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thalidomide

( tha-LI-doe-mide )
Other Name(s): Thalomid®
Appearance: capsule In various strengths and colours

Medication Information Sheet
thalidomide (tha-LI-doe-mide)
This document provides general information about your medication. It does not replace the advice of your health care professional. Always discuss your therapy with your health care professional and refer to the package insert for more details.

Other Name: Thalomid®

Appearance:
capsule

In various strengths and colours

What is this medication for?
  • For treating multiple myeloma
What should I do before I have this medication?
  • Your doctor and pharmacy must be registered with the RevAid® program.
     
  • You must register with the RevAid® program before starting thalidomide.
     
  • Tell your doctor and pharmacist if you have or had:
    • bleeding problems or blood clots,
    • liver problems such as hepatitis,
    • heart problems such as irregular heartbeat or stroke,
    • take hormonal drugs such as birth control pills, hormone replacement, or medications that make you feel sleepy,
    • if you feel numbness, tingling or pain or a burning feeling in your feet or hands.
       
  • People with cancer have a higher risk of getting other cancers or developing blood clots. Some cancer medications may increase these risks, especially if used for a long period of time. Discuss any concerns about this medication with your health care team.
How will this medication affect sex, pregnancy and breastfeeding?
  • The use of this medication in men or women may cause harm to the unborn baby if pregnancy occurs. Let your health care team know if you or your partner is pregnant, becomes pregnant during treatment, or if you are breastfeeding
     
  •  If there is ANY chance that you or your partner may become pregnant, you and your partner together must:
    ►Use 2 effective forms of birth control at the same time while taking this drug AND have regular pregnancy tests. (See the RevAid® program for full details of requirements).  Do not take birth control pills as these can increase your risk of blood clots.
     
  • Do not breastfeed while taking thalidomide.
     
  • This medication may affect fertility (ability to get pregnant)
How is this medication given?
  • Take it exactly as directed by your doctor. Make sure you understand the instructions.
     
  • Swallow whole with a glass of water, with or without food. Do not crush or open the capsules.
     
  • Take the dose at about the same time each day. You may take the dose at bedtime to prevent feely sleepy during the day.
     
  • If you miss a dose, take it if it is within 12 hours of the missed dose, otherwise skip that dose and take your next dose at the usual time. Do not double the dose to make up for the missed dose.
What else do I need to know while on this medication?
  • This medication can interact with other medications and can result in the treatment not working as well or cause severe side effects.

  • Make sure your health care team knows about all your medications (prescription, over-the-counter, herbals and supplements). Check with your health care team before starting or stopping any of them.

  • For mild aches and pain:

    • You may take acetaminophen (Tylenol®) tablets. Ask your health care team about the right dose for you. 
    • Ibuprofen (Advil®, Motrin®), naproxen (Aleve®) or aspirin (acetylsalicylic acid, ASA), including low dose aspirin for heart conditions, may increase your chance of bleeding.
    • Talk to your health care team before you start or stop these medications.
    • If you feel unwell, take your temperature before taking any of these medications. They may hide a fever. 
    • Talk to your health care team or go to the closest emergency room right away if you have a fever.  See the Fever pamphlet for more information.
  • Drinking alcohol and smoking during your treatment may increase some side effects and make your medication less effective. Speak to your health care team about smoking and drinking alcohol while on treatment.

How should I safely store this medication?
  • Keep this medication in the original packaging at room temperature in a dry place, away from heat and light. Keep out of sight and reach of children and pets.

  • Do not throw out any unused medications at home. Bring them to your pharmacy to be thrown away safely.

  • Females who may be pregnant and are helping you with your medications must wear latex gloves to handle this medication.
What are the side effects of this medication?

You may not have all of the side effects below. You may have side effects that are not listed.

Side effects and what to do When to contact doctor?
Common Side Effects (25-49 out of 100 people)

Unusual bleeding or bruising (may be severe)

You may have black stools, cough up blood, blood in your urine, purple or red dots on your skin or bleeding that will not stop. 

