Thalidomide (Thalomid)

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How does this medicine work?

Thalidomide may be used to treat brain tumors, other tumors, or patients who have graft versus host disease after bone marrow transplantation. It works by preventing blood vessel growth into tumors, "starving" the tumor of nutrients necessary for growth.

How is it given?

Thalidomide is given by mouth. It comes in capsule form. Because it may cause drowsiness, it should be given at bedtime. It should be given at regular times to keep a steady level in the bloodstream. Your child should be awake and alert when taking any medicine.

Do not take the capsule out of the blister pack until it is time to take it.

The capsule should be taken whole and not broken or chewed.

___ For children who cannot swallow capsules:

1. Put on gloves.
2. Open capsule inside a clear plastic bag.
3. Mix the powder with a very small amount (1 teaspoon) of soft food, such as applesauce, yogurt, ice cream, chocolate syrup, or jelly. Make sure your child takes all of the mixture.
4. Wash spoons and container right after use. Discard the plastic bag and gloves.

Are there any precautions about food or other medicines?

Thalidomide should be given at bedtime and at least 1 hour after the evening meal (on an empty stomach).

Do not give any other medicines, including over-the-counter medicine, until you have checked with your child's doctor or pharmacist. Alcohol and barbiturates (sleeping medicines) will cause extra drowsiness when taken with thalidomide.

What should I do if a dose is missed?

If one dose is missed, give it as soon as remembered. Never give a double dose.

More than one capsule may be needed for each dose. If your child vomits (throws up) within 30 minutes after receiving a capsule, give it again. If your child vomits after 30 minutes, do not repeat that capsule. (Use safety equipment to clean up any vomit.)

Call the doctor if your child misses or vomits 2 doses in a row.

What are the side effects?

Thalidomide can cause severe birth defects or death to an unborn baby. Even one capsule can cause serious harm. Pregnant women should not take thalidomide. Men should not father children while taking thalidomide. Before the doctor prescribes thalidomide for you or your child, you will receive special written information about this drug and its ability to harm an unborn child.

Other side effects include:

Common

• drowsiness
• dizziness
• change in appetite

Occasional

• nausea (upset stomach)
• constipation
• rash, hives
• weakness in legs and arms
• dry mouth and skin
• numbness, tingling, burning, pain, or cramps in the hands and feet
• sensitivity of skin and eyes to the sun
• headache
• mood changes
• no menstruation

Rare

• nightmares
• concentration problems
• hallucinations
• depression
• low white blood count
• liver or kidney problems

When should I call the doctor?

• possible pregnancy
• rash or hives
• red or purple spots on the skin
• numbness, burning, tingling, pain, or weakness in hands or feet
• yellowing of the eyes or skin
• extreme drowsiness
• hallucinations
• depression
• continued vomiting or diarrhea

What else do I need to know?

Never share this medicine with anyone else.

Thalidomide can cause severe birth defects and harm to an unborn child. Each time you receive another prescription of thalidomide, you and your child will be reminded of this very serious side effect. Every 1 to 3 months, both males and females are required to take a survey asking about sexual activity. Females of child-bearing age will have frequent pregnancy tests. Thalidomide does not make birth control pills less effective, but a second form of birth control is required for all sexually active females.

All caregivers should wear gloves when handling urine, stool, and vomit while your child is receiving the chemotherapy and for 48 hours afterward. Urine, stool, and vomit can be safely disposed of in septic tanks and the sewer system. Wash your hands well after taking the gloves off.

Any clothing or bed linens that are contaminated with urine, stool, or vomit should be washed separately from other laundry in hot water and detergent. Wear gloves when handling the contaminated laundry.

Avoid suntanning. To prevent sunburn, wear sunscreen and protective clothing when outdoors.

You and your child should know the names of all the medicines he or she is taking. Share this information with anyone involved in your child's care.

Always make sure you have enough medicine on hand. Thalidomide can only be prescribed for 28 days at a time. Automatic or telephone refills are not allowed and a new prescription must be written every 28 days.

Check the label for the expiration date. Bring unused or outdated thalidomide back to the pharmacy for special disposal. To prevent exposure to others in the community, do not flush it or put it in the garbage.

Store all medicines in their original container and away from direct sunlight or heat. Do not store in humid places such as the bathroom. Keep them out of children's reach, locked up if possible.

If too much or the wrong kind of chemotherapy medicine is taken, call the oncology clinic right away. If your child is unconscious or has a seizure, call 911.

Questions?

This is not specific to your child but provides general information. If you have any questions, please call the doctor or pharmacist.

Children's Hospitals and Clinics of Minnesota
Last reviewed 8/2015 

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