About
Thalidomide is a complex immunomodulatory drug possessing significant anti-angiogenic, anti-inflammatory, and anti-neoplastic properties. Its primary therapeutic applications include the treatment of multiple myeloma, often in combination with corticosteroids like dexamethasone, and for the management of erythema nodosum leprosum (ENL). In multiple myeloma, its multifaceted mechanism involves inhibiting the formation of new blood vessels, modulating the production of various cytokines (such as reducing TNF-α), and directly inducing apoptosis in malignant plasma cells. Despite its historical context, thalidomide has been successfully repurposed, demonstrating high efficacy in these specific conditions, albeit requiring stringent risk evaluation and mitigation strategies due to its profound teratogenic potential.
Uses
- Multiple myeloma
- Erythema nodosum leprosum (ENL)
- Refractory Crohn's disease (off-label)
- Graft-versus-host disease (off-label)
Directions For Use
Take orally, usually once daily at bedtime, as directed by your physician. Adhere strictly to the prescribed dosage and safety program.
Benefits
- Effective in multiple myeloma treatment.
- Reduces inflammation in ENL.
- Immunomodulatory effects.
- Anti-angiogenic properties.
- Can be used in combination regimens.
- Oral administration for convenience.
Side Effects
- Somnolence (drowsiness)
- Peripheral neuropathy
- Constipation
- Thromboembolism (blood clots)
- Rash
- Fatigue
- Dizziness
- Bradycardia
- Neutropenia
- Hypothyroidism
- Teratogenicity (severe birth defects)
- Orthostatic hypotension
Safety Measures
- Alcohol - Avoid alcohol as it can exacerbate central nervous system side effects like drowsiness and dizziness.
- Pregnancy - Thalidomide is a potent human teratogen, causing severe and life-threatening birth defects. It is absolutely contraindicated in pregnancy; strict adherence to a risk evaluation and mitigation strategy (REMS) program is mandatory.
- Breastfeeding - Breastfeeding is contraindicated during thalidomide therapy due to the potential for serious adverse effects in the infant.
- Liver - Use with caution in patients with hepatic impairment; monitor liver function tests regularly. Dose adjustments may be necessary.
- Kidney - Use with caution in patients with renal impairment; monitor kidney function tests regularly. Dose adjustments may be necessary.
- Lung - Rare cases of interstitial lung disease have been reported. Monitor for new or worsening respiratory symptoms.
Disclaimer
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