Thalidomide
1 medicine
Thalidomide is an immunomodulatory medicine used for multiple myeloma and severe leprosy reactions; a single dose taken during pregnancy can cause severe birth defects, so it is dispensed only under a strict pregnancy-prevention program.
Key facts
- Thalidomide is an immunomodulatory and anti-inflammatory medicine used mainly for multiple myeloma and for severe inflammatory reactions in leprosy.
- A single dose taken during pregnancy can cause severe birth defects, including missing or shortened limbs and damage to internal organs. It is dispensed only through a strict pregnancy-prevention program with mandatory contraception and pregnancy testing.
- It also increases the risk of dangerous blood clots and of nerve damage (peripheral neuropathy), which can become permanent.
- Seek urgent care for leg swelling or pain, sudden breathlessness, or new numbness, tingling, or weakness in the hands or feet.
What thalidomide treats
Thalidomide treats multiple myeloma, a cancer of plasma cells in the bone marrow, usually combined with a steroid and other anti-cancer drugs. It also treats erythema nodosum leprosum, a painful inflammatory skin reaction that occurs in some people with leprosy. It is prescribed only under specialist supervision.
How thalidomide works
Thalidomide changes how immune cells signal to each other, reducing production of tumour necrosis factor-alpha and other inflammatory chemicals, and it blocks the growth of new blood vessels that feed tumours and inflamed tissue. In multiple myeloma it also disrupts the survival of cancer cells directly.
Before you take it
- Thalidomide must never be taken during pregnancy. It is one of the most powerful known human teratogens, and a single dose taken early in pregnancy can cause severe limb, ear, eye, heart, and gut defects.
- Anyone who can become pregnant must use two reliable forms of contraception, undergo regular pregnancy testing, and follow the pregnancy-prevention program exactly. Men taking thalidomide must use condoms, since the drug is present in semen.
- Tell your prescriber about a history of blood clots, nerve damage, a slow heart rate, or seizures.
- Do not donate blood or semen while taking thalidomide.
Side effects
Common effects include drowsiness, constipation, dry mouth, dizziness, and tremor.
Stop and seek urgent medical care for any of these:
- Numbness, tingling, or weakness in the hands or feet.
- Leg swelling or pain, or sudden shortness of breath and chest pain.
- Unusual bruising, bleeding, or signs of infection from a low blood cell count.
- Any suspicion of pregnancy.
Safety essentials
- Pregnancy prevention is the overriding rule: thalidomide causes severe, irreversible birth defects even after a single exposure, so it is supplied only under a controlled program with contraception, pregnancy testing, and strict tablet accounting.
- It increases the risk of dangerous blood clots, especially when combined with steroids or chemotherapy; your prescriber may add a blood-thinning medicine.
- Peripheral neuropathy can become permanent if the drug is continued after symptoms start, so report any new numbness, tingling, or pain right away so your dose can be reviewed.
This page is educational and does not replace advice from a doctor or pharmacist who knows your health history.