How to take the medicine?
Thalidomide comes as a capsule to take by mouth. Thalidomide is usually taken with water once a day at bedtime and at least 1 hour after an evening meal.The usual starting dose for AVM is 50mg / day but can be increased to 200mg/day if tolerated well.
What do we expect from the medicine?
Your symptoms should improve in 1-3 months. Pain will improve . Most patients will have no progression of disease with the drug and few will show decrease in size also.
What side effects can this medication cause?
Thalidomide may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
- drowsiness
- confusion
- anxiety
- depression or mood changes
- difficulty falling asleep or staying asleep
- bone, muscle, joint, or back pain
- weakness
- headache
- change in appetite
- weight changes
- nausea
- constipation
- dry mouth
- dry skin
- pale skin
- uncontrollable shaking of a part of the body
- swelling of the hands, feet, ankles, or lower legs
- difficulty achieving or maintaining an erection
Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately or get emergency medical treatment:
- rash
- itching
- hives
- blistering and peeling skin
- swelling of the face, throat, tongue, lips, or eyes
- hoarseness
- difficulty swallowing or breathing
- fever, sore throat, chills, cough, or other signs of infection
- slow or fast heartbeat
- seizures
Thalidomide may cause nerve damage that can be severe and permanent. This damage may occur any time during or after your treatment. Your doctor will examine you regularly to see how thalidomide has affected your nervous system. If you experience any of the following symptoms, stop taking thalidomide and call your doctor immediately: numbness, tingling, pain, or burning in the hands and feet.
Important Warning
Risk of severe, life-threatening birth defects caused by thalidomide.
For all people taking thalidomide:
Thalidomide must not be taken by women who are pregnant or who could become pregnant while taking this medication. Even a single dose of thalidomide taken during pregnancy can cause severe birth defects (physical problems present in the baby at birth) or death of the unborn baby. Do not donate blood while you are taking thalidomide and for 4 weeks after your treatment.
For women taking thalidomide:
If you can become pregnant, you will need to meet certain requirements during your treatment with thalidomide. You need to meet these requirements even if you have a history of not being able to become pregnant. You may be excused from meeting these requirements only if you have not menstruated (had a period) for 24 months in a row, or you have had a hysterectomy (surgery to remove your uterus).
You must use two acceptable forms of birth control for 4 weeks before you begin to take thalidomide, during your treatment, and for 4 weeks after your treatment. Your doctor will tell you which forms of birth control are acceptable. You must use these two forms of birth control at all times unless you can guarantee that you will not have any sexual contact with a male for 4 weeks before your treatment, during your treatment, and for 4 weeks after your treatment.
For men taking thalidomide:
Thalidomide is present in semen (fluid containing sperm that is released through the penis during orgasm). You must either use a latex or synthetic condom or completely avoid any sexual contact with a woman who is pregnant or may become pregnant while you are taking this medication and for 4 weeks after your treatment. This is required even if you have had a vasectomy (surgery to prevent sperm from leaving your body and causing pregnancy).
Risk of blood clot:
There is a risk that you will develop a blood clot in your arms, legs or lungs. This risk is greater when thalidomide is used along with other chemotherapy medications such as dexamethasone. Call your doctor immediately if you experience any of the following symptoms: pain, tenderness, redness, warmth, or swelling in the arms or legs; shortness of breath; or chest pain. Your doctor may prescribe an anticoagulant (‘blood thinner’) or aspirin to help stop clots from forming during your treatment with thalidomide.
Montioring:
- CBC before starting ; monthly for 3 months then 3 monthly
- Two point discrimination test at each visit by doctor for first few months