About

Thalidomide is an immunomodulatory drug with anti-angiogenic and anti-inflammatory properties, primarily used in the treatment of multiple myeloma and certain manifestations of leprosy. Its exact mechanism of action in multiple myeloma is complex and involves several pathways, including inhibition of angiogenesis, modulation of cytokine production (e.g., TNF-alpha), and direct anti-tumor effects by inducing apoptosis in myeloma cells. In leprosy, it is effective in treating erythema nodosum leprosum (ENL).

Due to its severe teratogenic effects, thalidomide is subject to strict risk management programs to prevent exposure during pregnancy. Despite its historical notoriety, its unique immunomodulatory and anti-angiogenic properties have made it a valuable therapeutic agent for specific conditions where its benefits outweigh the risks, particularly in combination therapies for multiple myeloma. Close monitoring for peripheral neuropathy and thromboembolic events is crucial during treatment.

Uses

Treatment of multiple myeloma in combination with dexamethasone.
Acute treatment of the cutaneous manifestations of moderate to severe erythema nodosum leprosum (ENL).
Maintenance treatment of ENL to prevent recurrence.
Off-label use in certain other inflammatory or neoplastic conditions.

Directions For Use

Take orally, usually at bedtime, with water, as directed by your physician. Adhere strictly to the risk management program.

Benefits

Effective in treating multiple myeloma.
Reduces inflammation in erythema nodosum leprosum.
Modulates immune response.
Inhibits angiogenesis (formation of new blood vessels).
Can be used in combination therapies for enhanced efficacy.
Improves quality of life for ENL patients.

Side Effects

Peripheral neuropathy
Drowsiness/Sedation
Constipation
Fatigue
Rash
Thromboembolism (DVT, PE)
Dizziness
Orthostatic hypotension
Tremor
Neutropenia
Bradycardia
Teratogenicity

Safety Measures

Alcohol - Avoid or limit alcohol consumption as it can exacerbate central nervous system side effects like drowsiness and dizziness.
Pregnancy - Thalidomide is a severe human teratogen and is absolutely contraindicated in pregnancy. Strict contraception and participation in a risk management program are mandatory.
Breastfeeding - It is unknown if thalidomide is excreted in human milk. Due to the potential for serious adverse reactions in breastfed infants, breastfeeding is contraindicated.
Liver - Use with caution in patients with hepatic impairment. Liver function should be monitored, and dose adjustments may be considered.
Kidney - No specific dose adjustment is generally required for renal impairment, but caution is advised, and monitoring for side effects is important.
Lung - Rare cases of interstitial lung disease have been reported. Monitor for new or worsening respiratory symptoms like cough or dyspnea.

Disclaimer

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