How it Works

Thalomid (thalidomide) affects the immune system. It promotes immune responses to help slow tumor growth.

Thalidomide belongs to a class of drugs called immunomodulators that block the formation of growths that may become cancer. 

Like the other immunomodulatory drugs (IMiD® compounds), Thalidomide induces immune responses, enhances the ability of immune cells called T cells and NK (natural killer) cells to kill myeloma cells, and inhibits inflammation. It also inhibits the growth of blood vessels upon which cancer cells depend for sustenance and growth.

How it’s Administered

Thalidomide is an oral pill that should be taken on an empty stomach, or at least 1 hour after eating a meal. The medicine from an open capsule can be dangerous if it gets on your skin. If this occurs, wash your skin with soap and water.

Thalidomide is available in 50 mg, 100 mg, 150 mg, and 200 mg capsules. 

Who Should Take Thalidomide

Thalidomide is currently approved for the treatment of patients with newly diagnosed multiple myeloma (MM).

Thalidomide is also used in leprosy patients.

Who Shouldn’t Take Thalidomide

If thalidomide is taken during pregnancy, it can cause severe congenital disabilities or embryo-fetal death. Thalidomide should never be used by pregnant women or those who could become pregnant while taking the drug. Even a single dose [1 capsule (regardless of strength)] taken by a pregnant woman during her pregnancy can cause severe disabilities.

The use of thalidomide in multiple myeloma results in an increased risk of blood clots, such as deep venous thrombosis and pulmonary embolism. This risk increases significantly when thalidomide is combined with standard chemotherapeutic agents, including dexamethasone.

The Most Common Side Effects of Taking Thalidomide Include:

• Fever
• Low blood cell counts
• Headache
• Dizziness
• Drowsiness
• Weakness
• Tired feeling
• Anxiety
• Agitation 
• Confusion
• Numbness 
• Tremors
• Muscle weakness
• Nausea
• Loss of appetite 
• Constipation 
• Weight gain or loss
• Swelling
• Trouble breathing
• Rash
• Dry or peeling skin
• Low calcium level - muscle spasms or contractions, numbness or tingly feeling (around your mouth, or in your fingers and toes)

Commonly Used With

• Dexamethasone
• Velcade
• Adriamycin
• Melphalan
• Prednisone
• Vincristine

Currently Being Tested With Thalidomide

• Proteasome Inhibitors: Bortezomib, Ixazomib, Carfilzomib
• Corticosteroids: Dexamethasone
• Alkylating Agents: Melphalan
• Targeted Inhibitors: Selinexor
• Others: Endoxan

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