Uses of Thalamia: - Multiple myeloma - Lepra reaction Multiple myeloma, Erythema nodosum leprosum Hypersensitivity. Pregnancy and lactation.

Anti-Leprotic drugs, Immunosuppressant

Thalidomide is a synthetic glutamic acid derivative immunomodulator with anti-inflammatory, antiangiogenetic, sedative and hypnotic activity.In patients with erythema nodosum leprosum (ENL) the mechanism of action is not fully understood. Available data from in vitro studies and preliminary clinical trials suggest that the immunologic effects of this compound can vary substantially under different conditions, but may be related to suppression of excessive tumor necrosis factor-alpha (TNF-a) production and down-modulation of selected cell surface adhesion molecules involved in leukocyte migration. For example, administration of thalidomide has been reported to decrease circulating levels of TNF-a in patients with ENL, however, it has also been shown to increase plasma TNF-a levels in HIV-seropositive patients. As a cancer treatment, the drug may act as a VEGF inhibitor.

How to use Thalidomide: Take this medicine in the dose and duration as advised by your doctor. Do not chew, crush or break it. Thalidomide is to be taken empty stomach. Administration: Should be taken on an empty stomach. Take on an empty stomach at least 1 hr after a meal, w/ a full glass of water. Adult Dose: Oral Erythema nodosum leprosum (Type 2) Adult: 100-300 mg once daily at bedtime, reduced gradually by 50 mg every 2-4 wk once a satisfactory reponse is achieved. Not for monotherapy if moderate or severe neuritis present. Max: 400 mg/day. Patients < 50 kg: Initially, 100 mg daily. Multiple myeloma Adult: Initial dose of 200 mg once daily, increased by 100 mg at wkly intervals according to patient tolerance. Max: 800 mg daily.

Thalidomide enhances sedative activity of barbiturates, alcohol, chlorpromazine and reserpine. Avoid use of other drugs that have the potential to cause peripheral neuropathy. Increased risk of thromboembolic events with darbepoetin-alfa and doxorubicin. Potentially Fatal: Increased risk of bone marrow supression with peg interferon alfa.

Hypersensitivity. Pregnancy and lactation.

Common - Headache - Sleepiness - Nausea - Rash - Weakness - Dizziness - Edema (swelling) - Loss of appetite - Decreased white blood cell count - Decreased calcium level in blood - Weight gain - Fatigue - Muscle weakness - Fever - Anxiety - Blood clots - Dry skin - Weight loss - Confusion - Decreased white blood cell count (neutrophils) - Neuropathy - Constipation - Tremor >10% Somnolence (37%),Rash (21%),Edema (57%),Hypotension (16%),Leukopenia (17-35%),Neutropenia (31%),Increased bilirubin (14%),Myalgia (17%),Arthralgia (13%),Hematuria (11%),Thrombosis/embolism (23%),Headache (12%),Dyspnea (42%) 1-10% Asthenia (8%),General pain (8%),Impotence (8%),Malaise (8%),Pruritus (8%),Xerostomia (8%),Flatulence (8%),Tooth pain (4%),Impotence (3-8%),Vertigo (8%),Constipation (4%),Diarrhea (4%),Neck rigidity (4%) Frequency Not Defined Photosensitivity,Bradycardia,Hypo/hypertension,Peripheral neuropathy,Neutropenia Potentially Fatal: Stevens-Johnson syndrome, toxic epidermal necrolysis and blood dyscrasias.

Pregnancy Category X. Studies in animals or human beings have demonstrated foetal abnormalities or there is evidence of foetal risk based on human experience or both, and the risk of the use of the drug in pregnant women clearly outweighs any possible benefit. The drug is contraindicated in women who are or may become pregnant.

Precaution: All females of childbearing potential must use 2 reliable forms of contraception simultaneously 4 wk before starting therapy, during and 4 wk after therapy is discontinued. Therapy to be stopped immediately if pregnancy occurs. Male: Use of barrier methods of contraception if partner is of child-bearing potential. Do not donate blood or sperm during therapy. Patient should not drive or operate machinery. Discontinue therapy if any skin rash develops. Do not resume therapy if the rash is exfoliative, purpuric, or bullous, or if Stevens-Johnson syndrome or toxic epidermal necrolysis suspected. Lactation: not known if excreted in breast milk, not recommended

Anti-Leprotic drugs, Immunosuppressant

Thalidomide is a synthetic glutamic acid derivative immunomodulator with anti-inflammatory, antiangiogenetic, sedative and hypnotic activity.

Pregnancy Category X. Studies in animals or human beings have demonstrated foetal abnormalities or there is evidence of foetal risk based on human experience or both, and the risk of the use of the drug in pregnant women clearly outweighs any possible benefit. The drug is contraindicated in women who are or may become pregnant.