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
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