Uses
Thalidomide is used in combination with dexamethasone to treat multiple myeloma. This medicine is also used to treat moderate to severe new lesions of leprosy and as maintenance treatment to prevent and keep erythema nodosum leprosum (skin lesions of leprosy) from coming back. Thalidomide works on the immune system to reduce inflammation. It also interferes with the growth of multiple myeloma cells, which are eventually destroyed in the body. Thalidomide is an antineoplastic (cancer medicine) and leprostatic agent.
Dosage
The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
For oral dosage form (capsules):
For erythema nodosum leprosum:
Adults and children 12 years of age and older—At first, 100 to 300 milligrams (mg) once a day. Your doctor may adjust your dose as needed.
Children younger than 12 years of age—Use and dose must be determined by your doctor.
For multiple myeloma (in combination with dexamethasone):
Adults and children 12 years of age and older—200 milligrams (mg) once a day in a 28-day cycle.
Children younger than 12 years of age—Use and dose must be determined by your doctor.
Warnings and Precautions
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:
Allergies
Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.
Pediatric
Appropriate studies have not been performed on the relationship of age to the effects of thalidomide in children younger than 12 years of age. Safety and efficacy have not been established.
Geriatric
Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of thalidomide in the elderly. However, elderly patients are more likely to have unwanted effects (eg, blood clotting problems, heart rhythm problem), which may require caution and an adjustment in the dose for patients receiving this medicine.
Breastfeeding
Studies in women breastfeeding have demonstrated harmful infant effects. An alternative to this medication should be prescribed or you should stop breastfeeding while using this medicine.
Thalidomide can temporarily lower the number of white blood cells in your blood, increasing the chance of getting an infection. It can also lower the number of platelets, which are necessary for proper blood clotting. If this occurs, there are certain precautions you can take, especially when your blood count is low, to reduce the risk of infection or bleeding:
If you can, avoid people with infections. Check with your doctor right away if you think you are getting an infection or if you get a fever or chills, cough or hoarseness, lower back or side pain, or painful or difficult urination.
Check with your doctor right away if you notice any unusual bleeding or bruising, black, tarry stools, blood in the urine or stools, or pinpoint red spots on your skin.
Be careful when using a regular toothbrush, dental floss, or toothpick. Your medical doctor, dentist, or nurse may recommend other ways to clean your teeth and gums. Check with your medical doctor before having any dental work done.
Do not touch your eyes or the inside of your nose unless you have just washed your hands and have not touched anything else in the meantime.
Be careful not to cut yourself when you are using sharp objects such as a safety razor or fingernail or toenail cutters.
Avoid contact sports or other situations where bruising or injury could occur.
This medicine may cause nerve problems, including peripheral neuropathy. Check with your doctor right away if you have tingling, burning, numbness, or painful sensations, unsteadiness, or weakness in the arms, hands, legs, or feet.
This medicine may cause dizziness and low blood pressure. Check with your doctor right away if you have chills, cold sweats, confusion, or dizziness, faintness, or lightheadedness when getting up suddenly from lying or sitting position. Sit upright for a few minutes before standing up.
Check with your doctor right away if you have chest pain or discomfort, lightheadedness, dizziness, or fainting, slow or irregular heartbeat, trouble breathing, or unusual tiredness. These may be symptoms of bradycardia (slow heartbeat).
