Consumer Medicine Information
WHAT IS IN THIS LEAFLET
This leaflet answers some common questions about Thalomid.
It does not contain all the available information.
It does not take the place of talking to your doctor or pharmacist.
All medicines have risks and benefits. Your doctor has weighed the risks of you taking
Thalomid against the benefits this medicine is expected to have for you.
If you have any concerns about taking this medicine, ask your doctor or pharmacist.
Keep this leaflet with the medicine.
You may need to read it again.
WHAT THALOMID IS USED FOR
Thalomid contains an active substance called thalidomide. Thalomid belongs to a group
of medicines known as immuno-modulating agents that work by acting on the cells involved
in the body's immune system. The immune system is part of the body's defence which
helps to fight illness and infection.
Treatment of Multiple Myeloma
Thalomid is used to treat multiple myeloma, a cancer of the bone marrow.
It is used in combination with other medicines, melphalan and prednisone, for the
treatment of newly diagnosed multiple myeloma in patients aged over 65 years or patients
who cannot receive high dose chemotherapy. It is also used in combination with dexamethasone
at the start of high dose chemotherapy treatment or a bone marrow transplant. To find
out more about these medicines, please ask your doctor.
Thalomid may also be used for the treatment of multiple myeloma after other treatments
Treatment of Skin Symptoms associated with Severe Erythema Nodosum Leprosum (ENL)
Thalomid is also used for the treatment of the skin symptoms associated with moderate
to severe erythema nodosum leprosum (ENL) which can occur if you have leprosy. Thalidomide
can also help to stop the skin symptoms returning.
Your doctor, however, may have prescribed Thalomid for another purpose.
Ask your doctor if you have any questions about how Thalomid works or why this medicine
has been prescribed for you.
This medicine is available only with a doctor's prescription.
BEFORE YOU TAKE THALOMID
When you must not take it
Do not take Thalomid if you have an allergy to thalidomide or any of the ingredients
listed at the end of this leaflet.
Some of the symptoms of an allergic reaction may include:
Shortness of breath
Wheezing or difficulty breathing
Swelling of the face, lips, tongue or other parts of the body
Rash, itching or hives on the skin.
If you think you may be allergic to Thalomid, ask your doctor for advice.
Do not give this medicine to a child under the age of 12 years.
Safety and effectiveness in children younger than 12 years have not been established.
Do not take this medicine if you are pregnant, or think you may be pregnant, or are
planning to become pregnant.
Thalomid causes birth defects (deformed babies) and death to an unborn baby, and may
affect your developing baby if you take it during pregnancy.
Do not take this medicine if you are able to become pregnant but unable to follow
the required pregnancy prevention measures (outlined in the i-access® program - see section 'Before you start to take it' below).
Do not breastfeed if you are taking this medicine.
It is not known if thalidomide is passed into breast milk. However, as thalidomide
is known to cause birth defects, do not breastfeed while you are receiving Thalomid.
Do not take this medicine if you are a male patient who is unable to follow the required
pregnancy prevention measures (outlined in the i-access® program - see section 'Before you start to take it' below).
If any of these apply to you, tell your doctor before you take Thalomid.
Before you start to take it
Follow your doctor's instructions carefully.
You will have been given specific instructions by your doctor particularly on the
effects of thalidomide on unborn babies.
If you have not fully understood these instructions, please ask your doctor again
before taking thalidomide.
Your doctor will have enrolled you in the i-access® program to ensure that thalidomide is used safely.
The i-access® program
Thalidomide can cause severe and life-threatening human birth defects (deformed babies)
and death to an unborn baby if taken during pregnancy.
To avoid exposure to unborn babies, Thalomid is available only under a special distribution
program called the i-access® program. This program is designed to ensure that Thalomid is always prescribed and
taken in the recommended way. Importantly, only patients who are enrolled in this
program and therefore have agreed to fully comply with all the requirements of this
program can receive Thalomid.
Some of the requirements of the i-access® program are outlined in the following sections.
