and slows myeloma growth. Dexamethasone kills myeloma cells directly. The goal is to control the myeloma for as long as possible.

Often used for

• multiple myeloma that has come back after 1 to 3 earlier treatments

First 2 cycles

Elotuzumab is given every week (days 1, 8, 15 and 22).

Cycle 3 onward

Elotuzumab is given every 2 weeks (days 1 and 15). Treatment continues as long as it works and is tolerated.

The medicines in this plan

Elotuzumab

Antibody given through a vein over about 1 to 2 hours (longer the first time). Weekly for the first 2 cycles, then every 2 weeks.

Lenalidomide

Capsules taken by mouth once a day on days 1 to 21 of each 28 day cycle.

Dexamethasone

Steroid given weekly. On elotuzumab days, part is taken by mouth and part is given through a vein before the infusion.

How you get it

Elotuzumab is given in the clinic through a vein after medicines that help prevent infusion reactions. Lenalidomide is taken at home. Each cycle is 28 days. Your schedule may be different.

A typical cycle

Elotuzumab days

Premedicines (antihistamine, acid blocker, acetaminophen and dexamethasone), then the elotuzumab infusion.

Days 1 to 21

Lenalidomide capsule once a day at home.

Days 22 to 28

Rest week with no lenalidomide.

Every cycle

Blood tests to check counts, kidneys and myeloma proteins.

Common side effects and what helps

• Infusion reactions such as fever, chills or a change in blood pressure, mostly with the first doses. Premedicines help prevent them.
• Tiredness. Rest and short walks can help.
• Diarrhea or constipation. Drink fluids and tell your team if it lasts.
• Low white blood cell counts and infections, including colds and pneumonia. Wash your hands often and stay away from people who are sick.
• Cough or stuffy nose.
• Swelling in the legs or feet. Raise your legs when you sit.
• Muscle cramps or back pain.
• Trouble sleeping, mood changes and high blood sugar on dexamethasone days. Take it in the morning with food.

Call your care team right away if you have

• A fever of 100.4 degrees Fahrenheit (38 degrees Celsius) or higher, or chills
• Trouble breathing, chest tightness or feeling faint during or after an infusion
• Swelling, pain or warmth in one leg or arm, or sudden shortness of breath (signs of a blood clot)
• Trouble breathing, chest pain, or a fast or pounding heartbeat
• Bleeding that will not stop, blood in your urine or stool, or many new bruises
• Painful skin rash with blisters, which can be shingles

Good to know

• Lenalidomide can cause severe birth defects. You must follow a safety program: pregnancy tests and birth control for those who could become pregnant, and condoms for men. Do not donate blood or sperm.
• Lenalidomide raises the risk of blood clots. Most people take aspirin or another blood thinner.
• Elotuzumab can show up in some myeloma protein blood tests. Your team knows how to read these results.
• People on this plan have a higher chance of infections, including shingles. You may take an antiviral medicine to prevent shingles.
• Elotuzumab may slightly raise the chance of a second cancer over time. Your team will keep up with routine checks.

At home

• Take lenalidomide at the same time each day. Swallow it whole and do not open the capsules.
• On elotuzumab days, take the dexamethasone pills when your team tells you, so they work in time.
• Take your blood thinner and any antiviral medicine as prescribed.
• Drink plenty of fluids unless told to limit them.
• Wash your hands often and stay away from people who are sick.

Questions to ask

• How long will each infusion visit take?
• How long will I stay on this treatment?
• Which blood thinner should I take?
• Should I get any vaccines before or during treatment?
• How will we track whether the myeloma is responding?

Multiple myeloma

Last updated: 2026-10-27. Medically reviewed by Veli Bakalov, MD, medical oncologist (October 2026). General education from Step by Step, the patient portal of HemeOncBuddy.