Thalidomide - Pharmacology: Possesses immunomodulatory, anti-inflammatory, and antiangiogenic properties; mechanism of action not fully understood.
Indication: Acute treatment of cutaneous manifestations of moderate to severe erythema nodosum leprosum (ENL); maintenance therapy for prevention and suppression of cutaneous manifestations of ENL recurrence; treatment of newly diagnosed multiple myeloma in combination with dexamethasone.
Graft versus host disease after bone marrow transplantation; refractory multiple myeloma; primary brain tumors; appetite stimulant for cachexia in advanced cancer; aphthous ulcers; prostate cancer (in combination with docetaxel).
Thalidomide affects the immune system. It helps promote immune responses to prevent inflammation in the body.
Thalidomide is used to treat and prevent the debilitating and disfiguring skin sores caused by erythema nodosum leprosum (ENL), an inflammatory complication of leprosy. It is also used together with another medicine called dexamethasone to treat multiple myeloma (bone marrow cancer).
Thalidomide may also be used for purposes other than those listed in this medication guide.
Thalidomide is an immunomodulatory agent with a spectrum of activity that is not fully characterized. Thalidomide is racemic — it contains both left and right handed isomers in equal amounts: one enantiomer is effective against morning sickness, and the other is teratogenic. The enantiomers are converted to each other in vivo. That is, if a human is given D-thalidomide or L-thalidomide, both isomers can be found in the serum. Hence, administering only one enantiomer will not prevent the teratogenic effect in humans.
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. Oral 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.
Adult: PO Erythema nodosum leprosum (Type 2) 100-300 mg at bedtime, reduce gradually once a satisfactory reponse is achieved. Max: 400 mg/day. Multiple myeloma Initial: 200 mg once daily, increase slowly according to patient tolerance. Max: 800 mg/day.