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Thalidomide

About Thalidomide

Thalidomide is 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. Multiple myeloma is a type of cancer that affects a type of white blood cells called plasma cells. ENL is an immune-mediated inflammatory complication of leprosy.
 
Thalidomide contains ‘Thalidomide’, which works by helping the body’s immune system and directly attacks cancer. It 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.

You are advised to take Thalidomide for as long as your doctor has prescribed it for you, depending on your medical condition. In some cases, you may experience certain common side effects such as constipation, dizziness, sleepiness, tiredness, tremors, dysaesthesia (abnormal sensation), low blood cell count, nausea, vomiting, and swelling of hands and feet. Speak with 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 below 18 years as safety and effectiveness have not been established. Avoid consuming alcohol along with Thalidomide as it could lead to increased dizziness. Inform your doctor about your health condition and medications to rule out any side effects/interactions.

Uses of Thalidomide

Treatment of Multiple myeloma, Erythema Nodosum Leprosum (ENL)

Medicinal Benefits

Thalidomide belongs to the group of medicines called immunomodulatory agents used to treat multiple myeloma. Thalidomide works by helping the body’s immune system and directly attacks cancer. It 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. Thalidomide is also used to treat and prevent skin symptoms of erythema nodosum leprosum and as maintenance therapy for prevention and suppression of erythema nodosum leprosum recurrence.

Directions for Use

Swallow Thalidomide as a whole with water; do not crush or chew it.

Storage

Store in a cool and dry place away from sunlight

Side Effects of Thalidomide

  • Constipation
  • Dizziness
  • Sleepiness
  • Tiredness
  • Tremor
  • Dysaesthesia (abnormal sensation)
  • Low blood cell count
  • Swelling of hands and feet
  • Nausea
  • Vomiting
  • Indigestion

Drug Warnings

Do not take Thalidomide if you are allergic to any of its components. Inform your doctor if you have/had blood clots, heart attack, neuropathy, slow heart rate, high blood pressure, low blood pressure, infections, 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 unknown if it passes into breastmilk. Thalidomide may cause dizziness, sleepiness and blurred vision, so drive only if you are alert. Thalidomide is not recommended for children. 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 have 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: Thalidomide may interact with digitalis glycosides (digoxin), blood thinner (warfarin), bisphosphonate (pamidronate), anti-depressant (duloxetine), antipsychotics (aripiprazole, prochlorperazine), antibiotic (levofloxacin), pain killer (tramadol), anti-neoplastic agent (bortezomib), antiemetic (ondansetron), barbiturates (pentobarbital, phenobarbital, secobarbital), antihistamines, anxiolytics, hypnotics, opiate derivatives, anticholinesterases, herbal supplement used to treat depression (St. John’s wort) and beta-blockers.

Drug-Food Interactions: No interactions found/established.

Drug-Disease Interactions: Inform your doctor if you have seizures, HIV infection, hypotension, neuropathy, or neutropenia (low levels of neutrophils).

Drug-Drug Interactions Checker List:

  • DIGOXIN
  • WARFARIN
  • DULOXETINE
  • ARIPIPRAZOLE
  • PROCHLORPERAZINE
  • LEVOFLOXACIN
  • TRAMADOL
  • BORTEZOMIB
  • ONDANSETRON
  • PHENOBARBITAL
  • SECOBARBITAL
  • Safety Advice

    • Safety Warning

      Alcohol

      unsafe

      You are recommended to avoid alcohol consumption while taking Thalidomide as it might cause increased sleepiness.

    • Safety Warning

      Pregnancy

      unsafe

      Thalidomide 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.

    • Safety Warning

      Breast Feeding

      unsafe

      Avoid breastfeeding while taking Thalidomide as it is unknown if Thalidomide passes into breastmilk.

    • Safety Warning

      Driving

      unsafe

      Thalidomide may cause dizziness, sleepiness, and blurred vision. Do not drive or operate heavy machinery unless you are alert.

    • Safety Warning

      Liver

      caution

      Please consult your doctor if you have a liver impairment or any concerns regarding this.

    • Safety Warning

      Kidney

      caution

      Please consult your doctor if you have kidney impairment or any concerns regarding this.

    • Safety Warning

      Children

      unsafe

      Thalidomide is not recommended for children below 18 years as safety and effectiveness have not been established.

    Habit Forming

    No

    Diet & Lifestyle Advise

    • Eat a healthy diet and exercise regularly to maintain proper weight.

    • Avoid smoking and alcohol consumption.

    • Include food rich in iron, such as lean red meat, raisins, bell peppers, Brussel sprouts, and broccoli.

    • To prevent constipation, consume fibre rich foods such as whole grains, broccoli, dried fruits, nuts, beans, apples, oranges, and pears. 

    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 vasectomy.

    • 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 arm or leg.

    Patients Concern

    Disease/Condition Glossary

    Multiple myeloma: Multiple myeloma is a type of cancer that affects a type of white blood cells called plasma cells. These cells collect in the bone marrow and divide uncontrollably, 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 reduced greatly or disappear after a period of 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 be reluctant to speak with your doctor if you experience any difficulty while taking Thalidomide.

    Orthostatic hypotension could be a side-effect of Thalidomide. Orthostatic hypotension is a sudden lowering in 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.

    Available Medicines for

    Thalidomide

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