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thalidomide (Thalamid, Corronarobetin)

Special prescribing requirements. Prescribers & pharmacists must be registered with the System for Thalidomide Education & Prescribing Safety (S.T.E.P.S.) to prescribe or dispense Thalomid. [3] Indications: - erythema nodosum of leprosy - lichen planus - multiple myeloma (combination chemotherapy) - subacute cutaneous lupus erythematosus [5] - discoid lupus erythematosus - actinic prurigo - aphthous stomatitis - graft vs host disease [5] - refractory Crohn's disease [6] - recurrent small-intestinal angiodysplasia [8] Contraindications: - pregnancy - use in patients with renal insufficiency has not been established [4] Dosage: 100-300 mg PO QD Adverse effects: 1) teratogenic, do not use in woman of child-bearing age -> phocomelia, cardiac anomalies 2) peripheral neuropathy 3) dizziness & orthostatic hypotension 4) neutropenia 5) may increase viral load in HIV+ patients 6) bradycardia 7) venous thromboembolism* 8) neutrophilic dermatosis - pyoderma gangrenosum, Sweet syndrome [7] 9) constipation, somnolence, limb numbness, peripheral edema, elevated serum transaminases [8] * prophylaxis for deep vein thrombosis Mechanism of action: 1) immune modulation 2) angiogenesis inhibitor 3) alterations in expression of a) adhesion molecules b) cytokines

Interactions

drug interactions

Related

phocomelia

General

antineoplastic immunomodulator pharmaceutical angiogenesis inhibitor (angiostatic agent)

Properties

MISC-INFO: elimination route PLASMA 1/2life 5-7 HOURS pregnancy-category X

Database Correlations

PUBCHEM correlations

References

  1. Harrison's Principles of Internal Medicine, 13th ed. Isselbacher et al (eds), McGraw-Hill Inc. NY, 1994, pg 1039
  2. Thalidomide Continues Its Comeback Against Multiple Myeloma http://www.nci.nih.gov/clinicaltrials/results/thalidomide-comeback0500
  3. System for Thalidomide Education & Prescribing Safety (S.T.E.P.S.) to prescribe or dispense Thalomid. (888) 423-5436
  4. Geriatric Review Syllabus, 7th edition Parada JT et al (eds) American Geriatrics Society, 2010
  5. Deprecated Reference
  6. Lazzerini M et al Effect of Thalidomide on Clinical Remission in Children and Adolescents With Refractory Crohn Disease. A Randomized Clinical Trial. JAMA. 2013;310(20):2164-2173 PMID: 24281461 http://jama.jamanetwork.com/article.aspx?articleid=1785463
  7. Medical Knowledge Self Assessment Program (MKSAP) 17, American College of Physicians, Philadelphia 2015
  8. Chen H, Wu S, Tang M et al. Thalidomide for recurrent bleeding due to small-intestinal angiodysplasia. N Engl J Med 2023 Nov 2; 389:1649. PMID: 37913505 Clinical Trial. https://www.nejm.org/doi/10.1056/NEJMoa2303706

Component-of

dexamethasone/thalidomide (ThaD) melphalan/prednisone/thalidomide (ThaMP) recombinant parathyroid hormone (1-84) (Natpara) thalidomide, dexamethasone & pegylated liposomal doxorubicin (ThADD)