1. For women taking Thalomid
Before starting this treatment, ask your doctor if you are able to become pregnant,
even if you think this is unlikely e.g. if your periods have stopped.
If you are able to become pregnant:
Your doctor will make sure that you have pregnancy tests before treatment, every 4
weeks during treatment, and 4 weeks after stopping treatment.
Use reliable means of contraception for at least 4 weeks before starting Thalomid
treatment, during treatment and treatment interruption, and for at least 4 weeks after
Thalomid treatment has stopped.
Your doctor will tell you what method of contraception to use.
You must stop taking Thalomid and inform your doctor straight away if:
You miss or think you have missed a period, or you have unusual menstrual bleeding,
or suspect you are pregnant.
You have heterosexual intercourse without using reliable means of contraception.
2. For men taking Thalomid
If your partner is able to become pregnant, use barrier methods of contraception (e.g.
condoms) during Thalomid treatment, during treatment interruption, and for 4 weeks
after treatment has stopped.
If your partner becomes pregnant whilst you are taking this medicine, tell your doctor
Do not donate semen during treatment or for 4 weeks after stopping treatment.
3. For all patients taking Thalomid
Do not donate blood during Thalomid treatment and for 4 weeks after stopping treatment.
Discuss with your doctor if you have or have had any of the following medical conditions:
Heart attack, blood clots, high blood pressure or high cholesterol
Hepatitis B virus infection
Numbness, tingling or pain in your hands and feet
Severe skin rash
You have had surgery in the previous 7 days or have wounds which are healing
Kidney or liver problems.
If you have not told your doctor about any of the above, tell him/her before you start
It is important to note that a small number of patients with multiple myeloma may
develop additional types of cancer (regardless of their type of therapy). At this
stage it cannot be excluded that this risk may be slightly increased with Thalomid
treatment. Therefore, your doctor will carefully evaluate the benefit and risk when
you are prescribed Thalomid.
If you are not sure if any of the above applies to you, talk to your doctor before
taking this medicine.
Taking other medicines
Tell your doctor or pharmacist if you are taking any other medicines, including any
that you can get without a prescription from your pharmacy, supermarket or health
Some medicines and Thalomid may interfere with each other. These include:
medicines that cause drowsiness, such as sleeping pills
medicines used to treat depression or anxiety
medicines used to treat heart problems and/or high blood pressure
medicines that can induce bleeding, such as aspirin
medicines used to treat anaemia
hormone replacement therapy
medicines used in the treatment of cancer such as vincristine
medicines used in the treatment of AIDS such as zalcitabine and didanosine.
These medicines may be affected by Thalomid or may affect how it works. You may need
to take different amounts of your medicines, or you may need to take different medicines.
Your doctor or pharmacist has more information on medicines to be careful with or
to avoid while taking Thalomid.
HOW TO TAKE THALOMID
Follow all directions given to you by your doctor or pharmacist carefully.
They may differ from the information contained in this leaflet. You should check with
your doctor if you are not sure.
How much to take
Your doctor will choose the dose for you, monitor your progress and may adjust your
dose. Your doctor will tell you how much Thalomid to take and for how long you will
need to take it.
For the treatment of newly diagnosed multiple myeloma, the usual dose is 200 mg a
day, taken in treatment cycles lasting 4 to 6 weeks, in combination with the following
melphalan and prednisolone which are taken on Days 1 to 4 of each 6-week cycle.
dexamethasone which is taken on Days 1 to 4, 9 to 12 and 17 to 20 of each 4-week cycle.
For newly diagnosed multiple myeloma patients above 75 years of age taking Thalomid
in combination with melphalan and prednisone, the thalidomide recommended starting
dose is 100 mg per day.
For the treatment of multiple myeloma after failure of other treatments, doses of
Thalomid from 200 mg a day up to 400 mg a day may be given.
For the treatment of erythema nodosum leprosum, Thalomid may be given in doses of
100 to 400 mg a day.
How to take it
Swallow the capsules whole with a full glass of water.
Do not crush or chew the capsule.
