Thalidomide

Details About Generic Salt ::  Thalidomide 

Main Medicine Class:: Immunology , Allergy   Sub Medicine Class ::  Immunuosuppressants

14A. IMMUNUOSUPPRESSANTS in 14. IMMUNOLOGY & ALLERGY
THALIDOMIDE
SYNTHETIC GLUTAMIC ACID DERIVATIVE | ANGIOGENESIS INHIBITOR
PK: A: Slow M: Non-enzymatic hydrolysis E: Urine

Indications & Dose: ERYTHEMA NODOSUM LEPROSUM Severe PO Adult Initially 400mg/day, reduces gradually by 50mg q2-4wk once a satisfactory response is achieved | Moderate-to-severe PO Adult Initially 100-300mg OD, if satisfactory response reduce dose gradually by 50mg q2-4wk Child > 12 yr: Same as adult dose | GRAFT VERSUS HOST DISEASE PO Adult 0.8-1.6g OD | NEWLY DIAGNOSED MULTIPLE MYELOMA Combination therapy PO Adult 200mg OD with dexamethasone 40mg (days 1-4, 9-12 & 17-20) q28days | REFRACTORY CROHN’S DISEASE PO Adult 50-300mg/day, MD 100mg/day

Contra: Hypersensitivity, women of childbearing potential

Precautions: CVD, hypersensitivity/skin reactions, neutropenia, orthostatic hypotension, peripheral neuropathy, sedation, seizures, risk factors for thrombosis, constipation, hepatic/renal impairment, neurological disorders, HIV infected patients, women receiving contraceptives

ADR: Serious: bradycardia, VTE, peripheral neuropathy, orthostatic hypotension, erythematous macular rash, SJS, TEN, neutropenia, increased viral load in HIV patients, Others: constipation, dizziness, drowsiness, somnolence

DDI: Serious Interferon α causes severe bone marrow depression, Doxorubicin increases risk of DVT in patients with multiple myeloma, CNS Depressants increases sedative effect, Epoetin alfa results in DVT

Diet: 1h after food

Monitor: CBC, Platelets, signs of neuropathy, viral load (HIV-seropositive patients)

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