Thalidomide

What is Thalidomide

Thalidomide has immunomodulatory, antiangiogenic, and antitumor properties, although its exact mechanism of action is unknown.

It is indicated for the acute treatment of the cutaneous manifestations of moderate to severe erythema nodosum leprosum (ENL) and as maintenance therapy for prevention and suppression of the cutaneous manifestations of ENL recurrence.

It is not indicated as monotherapy for acute ENL treatment in the presence of moderate to severe neuritis.

Thalidomide is also indicated in combination with dexamethasone for the treatment of patients with newly diagnosed multiple myeloma.

Thalidomide is a known teratogen that may cause birth defects or embryo-fetal death. Routine pregnancy testing is required in females of reproductive potential.

Brand Name

Thalomid

Indications

1. AIDS-associated wasting syndrome
2. aphthous ulcer
3. astrocytoma
4. Behcet’s syndrome
5. cachexia
6. Crohn’s disease
7. discoid lupus erythematosus
8. erythema nodosum leprosum (ENL)
9. graft-versus-host disease (GVHD)
10. Kaposi’s sarcoma
11. malignant glioma
12. multiple myeloma
13. myelodysplastic syndrome (MDS)
14. peripheral T-cell lymphoma (PTCL)
15. prurigo
16. systemic lupus erythematosus (SLE)

Side Effects

1. abdominal pain
2. acne vulgaris
3. agitation
4. agitation
5. alopecia
6. amblyopia
7. amenorrhea
8. amnesia
9. anaphylactoid reactions
10. anemia
11. angioedema
12. anorexia
13. anorexia
14. anxiety
15. anxiety
16. arthralgia
17. asthenia
18. asthenia
19. atrial fibrillation
20. back pain
21. bleeding
22. blurred vision
23. bradycardia
24. bullous rash
25. carpal tunnel syndrome
26. chills
27. confusion
28. confusion
29. constipation
30. constipation
31. cough
32. cyanosis
33. depression
34. diabetes mellitus
35. diarrhea
36. diplopia
37. dizziness
38. dizziness
39. Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)
40. dyspepsia
41. dyspnea
42. dyspnea
43. edema
44. edema
45. elevated hepatic enzymes
46. eosinophilia
47. epistaxis
48. eructation
49. erythema multiforme
50. erythema nodosum
51. euphoria
52. exfoliative dermatitis
53. fatigue
54. fatigue
55. fetal death
56. fever
57. fever
58. flatulence
59. galactorrhea
60. GI bleeding
61. GI obstruction
62. GI perforation
63. gynecomastia
64. headache
65. hearing loss
66. hematuria
67. hepatitis
68. hyperbilirubinemia
69. hyperbilirubinemia
70. hyperesthesia
71. hyperglycemia
72. hyperhidrosis
73. hyperkalemia
74. hypertension
75. hypertonia
76. hyperuricemia
77. hypocalcemia
78. hypocalcemia
79. hypoesthesia
80. hypokalemia
81. hypomagnesemia
82. hyponatremia
83. hypophosphatemia
84. hypotension
85. hypothyroidism
86. ichthyosis
87. impotence (erectile dysfunction)
88. increased urinary frequency
89. infection
90. insomnia
91. interstitial lung disease
92. leukemia
93. leukocytosis
94. leukopenia
95. leukopenia
96. lymphadenopathy
97. lymphoma
98. lymphopenia
99. maculopapular rash
100. malaise
101. muscle cramps
102. myalgia
103. myasthenia
104. myocardial infarction
105. myocarditis
106. nausea
107. nausea
108. neuritis
109. neutropenia
110. neutropenia
111. new primary malignancy
112. nystagmus
113. ocular pain
114. oliguria
115. organ transplant rejection
116. orthostatic hypotension
117. pancytopenia
118. paresthesias
119. peptic ulcer
120. pericarditis
121. peripheral edema
122. peripheral neuropathy
123. peripheral neuropathy
124. peripheral vasodilation
125. petechiae
126. pharyngitis
127. photosensitivity
128. pleural effusion
129. pneumonitis
130. proteinuria
131. pruritus
132. psychosis
133. pulmonary embolism
134. pulmonary hypertension
135. purpura
136. pyuria
137. rash
138. rash
139. renal failure (unspecified)
140. rhinitis
141. seborrhea
142. seizures
143. SIADH
144. sinus tachycardia
145. sinusitis
146. skin necrosis
147. splenomegaly
148. Stevens-Johnson syndrome
149. stomatitis
150. stroke
151. suicidal ideation
152. syncope
153. teratogenesis
154. thrombocytopenia
155. thromboembolism
156. thrombosis
157. tinnitus
158. toxic epidermal necrolysis
159. tremor
160. tremor
161. tumor lysis syndrome (TLS)
162. urticaria
163. vertigo
164. vertigo
165. vomiting
166. weakness
167. weakness
168. weight gain
169. weight gain
170. weight loss
171. weight loss
172. xerophthalmia
173. xerosis
174. xerostomia
175. xerostomia

Monitoring Parameters

• CBC with differential
• heart rate
• platelet count
• pregnancy testing
• serum electrolytes
• serum uric acid

Contraindications

• accidental exposure
• bleeding
• blood donation
• bradycardia
• breast-feeding
• contraception requirements
• driving or operating machinery
• dysfunctional uterine bleeding
• ethanol ingestion
• geriatric
• GI bleeding
• human immunodeficiency virus (HIV) infection
• infertility
• intrauterine fetal death
• male-mediated teratogenicity
• menstrual irregularity
• myocardial infarction
• neutropenia
• orthostatic hypotension
• peripheral neuropathy
• pregnancy
• pregnancy testing
• reproductive risk
• seizure disorder
• seizures
• serious rash
• sperm donation
• stroke
• thalidomide hypersensitivity
• thrombocytopenia
• thromboembolism
• treatment outside of a clinical trial
• tumor lysis syndrome (TLS)

