THALIDOMIDE

Immunomodulatory medicine

Dosage Forms

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Tablet

50 mg

Uses

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  • Multiple myeloma (first line in untreated patients ≥ 65 years)
  • Erythema nodosum leprosum (a complication of leprosy)

Dose and Duration

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All uses

Adult over 18 years: 200 mg once daily at bedtime for 6-week cycle (max 12 cycles).

Child below 18 years: not recommended.

Contra-indications

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  • Pregnancy
  • Hypersensitivity
  • Women of child bearing potential
  • Patients unable to comply with the required contraceptive measures

Side Effects

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  • Weakness, drowsiness, dysaesthesia, tingling or pricking sensation, headache, dizziness
  • Joint pain, muscle pain, peripheral neuropathy
  • Constipation, dyspepsia, dry mouth, vomiting
  • Cardiac failure, deep vein thrombosis, hypotension, syncope
  • Depression
  • Dry skin, fever
  • Haematuria
  • Hepatic disorders
  • Myelosuppression
  • Peripheral oedema
  • Pneumonia, pulmonary embolism, interstitial lung disease
  • Rash, Stevens-Johnson syndrome, toxic skin eruption

Patient Instructions

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  • Seek medical advice if you develop fever, sore throat, chest pain, bleeding or swelling of a limb.
  • Seek medical advice if signs such as paraesthesia, abnormal coordination or weakness develop.

Pregnancy

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  • Do not use.

Breast-feeding

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  • Do not use.

⚠️ Caution

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  • Monitor white blood cell and platelet count. Reduce dose or interrupt treatment if neutropoenia or thrombocytopenia develop.
  • Thromboprophylaxis may be required in the first 5 months in patients with other risk factors to thrombosis.
  • Rule out pregnancy before starting treatment. Thalidomide is teratogenic. Women and men must practice effective contraception at least 1 month before, during, and for at least 1 month after treatment.
  • Avoid using combined oral contraceptives and copper-releasing intrauterine devices.
  • Use with caution in severe hepatic failure and severe renal failure. Monitor liver function.