About This Drug
Pomalidomide is used to treat cancer. It is given by mouth (orally).
Possible Side Effects (More Common)
- Bone marrow depression. This is a decrease in the number of white blood cells, red blood cells, and platelets. This may raise your risk of infection, make you tired and weak (fatigue), and raise your risk of bleeding.
- General weakness and discomfort
- Swelling of your legs, ankles and/or feet
- Constipation or loose bowel movements (diarrhea)
- Nausea and throwing up (vomiting). Medicines are available to stop and lessen these side effects.
- Feeling dizzy
- Trouble breathing or feeling short of breath
Possible Side Effects (Less Common)
- Flu-like symptoms: fever, headache, muscle and joint aches, and fatigue (low energy, feeling weak)
- This drug may affect how your kidneys work. Your kidney function will be checked as needed.
- Decreased appetite
- Effects on the nerves are called peripheral neuropathy. You may feel numbness, tingling, or pain in your hands and feet. It may be hard for you to button your clothes, open jars, or walk as usual. The effect on the nerves may get worse with more doses of the drug. These effects get better in some people after the drug is stopped but it does not get better in all people.
- Blood clots. A blood clot in your leg may cause your leg to swell, appear red and warm, and/or cause pain. A blood clot in your lungs may cause trouble breathing, pain when breathing, and/or chest pain.
Treating Side Effects
- Drink 6-8 cups of fluids each day unless your doctor has told you to limit your fluid intake due to some other health problem. A cup is 8 ounces of fluid. If you throw up or have loose bowel movements, you should drink more fluids so that you do not become dehydrated (lack water in the body from losing too much fluid).
- Ask your doctor or nurse about medicine that is available to help stop or lessen fever, headache, muscle and joint aches.
- If you have numbness and tingling in your hands and feet, be careful when cooking, walking, and handling sharp objects and hot liquids.
- If you get a rash do not put anything on it unless your doctor or nurse says you may. Keep the area around the rash clean and dry. Ask your doctor for medicine if your rash bothers you.
- Take this medicine by mouth on an empty stomach, at least two hours before eating and two hours after eating.
- Take this medicine with water and swallow tablets whole. Do not chew, break or crush this medicine.
- Patients will need to register with a program called Pomalyst REMS® before starting to take this medication. Discuss this with your doctor before starting medication.
- Missed dose: If you miss a dose, take it as soon as you remember as long as it is within 12 hours of your scheduled dose. If it has been more than 12 hours, do not take the missed dose. Take your scheduled dose the next day at your normal time. Do not take more than one dose at a time to make up for missed doses.
Food and Drug Interactions
- Pomalidomide may interact with grapefruit, which could affect the level of the drug in your system. Check with your doctor or nurse before eating grapefruit or drinking grapefruit juice.
- This drug may interact with other medicines. Tell your doctor and pharmacist about all the medicines and dietary supplements (vitamins, minerals, herbs and others) that you are taking at this time. The safety and use of dietary supplements and alternative diets are often not known. Using these might affect your cancer or interfere with your treatment. Until more is known, you should not use dietary supplements or alternative diets without your cancer doctor's help.
When to Call the Doctor
Call your doctor or nurse right away if you have any of these symptoms:
- Fever of 100.5 F (38 C) or above
- Easy bruising or bleeding
- Wheezing or trouble breathing
- Rash or itching
- Feeling dizzy or lightheaded
- Feeling that your heart is beating in a fast or not normal way (palpitations)
- Loose bowel movements (diarrhea) more than 4 times a day or diarrhea with weakness or feeling lightheaded
- Blurred vision or other changes in eyesight
- Painful urination; blood in urine
- Pain in your lower back or side
- Feeling confused or agitated
- Nausea that stops you from eating or drinking
- Throwing up more than 3 times a day
- Chest pain or symptoms of a heart attack. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes. Or the discomfort may go away and come back. It can feel like uncomfortable pressure, squeezing, fullness, or pain. Sometimes discomfort is felt in one or both arms, the back, neck, jaw, or stomach. If any of these symptoms last 2 minutes, call 911.
- Symptoms of a stroke such as sudden numbness or weakness of your face, arm, or leg, especially on one side of your body; sudden confusion, trouble speaking or understanding; sudden trouble seeing in one or both eyes; sudden trouble walking, dizziness, loss of balance or coordination; or sudden, severe headache with no known cause. If you have any of these symptoms for 2 minutes, call 911.
- Signs of liver problems: dark urine, pale stools, severe stomach pain, feeling very tired and weak, itching, or yellowing of the eyes or skin,
Call your doctor or nurse as soon as possible if any of these symptoms happen:
- Change in hearing, ringing in the ears
- Decreased urine
- Unusual thirst or frequent urination
- Pain in your mouth or throat that makes it hard to eat or drink
- Nausea that is not relieved by prescribed medicines
- Rash that is not relieved by prescribed medicines
- Heavy menstrual period that last longer than normal
- Numbness, tingling, decreased feeling or weakness in fingers, toes, arms, or legs
- Trouble walking or changes in the way you walk; feeling clumsy when buttoning clothes, opening jars, or other routine hand activities
- Swelling of legs, ankles, or feet
- Weight gain of 5 pounds in one week (fluid retention)
- Lasting loss of appetite or rapid weight loss of five pounds in a week
- Fatigue that interferes with your daily activities
- Headache that does not go away
- Painful, red, or swollen areas on your hands or feet.
- No bowel movement for 3 days or you feel uncomfortable
- Extreme weakness that interferes with normal activities
Sexual Problems and Reproduction Concerns
- Infertility warning: Sexual problems and reproduction concerns may happen. In both men and women, this drug may affect your ability to have children. This cannot be determined before your treatment. Talk with your doctor or nurse if you plan to have children. Ask for information on sperm or egg banking.
- In men, this drug may interfere with your ability to make sperm, but it should not change your ability to have sexual relations.
- In women, menstrual bleeding may become irregular or stop while you are getting this drug. Do not assume that you cannot become pregnant if you do not have a menstrual period.
- Women may go through signs of menopause (change of life) like vaginal dryness or itching. Vaginal lubricants can be used to lessen vaginal dryness, itching, and pain during sexual relations.
- Genetic counseling is available for you to talk about the effects of this drug therapy on future pregnancies. Also, a genetic counselor can look at the possible risk of problems in the unborn baby due to this medicine if an exposure happens during pregnancy.
- Pregnancy warning:
- This drug may cause very harmful effects on an unborn child. Pomalidomide should never be used by women who are pregnant or who could become pregnant while taking the drug. Even 1 dose taken by a pregnant woman can cause these very harmful effects, including death of the unborn child. Your healthcare team will talk to you and give you written information about this risk.
- Two negative pregnancy tests are required to be able to take this drug if you are at an age that you can get pregnant.
- You will need to have routine pregnancy tests while you are taking this drug.
- To prevent pregnancy, two methods of reliable birth control must be used by you and your partner for 4 weeks before you take this drug, while you are taking this drug, and for 4 weeks after your last dose of this drug.
- Women who are taking this drug or a woman whose partner is taking this drug need to call their doctor right away if they think they are pregnant or if they get pregnant.
- Breast feeding warning: It is not known if this drug passes into breast milk. For this reason, women should talk to their doctor about the risks and benefits of breast feeding during treatment with this drug because this drug may enter the breast milk and badly harm a breast feeding baby.
Revised September 2014