• Leukemias, lymphomas, and other hematologic cancers

Thalomid Generic Name & Formulations

General Description

Thalidomide 50mg, 100mg, 150mg, 200mg; caps.

Pharmacological Class


How Supplied

Caps 50mg—1, 28; 100mg, 150mg, 200mg—28


Thalomid Indications


Newly diagnosed multiple myeloma in combination with dexamethasone. Treatment, suppression and prevention of cutaneous manifestations of erythema nodosum leprosum (ENL).

Thalomid Dosage and Administration


Take at bedtime, at least 1 hour after evening meal. Multiple myeloma: 200mg once daily in combination with dexamethasone in 28-day treatment cycles. ENL: initially 100–300mg/day; <50kg: start with lower dose; continue until signs/symptoms of active reaction have subsided (usually at least 2 weeks), then taper off in 50mg decrements every 2–4 weeks. Severe ENL: may start at higher doses; max 400mg/day. Moderate-to-severe neuritis with severe ENL: give concomitant corticosteroids (see full labeling). Consider dose reduction, delay, or discontinuation in those who develop NCI CTC Grade 3/4 adverse reactions.


<12yrs: not established.

Thalomid Contraindications



Thalomid Boxed Warnings

Boxed Warning

Embryo-fetal toxicity. Venous thromboembolism.

Thalomid Warnings/Precautions


Must register patient in the Thalomid REMS program; patient must understand toxicity with fetal exposure. Counsel patient on need for contraception; female: use 2 forms of contraception 1 month before, during, and 1 month after therapy; male: use condom during and 1 month after therapy; obtain negative pregnancy test within 24 hours prior to starting treatment; repeat at least weekly for 1st month then every 4 weeks; get informed consent. Monitor for neuropathy monthly for first 3 months; discontinue if symptoms develop. Monitor for signs/symptoms of thromboembolic events, neutropenia, bradycardia, syncope, orthostatic hypotension, tumor lysis syndrome. Reevaluate if ANC <750/mm2; consider withholding if neutropenia persists. Monitor blood and platelet counts. Monitor for signs/symptoms of bleeding including petechiae, epistaxis, and GI bleed. Measure HIV viral load after 1st and 3rd months, and every 3 months thereafter. Permanently discontinue if angioedema, anaphylaxis, Grade 4 rash, skin exfoliation, bullae, or any other severe dermatologic reactions occur. History of seizure. Avoid contact with non-intact capsule or powder content. Maximum 1 month per ℞. Discontinue immediately if pregnancy occurs. Nursing mothers: not recommended.



Thalomid Pharmacokinetics

See Literature

Thalomid Interactions


Increased mortality when PD-1 or PD-L1 blocking antibody (eg, pembrolizumab) is added to thalidomide analogue plus dexamethasone regimen in multiple myeloma: not recommended. Increased sedative effect with barbiturates, alcohol, chlorpromazine, reserpine. Caution with drugs associated with peripheral neuropathy. Avoid drugs (eg, rifampin, carbamazepine, St. John's wort) that decrease effectiveness of hormonal contraceptives. Increased risk of thromboembolism with concomitant erythropoietic agents, or estrogen-containing therapies in those receiving thalidomide with dexamethasone.

Thalomid Adverse Reactions

Adverse Reactions

Fatigue, hypocalcemia, edema, constipation, neuropathysensory, dyspnea, muscle weakness, leukopenia, neutropenia, rash/desquamation, confusion, anorexia, nausea, anxiety/agitation, asthenia, tremor, fever, weight loss, thrombosis/embolism, neuropathy-motor, weight gain, dizziness, dry skin, somnolence, headache; severe cutaneous reactions (eg, SJS, TEN, DRESS), hypersensitivity.

Thalomid Clinical Trials

See Literature

Thalomid Note


Available only through Thalomid REMS program. Suspected fetal exposure must be reported to the FDA at (800) FDA-1088 and Celgene at (888) 423-5436.

Thalomid Patient Counseling

See Literature