When to take it
Take this medicine by mouth, at least one hour after food.
If you have to take multiple capsules, take them as a single dose before going to
This will make you feel less sleepy at other times.
If you forget to take Thalomid
If you forget to take Thalomid at your regular time and
less than 12 hours have passed, take your capsule immediately. Take your next capsule
at the usual time.
more than 12 hours have passed, do not take your capsule. Take your next capsule at
the usual time the next day.
If you are not sure what to do, ask your doctor or pharmacist.
If you have trouble remembering when to take your medicine, ask your pharmacist for
If you take too much Thalomid (overdose)
Immediately telephone your doctor or Poisons Information Centre (telephone 13 11 26)
for advice, or go to Accident and Emergency at your nearest hospital, if you think
that you or anyone else may have taken too much Thalomid. Do this even if there are
no signs of discomfort or poisoning. Keep the telephone numbers for these places handy.
If you have any further questions on the use of Thalomid, ask your doctor or pharmacist.
WHILE YOU ARE TAKING THALOMID
Things you must do
Women - Tell your doctor immediately if you suspect that you are pregnant. You should
also stop taking Thalomid in this case.
Tell any other doctors, dentists, and pharmacists who treat you that you are taking
If you are about to be started on any new medicine, tell your doctor, dentist or pharmacist
that you are taking this medicine.
Keep all your doctor's appointments so that your progress can be checked.
Your doctor may do some tests (blood tests, nerve function tests, etc.) from time
to time to make sure the medicine is working and to prevent unwanted side effects.
Things you must not do
Women - Do not become pregnant or breastfeed whilst taking Thalomid.
Men - Do not donate semen during treatment or for 4 weeks after stopping treatment.
Do not have sexual intercourse without using effective means of contraception.
Do not donate blood during treatment or for 4 weeks after stopping treatment.
Do not drive or operate machinery until you know how Thalomid affects you.
This medicine may cause drowsiness or dizziness in some people.
Do not drink alcohol while you are taking this medicine.
This is because alcohol can make you sleepy and this medicine can make you even sleepier.
Do not stop taking Thalomid (unless you suspect that you are pregnant) or change the
dose without first checking with your doctor.
Do not let yourself run out of medicine over the weekend or on holidays.
Do not give this medicine to anyone else, even if they have similar symptoms or the
same condition as you.
Do not take this medicine to treat any other complaints unless your doctor tells you
Things to be careful of
If you feel light-headed, dizzy or faint when getting out of bed or standing up, get
Standing up slowly, especially when you get up from bed or chairs, will help your
body get used to the change in position and blood pressure. If this problem continues
or gets worse, talk to you doctor.
Tell your doctor or pharmacist as soon as possible if you do not feel well while you
are taking Thalomid.
Like all medicines, Thalomid can have side effects. Sometimes they are serious, most
of the time they are not. You may need medical attention if you get some of the side
Do not be alarmed by the following list of possible side effects.
You may not experience any of them.
Tell your doctor or pharmacist if you notice any of the following and they worry you:
Constipation, indigestion, feeling sick (nausea), being sick (vomiting), stomach pain,
Rash, dry skin
Fainting, dizziness, sleepiness, tiredness, shaking (tremor), headache, blurred vision,
difficulty in co-ordinating movement, loss of balance
Swelling of the hands and feet, feeling generally unwell, weakness, feeling the cold
Depression, confusion, mood changes, anxiety
Low blood pressure; a spinning feeling in your head, making it difficult to stand
up and move normally
Slow heart rate
Decreased sexual drive, abnormal periods.
The above list mainly includes the more common side effects of your medicine.
Tell your doctor as soon as possible if you notice any of the following:
Numbness, tingling, abnormal co-ordination or pain in your hands and feet.
This may be due to nerve damage. It may become very severe, painful and disabling.
