Thalidomide

This information from Lexicomp® explains what you need to know about this medication, including what it’s used for, how to take it, its side effects, and when to call your healthcare provider.

Brand Names: US

Thalomid

Brand Names: Canada

Thalomid

Warning

  • Do not take this drug if you are pregnant. Even 1 dose during pregnancy may cause birth defects or loss of the unborn baby.
  • You must have 2 pregnancy tests that show you are NOT pregnant before starting this drug. You must have pregnancy tests done while taking this drug. Talk with your doctor.
  • If you may become pregnant, you must either not have sex or you must use 2 kinds of birth control when you have sex. Do this for at least 4 weeks before starting this drug, during treatment and any treatment breaks, and for at least 4 weeks after your last dose. Call your doctor right away if you have sex without using 2 kinds of birth control, if you think you may be pregnant, or if you miss your period during this time frame.
  • If your sex partner is pregnant or may get pregnant, always use a latex or synthetic condom during sex. Do this even if you have had a vasectomy. Use a latex or synthetic condom during treatment, during any breaks in treatment, and for at least 4 weeks after your last dose.
  • If you have unprotected sex with a partner who is or may get pregnant, or your partner gets pregnant within 4 weeks of your last dose, call your doctor right away.
  • The chance of blood clots in your veins or lungs may be raised with this drug. Call your doctor right away if you have any chest pain or pressure; coughing up blood; shortness of breath; or pain, warmth, or swelling of the legs or arms.

What is this drug used for?

  • It is used to treat multiple myeloma.
  • It is used to treat skin signs of leprosy.
  • It may be given to you for other reasons. Talk with the doctor.

What do I need to tell my doctor BEFORE I take this drug?

  • If you are allergic to this drug; any part of this drug; or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had.
  • If you are taking pembrolizumab or nivolumab.
  • If you are breast-feeding. Do not breast-feed while you take this drug.

This is not a list of all drugs or health problems that interact with this drug.

Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take this drug with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.

What are some things I need to know or do while I take this drug?

  • Tell all of your health care providers that you take this drug. This includes your doctors, nurses, pharmacists, and dentists.
  • Avoid driving and doing other tasks or actions that call for you to be alert until you see how this drug affects you.
  • To lower the chance of feeling dizzy or passing out, rise slowly if you have been sitting or lying down. Be careful going up and down stairs.
  • Have your blood work and other lab tests checked as you have been told by your doctor.
  • Do not donate blood while using this drug and for 1 month after stopping.
  • If you touch a broken capsule, or the drug inside the capsule, wash the area with soap and water.
  • You may have more of a chance of getting an infection. Some infections have been severe or deadly. Wash hands often. Stay away from people with infections, colds, or flu.
  • Call your doctor right away if you have any signs of infection like fever, chills, flu-like signs, very bad sore throat, ear or sinus pain, cough, more sputum or change in color of sputum, pain with passing urine, mouth sores, or a wound that will not heal.
  • You may bleed more easily. Be careful and avoid injury. Use a soft toothbrush and an electric razor.
  • Avoid alcohol, marijuana or other forms of cannabis, or prescription or OTC drugs that may slow your actions.
  • This drug may cause nerve problems. Most of the time, nerve problems have happened after long-term use over a few months. Nerve problems have also happened after short-term use. Signs of nerve problems may happen some time after the last dose of this drug. The signs may go away slowly or may not go away at all.
  • Severe skin reactions may happen with this drug. These include Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and other serious reactions. Sometimes, body organs may also be affected. These reactions can be deadly. Get medical help right away if you have signs like red, swollen, blistered, or peeling skin; red or irritated eyes; sores in your mouth, throat, nose, eyes, genitals, or any areas of skin; fever; chills; body aches; shortness of breath; or swollen glands.
  • If you are 65 or older, use this drug with care. You could have more side effects.
  • People who are pregnant or of childbearing age must not touch the capsules.
  • Certain other drugs may cause hormone-based birth control like birth control pills to not work. Be sure to tell your doctor or pharmacist about all drugs you take.
  • Hormone-based birth control like birth control pills may also raise the risk of blood clots.
  • IUDs and other implanted birth control may raise the risk of infection and bleeding in patients who have blood cell problems with this drug.
  • Do not donate sperm while using this drug and for 1 month after stopping.
  • This drug may affect being able to father a child. Talk with the doctor.

