Trade Name(s):

Thalomid

Available

50 mg capsules

Dose

100 to 300 mg daily at bedtime

Indications

Treatment of resistant cutaneous (skin only) lupus, Behcet’s disease, or pyoderma gangrenosum

Side Effects

The most notorious side effect of this drug is severe birth defects in babies born to mothers taking thalidomide. Drowsiness, nerve damage, nausea, constipation, rash, changes in mood, dry mouth, headaches, changes in heart rate, swelling of the limbs, and dry skin have all been reported. Low white blood cells, irregular menstrual periods, changes in blood sugar, and altered thyroid function are less frequently seen.

Monitoring

Baseline blood counts and blood chemistries can be performed and repeated only as needed. Women of child-bearing potential should use this medication with extreme caution if at all. If electing to use thalidomide, baseline serum or urine pregnancy tests should be performed and repeated every month while taking thalidomide and for 4 weeks after discontinuing. Baseline nerve conduction studies should also be performed and repeated every 6-12 months.

Important Points to Know

Notify your provider if you develop any numbness, tingling, or burning of the hands or feet, as well as for any rash, unexplained fever, change in heart rate, or low blood pressure. Alcohol should be avoided altogether or at least minimized while taking this medication. If women of child-bearing potential elect to use this medication, reliable birth control and monitoring as outlined above is mandatory. While expensive, thalidomide may be obtained at a minimal expense from the participating drug company by filling out paperwork.

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