How it is administered

Thalidomide is taken by mouth as a capsule. 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 works as an immunomodulatory agent, meaning it helps regulate the immune system. Its exact mechanism in multiple myeloma is not fully understood, but it is known to act through a protein called cereblon, which is part of a complex that helps tag certain proteins for destruction in cells.

Thalidomide has several actions: it can reduce inflammation, suppress the production of tumor necrosis factor-alpha (a substance involved in inflammation and cancer cell growth), and inhibit the growth of new blood vessels (angiogenesis) that tumors need to grow. In multiple myeloma, thalidomide also increases the activity of natural killer cells and certain immune system chemicals (cytokines) that help attack cancer cells. These combined effects help slow the growth of myeloma cells and can improve patient outcomes when used with other medications.

Who Should take it

Thalidomide is indicated for adults with newly diagnosed multiple myeloma, in combination with dexamethasone. It is used as part of the initial treatment to help control the disease and improve response rates.

Your doctor may recommend thalidomide if you are newly diagnosed with multiple myeloma and are able to take oral medications. It is important to follow your healthcare provider's instructions closely and to participate in the required safety monitoring program due to the medication's risks.

Who should not take it

Thalidomide must NOT be taken by women who are pregnant or who could become pregnant, as it can cause severe birth defects or death to an unborn baby, even after a single dose. Women of childbearing potential must use two forms of birth control and have regular pregnancy tests before, during, and after treatment.

People with a known allergy to thalidomide or any of its components should not take this medication. It should also be used with caution or avoided in patients with severe nerve damage (peripheral neuropathy), severe low white blood cell or platelet counts, or those who cannot comply with the strict safety measures required.

Commonly used with

Thalidomide is most commonly used in combination with dexamethasone, a steroid medication, for the treatment of multiple myeloma. It may also be used with other chemotherapy agents or supportive medications as part of a broader treatment plan, depending on your individual needs and your doctor's recommendations.

Commonly tested with

In clinical studies for multiple myeloma, thalidomide has been tested in combination with dexamethasone. It has also been studied with other chemotherapy agents and supportive treatments to assess its effectiveness and safety in various combinations for blood cancers.