How it is administered

Thalidomide is taken by mouth in the form of capsules. It is available in 50 mg, 100 mg, 150 mg, and 200 mg capsules. The medication should be swallowed whole with water, preferably at bedtime and at least 1 hour after the evening meal.

How it works

Thalidomide is an immunomodulatory agent, which means it helps regulate the immune system. Its exact mechanism of action is not fully understood, but it is known to work by affecting a protein called cereblon, which is part of a complex that helps control the breakdown of other proteins in cells. Thalidomide has several effects: it can reduce inflammation, suppress the production of certain immune signals (like tumor necrosis factor-alpha), and inhibit the growth of new blood vessels (angiogenesis).

In blood cancers such as multiple myeloma, thalidomide helps slow the growth of cancer cells and can increase the activity of natural killer cells, which are part of the immune system's defense against cancer. Its ability to modulate the immune response and reduce inflammation makes it useful in treating certain blood cancers.

Who Should take it

Thalidomide is indicated for use in combination with dexamethasone for the treatment of patients with newly diagnosed multiple myeloma, a type of blood cancer. It is also used for the acute treatment and maintenance therapy of moderate to severe erythema nodosum leprosum (ENL), a complication of leprosy, but this is not related to blood cancer.

For patients with blood cancers, especially multiple myeloma, thalidomide may be recommended as part of the initial treatment regimen to help control the disease and improve outcomes. It is important that the medication is prescribed and monitored by a healthcare professional experienced in treating blood cancers.

Who should not take it

Thalidomide must not be taken by women who are pregnant or who may become pregnant, as it can cause severe birth defects or death to an unborn baby. Even a single dose can be harmful. Women of childbearing potential must use effective contraception and have regular pregnancy tests before, during, and after treatment.

People who have shown hypersensitivity (allergic reactions) to thalidomide or any of its components should not take this medication. Caution is also advised in patients with severe nerve damage (peripheral neuropathy), heart disease, or a history of blood clots, as thalidomide can worsen these conditions.

Commonly used with

Thalidomide is most commonly used in combination with dexamethasone, a corticosteroid, for the treatment of multiple myeloma. It may also be used with other chemotherapy agents as part of a broader treatment regimen for blood cancers.

Because thalidomide can increase the risk of blood clots, patients may also be prescribed blood thinners (anticoagulants) to help reduce this risk.

Commonly tested with

In clinical studies, thalidomide has been tested in combination with dexamethasone for multiple myeloma. It has also been studied with other chemotherapy drugs and supportive care medications to determine the best treatment combinations for blood cancers.

Patients taking thalidomide may have regular blood tests to monitor for side effects such as low blood counts, liver function, and kidney function.