Fever, chills, infection (includes infections that happen when the immune system is impaired such as viral or fungal infections)

You have a fever if your temperature taken in your mouth (oral temperature) is:

  • 38.3°C (100.9°F) or higher at any time OR
  • 38.0°C (or 100.4°F) or higher for at least one hour.

While you are getting treatments:

  • Keep a digital thermometer at home and take your temperature if you feel hot or unwell (for example, chills).
  • Avoid taking medications that treat a fever before you take your temperature (for example, Tylenol®, acetaminophen, Advil® or ibuprofen) as they may hide a fever.
  • Do not eat or drink anything hot or cold right before taking your temperature.
  • Wash your hands often.
  • Check with your doctor before getting any vaccines, surgeries, medical procedures or visiting your dentist.

If you have a fever, talk to your health care team or go to the closest emergency room. 
See our Neutropenia (Low white blood cell count) pamphlet for more information.

Get emergency medical help right away

 

Side effects and what to do When to contact doctor?
Less Common Side Effects (10-24 out of 100 people)

Constipation

To help prevent constipation:

  • Drink more liquids and eat well. Drink at least 6 to 8 cups of liquids each day unless you have been told otherwise.
  • Be Active. Exercise can help to keep you regular.
  • Try to eat more fiber (e.g. fruits with skin, leafy greens and whole grains). If you take opioid pain medication, ask your health care team if eating more fibre is right for you.

To help treat constipation:

  • If you have not had a bowel movement in 2 to 3 days you may need to take a laxative. Ask your health care team what to do.

See the Constipation Pamphlet for more information.

Contact your health care team if no improvement or if severe

Drowsiness    

  • If you feel drowsy (sleepy), you should avoid driving or using machinery.
  • This may go away as your body adjusts to the medication. 
Contact your health care team if no improvement or if severe

Tingling, numb fingers and toes, tremors (may be severe)

  • May slowly get better after your treatment ends.
  • Contact your health care team if you have trouble doing up buttons, writing, picking up small objects, have pain or trouble moving.
Contact your health care team as soon as possible

Low blood pressure; dizziness

  • It may happen when the medication is being given to you. Let your healthcare team know right away if it occurs.
  • Check your blood pressure regularly.
  • If you feel dizzy or unwell you should lay down to avoid falling. Try to get up and move slowly once you feel better.
  • Do not drive a motor vehicle or operate machinery if you feel dizzy.
Contact your health care team if no improvement or if severe

Blood clot (may be severe)

  • It can cause pain, swelling and hardening of the vein in an arm or leg.
  • If the blood clot goes to your lungs, it can cause you to cough, have trouble breathing, have pain in your chest or cough up blood.
Get emergency medical help right away

 

Other rare, but serious side effects are possible.

If you experience ANY of the following, talk to your health care team or get emergency medical help right away:

  • chest pain or shortness of breath
  • red, itchy rash that may blister or peel (may occur with fever)
  • unable to pee, swelling of your legs or unexpected changes in your weight
  • yellow skin, eyes or dark urine
  • severe pain in your belly; may extend to your back
  • fainting, irregular or rapid heartbeat
  • seizures


For more links on how to manage your symptoms go to https://www.cancercareontario.ca/en/symptom-management.

The information set out in the medication information sheets, regimen information sheets, and symptom management information (for patients) contained in the Drug Formulary (the "Formulary") is intended to be used by health professionals and patients for informational purposes only. The information is not intended to cover all possible uses, directions, precautions, drug interactions or side effects of a certain drug, nor should it be used to indicate that use of a particular drug is safe, appropriate or effective for a given condition.

A patient should always consult a healthcare provider if he/she has any questions regarding the information set out in the Formulary. The information in the Formulary is not intended to act as or replace medical advice and should not be relied upon in any such regard. All uses of the Formulary are subject to clinical judgment and actual prescribing patterns may not follow the information provided in the Formulary.