Thalidomide
About Thalidomide
Thalidomide is used to treat multiple myeloma (a type of cancer). It is also used to treat and prevent symptoms of erythema nodosum leprosum (ENL) and as maintenance therapy for the prevention and suppression of erythema nodosum leprosum recurrence. ENL is an immune-mediated inflammatory complication of leprosy.
Thalidomide contains thalidomide, which helps control the growth of cancer cells. It supports the body’s immune response and slows the spread of cancer. It also helps reduce the blood supply that tumours need to grow. This helps manage multiple myeloma.
Take Thalidomide as prescribed by your doctor. You may experience common side effects such as constipation, dizziness, sleepiness, tiredness, tremors (shaking movements), dysaesthesia (abnormal sensation), low blood cell count, nausea, vomiting, and swelling of hands and feet. Talk to your doctor if you experience any of these side effects persistently.
Do not take Thalidomide if you are pregnant, as it might cause severe birth defects or the death of an unborn baby. Avoid taking Thalidomide if you are breastfeeding. Thalidomide may cause dizziness, sleepiness, and blurred vision, so drive only if you are alert. Thalidomide is not recommended for children under 18 years old.
Uses of Thalidomide
Medicinal Benefits
Thalidomide, when used as prescribed, may provide the following benefits:
For Multiple Myeloma:
- Helps control the growth of cancer cells in the bone marrow.
- Supports treatment when used along with other cancer medicines.
- Helps improve disease control and overall treatment response.
For Erythema Nodosum Leprosum (ENL):
- Helps reduce swelling, redness, and pain associated with this inflammatory condition.
- Calms immune-related inflammation.
- Improves comfort and quality of life during flare-ups.
Directions for Use
- Thalidomide should be taken at least one hour after meals.
- It is usually taken once daily, preferably at bedtime, or as prescribed by your doctor.
- Swallow Thalidomide as a whole with a glass of water.
- Do not crush, chew, or open it.
Storage
Side Effects of Thalidomide
- Constipation
- Dizziness
- Sleepiness
- Tiredness
- Tremor (shaking movements)
- Dysaesthesia (abnormal sensation)
- Low blood cell count
- Swelling of hands and feet
- Nausea
- Vomiting
- Indigestion
Medicines Containing this Salt
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Drug Warnings
- Do not take Thalidomide if you are allergic to any of its components.
- Inform your doctor if you have/had blood clots, a heart attack, neuropathy, a slow heart rate, high blood pressure, low blood pressure, infections, a viral infection, HIV, hepatitis B, epilepsy, liver or kidney problems.
- Do not take Thalidomide if you are pregnant, as it might cause severe birth defects or the death of the unborn baby.
- Avoid taking Thalidomide if you are breastfeeding, as it is not known if it passes into breastmilk.
- Thalidomide may cause dizziness, sleepiness, and blurred vision; therefore, drive only if you are alert.
- Thalidomide is not recommended for children under 18 years, as safety and efficacy have not been established.
- Avoid consuming alcohol with Thalidomide as it could lead to increased dizziness and sleepiness.
- Thalidomide, when taken with dexamethasone, increases the risk of deep vein thrombosis and pulmonary embolism.
- Stop taking Thalidomide and consult a doctor immediately if you think you are pregnant, if you have irregular periods, missed a period, have any change in menstrual bleeding, or if you have had sex without using two forms of birth control.
Drug Interactions
Drug-Drug Interactions: Inform your doctor if you are taking any of the following medicines, as there may be an interaction.
- Anticancer medicines (Thiotepa, Vincristine)
• Potential effect: May increase the risk of blood clots and other serious complications. - Hormone-related medicine (Ethinylestradiol)
• Potential effect: May increase the risk of blood clots and raise the chance of serious complications. - Immunity-lowering medicines (Tofacitinib, Baricitinib)
• Potential effect: May increase the risk of infections due to added immune suppression.
Drug-Food Interactions: No interactions found/established.
Drug-Disease Interactions: Inform your doctor if you have a history of the following conditions before taking Thalidomide.
- Seizures (fits)
- HIV infection
- Hypotension (low blood pressure)
- Neuropathy (nerve damage)
- Neutropenia (low levels of neutrophils)
Drug-Drug Interactions Checker List:
Safety Advice
Alcohol
unsafeYou are recommended to avoid alcohol consumption while taking Thalidomide as it might cause increased sleepiness.
Pregnancy
unsafeThalidomide belongs to pregnancy category X. Thalidomide should not be taken during pregnancy as it causes severe birth defects or death to an unborn baby. Use highly effective contraception if you are a woman of child-bearing age. Inform your doctor if you are pregnant, think you are pregnant or planning for pregnancy.