What are some side effects that I need to call my doctor about right away?

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

  • Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
  • Signs of bleeding like throwing up or coughing up blood; vomit that looks like coffee grounds; blood in the urine; black, red, or tarry stools; bleeding from the gums; abnormal vaginal bleeding; bruises without a cause or that get bigger; or bleeding you cannot stop.
  • Signs of low calcium levels like muscle cramps or spasms, numbness and tingling, or seizures.
  • A burning, numbness, or tingling feeling that is not normal.
  • Seizures.
  • Very bad dizziness or passing out.
  • Fast or slow heartbeat.
  • Swelling.
  • Swollen gland.
  • Feeling confused.
  • Not able to get or keep an erection.
  • Patients with cancer who take this drug may be at a greater risk of getting a severe health problem called tumor lysis syndrome (TLS). This may lead to death. Call your doctor right away if you have a fast or abnormal heartbeat; any passing out; trouble passing urine; muscle weakness or cramps; upset stomach, throwing up, diarrhea, or not able to eat; or feel sluggish.
  • The chance of heart attack or stroke due to blood clots may be raised. Call your doctor right away if you have signs of heart attack like chest pain that may spread to the arms, neck, jaw, back, or stomach; abnormal sweating; or feeling sick or throwing up. Call your doctor right away if you have signs of stroke like weakness on 1 side of the body; eyesight, speech, or balance problems; drooping on 1 side of the face; feeling confused; or severe headache.

What are some other side effects of this drug?

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

  • Feeling dizzy, sleepy, tired, or weak.
  • Constipation.
  • Headache.
  • Upset stomach.
  • Decreased appetite.
  • Dry skin.
  • Dry mouth.
  • Anxiety.
  • Shakiness.
  • Weight gain or loss.
  • Muscle or joint pain.

These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.

You may report side effects to your national health agency.

You may report side effects to the FDA at 1-800-332-1088. You may also report side effects at https://www.fda.gov/medwatch.

How is this drug best taken?

Use this drug as ordered by your doctor. Read all information given to you. Follow all instructions closely.

  • If taking once daily, take with water at bedtime at least 1 hour after the evening meal.
  • Swallow whole. Do not chew, break, or crush.
  • Do not open the capsules.
  • If someone else is giving you this drug, be sure that person wears gloves to avoid contact with this drug.

What do I do if I miss a dose?

  • Take a missed dose as soon as you think about it and go back to your normal time.
  • If it has been 12 hours or more since the missed dose, skip the missed dose and go back to your normal time.
  • Do not take 2 doses at the same time or extra doses.

How do I store and/or throw out this drug?

  • Store at room temperature protected from light. Store in a dry place. Do not store in a bathroom.
  • Store in original container.
  • Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
  • Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.

General drug facts

  • If your symptoms or health problems do not get better or if they become worse, call your doctor.
  • Do not share your drugs with others and do not take anyone else’s drugs.
  • Some drugs may have another patient information leaflet. If you have any questions about this drug, please talk with your doctor, nurse, pharmacist, or other health care provider.
  • This drug comes with an extra patient fact sheet called a Medication Guide. Read it with care. Read it again each time this drug is refilled. If you have any questions about this drug, please talk with the doctor, pharmacist, or other health care provider.
  • If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

Consumer Information Use and Disclaimer

This generalized information is a limited summary of diagnosis, treatment, and/or medication information. It is not meant to be comprehensive and should be used as a tool to help the user understand and/or assess potential diagnostic and treatment options. It does NOT include all information about conditions, treatments, medications, side effects, or risks that may apply to a specific patient. It is not intended to be medical advice or a substitute for the medical advice, diagnosis, or treatment of a health care provider based on the health care provider’s examination and assessment of a patient’s specific and unique circumstances. Patients must speak with a health care provider for complete information about their health, medical questions, and treatment options, including any risks or benefits regarding use of medications. This information does not endorse any treatments or medications as safe, effective, or approved for treating a specific patient. UpToDate, Inc. and its affiliates disclaim any warranty or liability relating to this information or the use thereof. The use of this information is governed by the Terms of Use, available at https://www.wolterskluwer.com/en/know/clinical-effectiveness-terms.

Last Reviewed Date

2023-04-13

Copyright

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Last Updated

Monday, December 12, 2022