Interactions

• Acebutolol
• Acetaminophen; Dichloralphenazone; Isometheptene
• Acetaminophen; Pentazocine
• Acetaminophen; Tramadol
• Aliskiren; Amlodipine
• Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
• Alpha-blockers
• Amiodarone
• Amitriptyline
• Amitriptyline; Chlordiazepoxide
• Amlodipine
• Amlodipine; Atorvastatin
• Amlodipine; Benazepril
• Amlodipine; Celecoxib
• Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
• Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
• Amlodipine; Olmesartan
• Amlodipine; Telmisartan
• Amlodipine; Valsartan
• Anxiolytics; Sedatives; and Hypnotics
• Atenolol
• Atenolol; Chlorthalidone
• Azelastine
• Azelastine; Fluticasone
• Barbiturates
• Bendroflumethiazide; Nadolol
• Benzodiazepines
• Beta-blockers
• Betaxolol
• Bismuth Subcitrate Potassium; Metronidazole; Tetracycline
• Bismuth Subsalicylate; Metronidazole; Tetracycline
• Bisoprolol
• Bisoprolol; Hydrochlorothiazide, HCTZ
• Bortezomib
• Brimonidine; Timolol
• Buspirone
• Butorphanol
• Butyrophenone
• Calcium-channel blockers
• Cannabidiol
• Carbidopa; Levodopa; Entacapone
• Carteolol
• Carvedilol
• Cenobamate
• Cetirizine
• Cetirizine; Pseudoephedrine
• Cimetidine
• Cisplatin
• Clevidipine
• Clomipramine
• Clozapine
• COMT inhibitors
• Darbepoetin Alfa
• Denosumab
• Desipramine
• Deutetrabenazine
• Dexamethasone
• Dienogest; Estradiol valerate
• Digoxin
• Diltiazem
• Disulfiram
• Docetaxel
• Dorzolamide; Timolol
• Doxazosin
• Doxepin
• Drospirenone
• Drospirenone; Estradiol
• Drospirenone; Ethinyl Estradiol
• Drospirenone; Ethinyl Estradiol; Levomefolate
• Elagolix; Estradiol; Norethindrone acetate
• Enalapril; Felodipine
• Entacapone
• Epoetin Alfa
• Esketamine
• Esmolol
• Estradiol; Levonorgestrel
• Estradiol; Norethindrone
• Estradiol; Norgestimate
• Ethanol
• Ethinyl Estradiol
• Ethinyl Estradiol; Desogestrel
• Ethinyl Estradiol; Ethynodiol Diacetate
• Ethinyl Estradiol; Etonogestrel
• Ethinyl Estradiol; Levonorgestrel
• Ethinyl Estradiol; Levonorgestrel; Ferrous bisglycinate
• Ethinyl Estradiol; Levonorgestrel; Folic Acid; Levomefolate
• Ethinyl Estradiol; Norelgestromin
• Ethinyl Estradiol; Norethindrone
• Ethinyl Estradiol; Norethindrone Acetate
• Ethinyl Estradiol; Norethindrone Acetate; Ferrous fumarate
• Ethinyl Estradiol; Norethindrone; Ferrous fumarate
• Ethinyl Estradiol; Norgestimate
• Ethinyl Estradiol; Norgestrel
• Etonogestrel
• Famotidine
• Famotidine; Ibuprofen
• Felodipine
• Fenofibric Acid
• Fosphenytoin
• Gabapentin
• H2-blockers
• Hydrochlorothiazide, HCTZ; Metoprolol
• Hydrochlorothiazide, HCTZ; Propranolol
• Imipramine
• Isradipine
• Labetalol
• Lasmiditan
• Lemborexant
• Leuprolide; Norethindrone
• Levobetaxolol
• Levobunolol
• Levocetirizine
• Levonorgestrel
• Lithium
• Lofexidine
• Loxapine
• Lumateperone
• Lurasidone
• Mestranol; Norethindrone
• Methocarbamol
• Metoprolol
• Metronidazole
• Molindone
• Nadolol
• Nalbuphine
• Nebivolol
• Nebivolol; Valsartan
• Nefazodone
• Nicardipine
• Nifedipine
• Nimodipine
• Nisoldipine
• Nizatidine
• Non-oral combination contraceptives
• Norethindrone
• Norgestrel
• Nortriptyline
• Opiate Agonists
• Oral Contraceptives
• Oritavancin
• Paclitaxel
• Pamidronate
• Penbutolol
• Pentazocine
• Pentazocine; Naloxone
• Perindopril; Amlodipine
• Perphenazine; Amitriptyline
• Phenothiazines
• Phenoxybenzamine
• Phentolamine
• Phenytoin
• Pimozide
• Pindolol
• Pramipexole
• Prazosin
• Pregabalin
• Propranolol
• Protriptyline
• Ramelteon
• Ranitidine
• Reserpine
• Ropinirole
• Sedating H1-blockers
• Segesterone Acetate; Ethinyl Estradiol
• Skeletal Muscle Relaxants
• Sotalol
• Succinylcholine
• Terazosin
• Thiothixene
• Timolol
• Tizanidine
• Tolcapone
• Tramadol
• Trandolapril; Verapamil
• Trazodone
• Trimipramine
• Verapamil
• Vincristine
• Vincristine Liposomal
• Zoledronic Acid