THALIDOMIDE

Thalidomide is an immunomodulatory agent with anti-cancer, anti-inflammatory, and anti-infective properties. It received FDA approval on 16th July 1998 for medical use.

Thalidomide is used to treat moderate to severe leprosy in combination with dexamethasone and is indicated for treating patients with newly diagnosed multiple myeloma. It is also indicated as maintenance therapy for the prevention and suppression of the cutaneous manifestations of erythema nodosum leprosum (ENL) recurrence. Thalidomide is also sometimes used to treat certain skin conditions involving swelling and irritation.

Temozolomide is a prescription drug available as an oral capsule. The drug will be prescribed by the healthcare professional. Your physician will determine the medicine's dose, dosage form, and frequency. Take the capsule as a single dose at bedtime. Swallow the capsule whole with water. Avoid crushing or chewing the capsule. Wash your skin carefully with soap and water in case of contact with a broken capsule.

The common side effects of thalidomide are sleepiness, rashes, headache, dizziness, impotence, decreased energy or strength, pain, tenderness, low calcium, and blood count levels, swelling of hands and feet, constipation, numbness or tingling sensation, nausea, and reduced appetite, anxiety, depression, confusion and mood swings, fever, weight loss or weight gain, indigestion, vomiting, dry mouth, muscle cramps, blurred vision, ear problems, and kidney damage. Other serious effects include nerve damage, decreased blood pressure, low WBC count, slow heartbeat, serious allergic reactions, tumor lysis syndrome, sudden pain in the chest or difficulty breathing, pain and swelling in the legs, and bleeding or bruising without injury.

If thalidomide is taken during pregnancy, it can cause severe birth defects or embryo-fetal death. It should never be used if you are pregnant, suspecting to be pregnant, or trying for pregnancy. Even one capsule regardless of its strength, taken during pregnancy can cause severe harmful effects on the fetus. Inform your physician if you are pregnant during the treatment or planning to get pregnant. Increased risk of deep vein thrombosis and pulmonary embolism in patients with multiple myeloma taking thalidomide with dexamethasone.

This drug may reduce the effectiveness of oral contraceptives; using two reliable methods of contraception is necessary. The drug may cause allergic reactions; notify your doctor if you see any signs of rash, itchy skin, redness, Swelling of your lips or tongue, sudden cough, and low blood pressure. Inform your physician if you have any kidney disease, liver disease, lung disease, blood/bleeding problems, or infection and about all the other prescribed, over-the-counter medicines, vitamins, nutritional supplements, or herbal medications you take. Avoid consuming alcohol while taking Thalidomide. Female patients with reproductive potential should take pregnancy tests frequently. Avoid consuming alcohol or operating heavy machinery after taking this medication.

Thalidomide must not be used by patients who are pregnant or suspect pregnancy. Effective contraception is required for at least 4 weeks before starting treatment, throughout the treatment period, and for at least 4 weeks after stopping Thalidomide. Handle this medication with disposable gloves to prevent skin contact. Patients must not donate blood or sperm during treatment and for seven days after completing Thalidomide therapy.

Celgene Europe B.V, Electronic Medicines Compendium (EMC), [Revised on Aug 2021] [Accessed on 21/02/2023], https://www.medicines.org.uk/emc/files/pil.6317.pdf Celgene Corporation, US Food and Drug Administration, [Revised on Jun 2019] [Accessed on 21/02/2023], https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/020785s067lbl.pdf Douglas F. Lake and Adrienne D. Briggs, Immunopharmacology, Lange’s Basic & Clinical Pharmacology, 14th Edition, 2018, 977-1002. D.H. Dockrell, S. Sundar, B.J. Angus, R.P. Hobson, Infectious Disease, Davidson’s Principles and Practice of Medicine, 22nd Edition, 2014, 293-386.