Breast Feeding
unsafeAvoid breastfeeding while taking Thalidomide as it is unknown if Thalidomide passes into breastmilk.
Driving
unsafeThalidomide may cause dizziness, sleepiness, and blurred vision. Do not drive or operate heavy machinery unless you are alert.
Liver
cautionPlease consult your doctor if you have a liver impairment or any concerns regarding this.
Kidney
cautionPlease consult your doctor if you have kidney impairment or any concerns regarding this.
Children
unsafeThalidomide is not recommended for children below 18 years as safety and effectiveness have not been established.
Habit Forming
Diet & Lifestyle Advise
Diet:
- Maintain a healthy, balanced diet to achieve an appropriate weight.
- Include iron-rich foods like lean meat, raisins, and green vegetables.
- Include fibre-rich foods, such as whole grains, fruits, and beans, to prevent constipation.
- Drink plenty of water to support digestion and reduce the risk of constipation.
Physical Activity:
- Do light to moderate exercise regularly to maintain strength and circulation.
- Avoid activities that increase the risk of injury if feeling weak or dizzy.
Habits & Safety:
- Avoid smoking and alcohol consumption.
- Use effective birth control as advised, as Thalidomide can cause serious birth defects.
- Do not donate blood during treatment.
- Take the medicine at night if it causes drowsiness and avoid driving if feeling sleepy.
Special Advise
- Do not take Thalidomide if you are pregnant, as it might cause severe birth defects or death of the unborn baby.
- Male patients taking Thalidomide must not donate semen and should use effective contraception during sexual activity even though they have undergone a vasectomy (male sterilization surgery).
- You must not donate blood while taking Thalidomide and for 4 weeks after discontinuing Thalidomide.
- Thalidomide might increase the risk of blood clots, so consult a doctor if you notice any symptoms such as chest pain, shortness of breath, swelling of an arm or leg.
Patients Concern
Disease/Condition Glossary
Multiple myeloma: Multiple myeloma is a type of cancer that affects a type of white blood cell called plasma cells. These cells accumulate in the bone marrow and proliferate unchecked, leading to kidney and bone damage. Symptoms include bone pain, loss of appetite, fever, and frequent infections. Generally, multiple myeloma cannot be cured, but the signs and symptoms can be substantially reduced or disappear over time.
Erythema Nodosum Leprosum (ENL): It is an immune-mediated inflammatory complication of leprosy. It is a painful disorder characterised by tender bumps under the skin, fever, arthritis, and fatigue.
FAQs
Thalidomide belongs to the group of medicines called immunomodulatory agents used to treat multiple myeloma. Thalidomide is also used to treat and prevent symptoms of erythema nodosum leprosum (ENL) and as maintenance therapy for the prevention and suppression of erythema nodosum leprosum recurrence.
Thalidomide stops the development of cancer cells, stops the blood vessels growing in cancer, and stimulates the part of the immune system to attack the cancer cells. Thereby, Thalidomide helps treat multiple myeloma.
Do not stop taking Thalidomide on your own. You are advised to take Thalidomide for as long as your doctor has prescribed it for you, depending on your medical condition. Do not hesitate to speak with your doctor if you experience any difficulties while taking Thalidomide.
Orthostatic hypotension could be a side-effect of Thalidomide. Orthostatic hypotension is a sudden lowering of blood pressure leading to dizziness on standing. If you experience this, do not try to stand up suddenly or start walking, instead lie down and get up slowly only when you feel better.
No, it is not safe to father a child while taking Thalidomide. Thalidomide is present in the semen of male patients taking Thalidomide; it could cause severe birth defects or death of the unborn baby. During sexual activity with females of reproductive potential, always use effective contraception such as latex or synthetic condom while taking Thalidomide and for at least 4weeks after discontinuing Thalidomide, even if you have undergone a successful vasectomy. Male patients taking Thalidomide must not donate semen.
Patients taking Thalidomide must not donate blood during the treatment with Thalidomide and for 4weeks after discontinuation of Thalidomide as the donated blood might be given to pregnant women whose foetus should not be exposed to thalidomide since it causes severe birth defects or death of the unborn baby.
People with multiple myeloma taking Thalidomide may have an increased risk for blood clots in veins, arteries, and lungs. The risk is higher if you take dexamethasone with Thalidomide for treating multiple myeloma. Consult your doctor immediately if you notice symptoms such as shortness of breath, chest pain, and swelling in the legs or arm.
Thalidomide may cause side effects such as nausea, vomiting, indigestion, dizziness, heartburn, constipation, tiredness, tremor or swelling of hands and feet. If these side effects persist or worsen, please consult your doctor.
If you forget to take a dose of Thalidomide, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take the next scheduled dose in the prescribed time. Do not double the dose to make up for the missed one, as this may increase the risk of side effects.
