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Thalidomide (Generic Name)

UPMC Content 2

About This Drug

Thalidomide is a drug used to treat cancer. It is given by mouth.

Possible Side Effects

  • Generalized weakness and discomfort (aches or pains)
  • Feeling tired
  • Rash
  • 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.
  • Constipation (not able to move bowels)
  • Feeling dizzy
  • Sensitivity to light (photosensitivity). Photosensitivity means that you may become more sensitive to the light from the sun, sun lamps, and tanning beds. Your eyes may water more, mostly in bright light.
  • 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.
  • 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.
  • Very harmful effects on an unborn child, including death.  Even 1 dose taken by a pregnant woman can cause these very harmful effects. Your healthcare team will talk to you and give you written information about this risk.

Treating Side Effects

  • Use effective methods of birth control during your cancer treatment. Your doctor will talk to you about this.
  • If you are drowsy, do not drive a car or operate machinery. Avoid alcohol and medicines that may make you drowsy, such as sedatives, unless your doctor tells you otherwise. You may want to try taking thalidomide in the evening to decrease feeling drowsy during the day.
  • 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.
  • If you are dizzy, get up slowly after sitting or lying down.
  • 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 are constipated, ask your doctor or nurse about medicines that are available to help stop or lessen constipation. Check with your doctor or nurse before you use enemas, laxatives, or suppositories.
  • Wear dark sunglasses and use sunscreen with SPF 30 or higher when you are outdoors even for a short time. Cover up when you are out in the sun. Wear wide-brimmed hats, long-sleeved shirts, and pants. Keep your neck, chest, and back covered.

Food and Drug Interactions

  • There are known interactions with thalidomide and grapefruit. Do not eat grapefruit or drink grapefruit while taking thalidomide.
  • There are also known interactions of thalidomide with some other medicines and products like acetaminophen, aspirin, and ibuprofen.  Ask your doctor what over-the-counter (OTC) medicines you can take for fever, headache and muscle and joint pain.
  • 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.

Important Information

  • Keep thalidomide in the blister pack until it is time to take your dose
  • Swallow capsules whole with water. Do not break, crush, or chew the capsules.
  • Take thalidomide at least one hour after a meal. Bedtime is the preferred time to take this medicine.
  • Missed dose: If you miss a dose, take it as soon as you remember as long as it is within 12 hours of your normal dose. If it has been more than 12 hours since your missed dose, do not take your missed dose, just take your next dose at your normal time. Do not take more than one dose at a time to make up for missed doses. Call your doctor right away if you take too much thalidomide.

When to Call Your Doctor

Call your doctor or nurse right away if you have any of these symptoms:

  • Chest pain
  • Trouble breathing
  • Cramping or pain in your leg
  • Swelling or redness and warmth of your leg
  • Rash
  • Temperature of 100.5 F (38 C) or above
  • Chills
  • Feeling confused

Call your doctor or nurse as soon as possible if you have any of these symptoms:

  • Numbness, tingling, pain, or a burning feeling in your feet or hands
  • Trouble walking or changes in the way you walk
  • Abdominal pain
  • No bowel movement for 3 days or if you become uncomfortable
  • Feeling dizzy and/or drowsy
  • Fatigue that interferes with normal activities
  • Swelling in your legs, feet, or ankles

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 warnings:
    • This drug may cause very harmful effects on an unborn child. Thalidomide 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