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Thalidomide

Find out what thalidomide is, how you have it and other important information about taking thalidomide. 

Thalidomide is a targeted cancer drugs (biological therapy) and is also known by its brand name, Thalidomide Celgene.

It is a treatment for myeloma. You may have thalidomide on its own or with the chemotherapy drug melphalan, and steroids, such as dexamethasone or prednisone.

You may also have thalidomide as part of a clinical trial for other cancers types.

How it works

Thalidomide is a type of cancer growth blocker. Researchers are still looking at how thalidomide works. It affects all sorts of cell processes, including how cells divide and grow.

We know that it interferes with chemicals that cells use to tell each other to grow. It also stimulates some of the immune system cells to attack the myeloma cells. Thalidomide stops tumours making their own blood vessels that they need in order to grow.

How you have it

Thalidomide are capsules that you take every day, with a glass of water, before going to bed. You can take the tablets with or without food. 

Taking your capsules

You must take capsules according to the instructions your doctor or pharmacist gives you.

You should take the right dose, not more or less.

Never stop taking a cancer drug without talking to your specialist first.

If you forget to take thalidomide at your regular time and less than 12 hours have passed, take the capsules straight away. If more than 12 hours have passed do not take the capsules. Take your next capsules at the usual time the next day. 

When you have it

You usually start on a low dose of thalidomide and your doctor then increases the dose unless you get bad side effects. For myeloma you may have this treatment for up to a year and 5 months.

Tests during treatment

You have blood tests before starting treatment and during your treatment. They check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.

Side effects

Important information

Other medicines, foods and drink

Cancer drugs can interact with some other medicines and herbal products. Tell your doctor or pharmacist about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies.

Pregnancy and contraception

Thalidomide can cause birth defects in children. So you must not become pregnant or father a child while you are taking this drug, and for a time afterwards. Your doctor or nurse will talk to you about contraception before you have the treatment.

Some people worry about taking thalidomide but it does not cause physical defects in adults.

Because thalidomide causes birth defects, you have to sign a consent form before you start treatment. This is to make sure you understand the risks of taking thalidomide and agree to use contraception for a specified period of time. 

If you are a woman of child bearing age you will need to have regular pregnancy tests during the treatment. Your doctor or nurse will tell you about this. 

Pregnant women should not touch or handle thalidomide. You must store it in a place where pregnant women or children cannot reach it.

Men with a female partner who could become pregnant should use condoms during sex for the time they are having treatment and for a week after finishing treatment. You must not donate semen during treatment or for 1 week afterwards.

Fertility

You may not be able to become pregnant or father a child after treatment with this drug. Talk to your doctor before starting treatment if you think you may want to have a baby in the future. Men may be able to store sperm before starting treatment. Women may be able to store eggs or ovarian tissue but this is rare.

Breastfeeding

Don’t breastfeed during this treatment because the drug may come through in your breast milk.

Treatment for other conditions

Always tell other doctors, nurses or dentists that you’re having this treatment if you need treatment for anything else, including teeth problems.

Immunisations

Don’t have immunisations with live vaccines while you’re having treatment and for at least 6 months afterwards.

In the UK, live vaccines include rubella, mumps, measles, BCG, yellow fever and Zostavax (shingles vaccine).

You can:

  • have other vaccines, but they might not give you as much protection as usual
  • have the flu vaccine
  • be in contact with other people who've had live vaccines as injections

Avoid contact with people who’ve had live vaccines taken by mouth (oral vaccines). This includes the rotavirus vaccine given to babies. The virus is in the baby’s urine for up to 2 weeks and can make you ill. So, you mustn't change their nappies for 2 weeks after their vaccination.

You also need to avoid anyone who has had oral polio or typhoid vaccination recently.

Donating blood

You should not donate blood during treatment and for 1 week afterwards.

Driving or operating machinery

Don't drive or operate machinery or tools if you have side effects such as dizziness, tiredness, sleepiness or blurred vision.

More information about this treatment

For further information about this treatment go to the electronic Medicines Compendium (eMC) website.

You can report any side effect you have to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.

Information and help

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