Thalide 50mg is a piperidinyl isoindole basically introduced as a non-barbiturate hypnotic but detached from the market due to teratogenic effects. It has been renewing and indicated for several immunological and inflammatory disorders. Thalide 50mg displays immunosuppressive and anti-angiogenic activity. It prevents release of tumor necrosis factor-alpha from monocytes and modulates another cytokine action.
Thalide 50mg in combination with dexamethasone is indicated for the treatment of patients with newly diagnosed multiple myeloma.
Thalide 50mg is used for the acute treatment of the cutaneousmanifestations of moderate to severe erythema nodosum leprosum (ENL).
Thalide 50mg is not used as monotherapy for such ENL treatment in the presence of moderate to severe neuritis.
Thalide 50mg is also used as maintenance therapy for prohibition and suppression of the cutaneous manifestations of ENL relapsed.
Mechanism of action
The immunologic effects of thalidomide vary considerably under different conditions but may be related to overthrow of exaggerated tumor necrosis factor-alpha (TNF-a) production and down-modulation of selected cell surface adhesion molecules involved in leukocyte migration. For example, patients getting of thalidomide has been resulted to reduce circulating levels of TNF-a in patients with ENL, however, it has also been shown to increase plasma TNF-a levels in HIV-seropositive patients. Since cancer therapy, the drug may work as a VEGF inhibitor.
Time to peak plasma concentration is 2.9 to 5.7 hours
plasma protein binding is 55% and 66% for the (+) R and (-) S enantiomers, respectively
Metabolized hepatically by enzymes of the cytochrome P450 enzyme system.
Excreted in the urine as unchanged drug is less than 0.7% of the dose. Half-life of thalidomide is 5 to 7 hours.
The dosage recommendation of following condition as follows :
Multiple Myeloma :
The recommended dose is 200mg PO qHS in 28-day cycles
Administer 40 mg of dexamethasone on days 1-4,9-12,17-20 of 28 days.
Erythema Nodosum leprosum :
The initial recommended dose is 100-300 mg PO qHS.
In case of more severe reaction then may initiate at 400mg. continue until active symptoms subsided, at least 2 weeks then titrate down by 50 mg increment q 2-4 weeks.
• Venous and arterial thromboembolism
• Increased Mortality
• Drowsiness and somnolence
• Peripheral neuropathy
• Dizziness and orthostatic hypotension
• Increased HIV viral load
• Tumor Lysis
• Hypersensitivity .
Prior initiating Thalide 50mg treatment, make sure to inform doctor about any other medications you are taking (containing prescription, over-the-counter, vitamins, herbal remedies, etc.). Avoid taking aspirin, or products including aspirin until the doctor especially permits this.
Avoid taking regimens that may cause drowsiness without first consulting your health care provider. Also avoid alcohol. For both men and women use contraceptives, and do not conceive a child (get pregnant) while taking Thalide 50mg. serious, life-threatening birth defects may have reported with even one 50 mg dose. Methods of contraception has two types, such as latex condoms and spermicides, are required.
For women of childbearing potential should use contraception 4 weeks before you can start Thalide 50mg. The manufacturer needed you to take a pregnancy test every month before you initiate a new prescription of thalidomide. This is to confirm that you or your significant other is not pregnant. Consult with your doctor when you may safely become pregnant or conceive a child after treatment. Do not breast feed while taking this medication.