What is thalidomide, and how does it work (mechanism of action)?
Thalidomide is an oral medication used for treating the skin conditions of leprosy, a disease caused by a parasite, Mycobacterium leprae. The mechanism of action of thalidomide is not well understood. The immune system reaction to Mycobacterium leprae plays an important role in producaing the skin manifestations of leprosy. Scientists believe that thalidomide modifies the reaction of the immune system to Mycobacterium leprae and thereby suppresses the skin reaction. Thalidomide also is being evaluated as a treatment for HIV and several other conditions. Thalidomide was approved by the FDA in July 1998.
What brand names are available for thalidomide?
Thalomid
Is thalidomide available as a generic drug?
GENERIC AVAILABLE: No
Do I need a prescription for thalidomide?
Yes
What are the uses for thalidomide?
Thalidomide is prescribed for the treatment and prevention of skin conditions that result from leprosy, and multiple myelomas. Off-label uses include the treatment of tuberculosis, aphthous ulcers, HIV-wasting syndrome, Crohn's disease, and Kaposi's sarcoma.
What are the side effects of thalidomide?
WARNING: Thalidomide is very harmful to the fetus. Therefore, thalidomide should be avoided during pregnancy. Men and women who are taking thalidomide should use appropriate methods of birth control. Moreover, women of childbearing age should practice two forms of birth control concurrently. Men taking thalidomide should not donate sperm, and thalidomide users should not donate blood since the recipients of the sperm and blood may receive small amounts of thalidomide.
The most common side effects are:
- drowsiness,
- headache,
- dizziness,
- low blood pressure,
- weakness, and
- rash.
Other important side effects include:
- impotence,
- diarrhea,
- constipation, and
- increased sensitivity.
Thalidomide also causes nerve damage (peripheral neuropathy), slow heart rate, hypertension, hypotension, and a decrease in white blood cells. Symptoms of nerve damage are tingling, numbness and pain in the feet or hands.
What is the dosage for thalidomide?
The recommended adult dose is 100-400 mg daily for treatment of leprosy. The dose for treating multiple myeloma is 200 mg daily in combination with dexamethasone. Thalidomide should be administered in the evening at least one hour after meals and with a full glass of water.
SLIDESHOW
Understanding Cancer: Metastasis, Stages of Cancer, and More See SlideshowWhich drugs or supplements interact with thalidomide?
Thalidomide increases the sedative effect of alcohol and other drugs that cause drowsiness (for example, diazepam [Valium]). Drugs that slow heart rate add to the heart slowing effects of thalidomide. Examples of such drugs include calcium channel blockers (CCBs), beta blockers, and digoxin (Lanoxin). The incidence of peripheral neuropathy increases when thalidomide is combined with other drugs (for example, amiodarone [Cordarone], cisplatin, phenytoin [Dilantin, Dilantin-125]) that also cause peripheral neuropathy.
What else should I know about thalidomide?
What preparations of thalidomide are available?
Capsules: 50, 100, 150, and 200 mg
How should I keep thalidomide stored?
Thalidomide should be store at room temperature 15 C - 30 C (59 F - 86 F) and protected from light.
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Summary
Thalidomide (Thalomid) is a drug prescribed for the treatment and prevention of skin conditions that result from leprosy and multiple myelomas. Off-label uses include the treatment of tuberculosis (TB), aphthous ulcers, HIV-wasting syndrome, Crohn's disease, and Kaposi's sarcoma. Review side effects, drug interactions, dosage, and information about preventing birth defects prior to taking this medication.
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Related Disease Conditions
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Leprosy
Leprosy (Hansen's disease) is a disfiguring disease caused by infection with Mycobacterium leprae bacteria. The disease is spread from person to person through nasal secretions or droplets. Symptoms and signs of leprosy include numbness, loss of temperature sensation, painless ulcers, eye damage, loss of digits, and facial disfigurement. Leprosy is treated with antibiotics and the dosage and length of time of administration depends upon which form of leprosy the patient has.
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Canker Sores
Canker sores are a common complaint, and are small ulcers on the inside of the mouth. Canker sores aren't contagious (as opposed to cold sores), and typically last for 10-14 days usually healing without scarring. A variety of things cause canker sores, for example, medications (aspirin, beta-blockers, NSAIDs, high blood pressure medication, and antibiotics); injury to the mouth from dental work, braces, or sports accidents; acidic foods; allergies; and diseases or conditions like celiac disease, Crohn's disease, and lupus. Canker sores can be cure with home remedies, and prescription and OTC topical and oral medication.
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Multiple Myeloma
Multiple myeloma is a form of cancer that develops in plasma cells, the white blood cells that make antibodies. Symptoms include bone pain, weakness, extreme thirst, nausea, frequent urination, and broken bones. Treatment of multiple myeloma depends upon the staging and symptoms of the disease.
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Scleroderma
Scleroderma is an autoimmune disease of the connective tissue. It is characterized by the formation of scar tissue (fibrosis) in the skin and organs of the body, leading to thickness and firmness of involved areas. Scleroderma is also referred to as systemic sclerosis, and the cause is unknown. Treatment of scleroderma is directed toward the individual features that are most troubling to the patient.
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Graft Versus Host Disease (GVHD)
Graft versus host disease (GVHD) is a condition that happens when immune cells from transplanted donor tissue attack the recipient's tissues. Signs and symptoms of acute GVHD include enteritis, hepatitis, and dermatitis. Chronic GVHD symptoms and signs include rash, skin discoloration, dry mouth or eyes, jaundice, fatigue, and wheezing, among others. The standard of GVHD treatment is immunosuppressant medications.
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What Is Weber-Christian Disease?
Weber-Christian disease is a rare inflammatory disease that affects the body's fat tissues. The disorder appears on the skin as red or purple tender, raised lumps usually on the thighs and lower legs. Other symptoms may include nausea, vomiting, weight loss, joint pain, and abdominal pain. There is no cure for the disease, but anti-inflammatory medications may help with inflammation.
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Castleman Disease
Castleman disease is a group of related conditions. It is a rare disease with an unknown prevalence. Castleman disease is caused by an abnormal growth of lymphocytes, a type of white blood cell. There are two types of Castleman disease; 1) unicentric, and 2) multicentric. Castleman disease is diagnosed by biopsy of the suspected lymph nodes. Castleman disease is treated with medications (for example, corticosteroids, chemotherapy drugs, immunodilating drugs, interferon-alfa, and antiviral medications), surgery, and radiation therapy. The life expectancy for a person with Castleman disease is difficult to determine because the condition is rare and takes different forms.
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