If you experience such symptoms, speak to your doctor immediately, who may reduce
the dose or discontinue the treatment. This side effect usually happens after you
have been taking Thalomid for several months but can happen sooner than this. It can
also happen some time after treatment has stopped. It may not go away, or may go away
Signs of frequent infections such as fever, severe chills, sore throat or mouth ulcers;
bleeding or bruising more easily than normal; and tiredness, headaches, shortness
of breath, dizziness and looking pale.
This may be due to low numbers of blood cells in your body. Your doctor may monitor
your blood cell numbers during treatment with Thalomid
Chest pain and dry cough
This may be due to a chest infection e.g. pneumonia, or other lung problems.
Seizures, fits or convulsions.
The above list includes serious side effects that may require medical attention.
If any of the following happens, stop taking Thalomid and see a doctor immediately
or go to Accident and Emergency at your nearest hospital:
Sudden signs of allergy
such as rash, itching or hives on the skin; swelling of the face, lips or tongue or
other parts of the body; and/or shortness of breath, wheezing or trouble breathing.
Severe skin reactions
including painful red patches on the skin; blisters; bleeding in the lips, eyes, mouth
and nose; and peeling of the skin. You may have a high temperature, chills and muscle
ache at the same time.
These could be due to rare but severe skin reactions such as Stevens-Johnson Syndrome,
Toxic Epidermal Necrolysis and Drug Reaction with Eosinophilia and Systemic Symptoms.
Blurred vision; severe headache; weakness or numbness in the face, arm or leg; trouble
speaking or understanding; loss of balance.
This may be due to a stroke which could be a result of blood clots in the blood vessels
of your brain.
Sudden pain in your chest or difficulty in breathing.
This may be due to a heart attack or blood clots in the artery leading to your lungs.
These can happen during treatment, or after treatment has stopped.
Pain or swelling in your legs, especially in your lower leg or calves.
This may be due to blood clots in the veins of your leg. These can happen during treatment,
or after treatment has stopped.
Feeling short of breath or getting tired easily after light physical activity, and
swollen ankles and feet.
This could be due to high blood pressure in the lungs or heart failure, a condition
where the heart muscle cannot pump blood strongly enough to supply blood throughout
Vomiting blood or material that looks like coffee grounds, bleeding from the back
passage, black sticky bowel motions (stools) or bloody diarrhoea.
These could be signs of bleeding in your gut.
Abdominal pain, dark urine, fever, joint pain, loss of appetite, nausea and vomiting,
yellowing of the skin and/or eyes.
These are symptoms of liver failure which, in some cases, may be due to Hepatitis
B virus infection. Some cases of Hepatitis B virus infection may not result in symptoms
The above list includes very serious side effects. You may need urgent medical attention.
Most of these side effects are uncommon.
Tell your doctor or pharmacist if you notice anything that is making you feel unwell.
Other side effects not listed above may also occur in some people.
AFTER TAKING THALOMID
Keep Thalomid out of the reach and sight of children.
Store your medicine in a cool, dry place where the temperature stays below 25°C.
Do not use Thalomid after the expiry date, which is stated on the pack after 'EXP'.
The expiry date refers to the last day of that month.
Do not use any pack that is damaged or shows signs of tampering. In that case, return
it to your pharmacist.
Keep this medicine in the original package in order to protect it from light.
If your doctor tells you to stop treatment with Thalomid or it has passed its expiry
date, return any medicine that is left over to your pharmacist.
Medicines should not be disposed of via wastewater or household waste. These measures
will help to protect the environment.
What Thalomid looks like
Thalomid is available as 50 mg or 100 mg capsules in blister packs containing 28 capsules.
Thalomid 50 mg capsules
White, opaque capsule shells imprinted with "Celgene 50mg" with a "Do not get pregnant"
symbol in black ink (SW-9008/SW-9009). The capsule shell contains gelatin and titanium
Thalomid 100 mg capsules
Tan, opaque capsule shells imprinted with "Celgene 100mg" with a "Do not get pregnant"
symbol in black ink (SW-9008/SW-9009). The capsule shell contains gelatin, titanium
dioxide (E171) and colourants black iron oxide and yellow iron oxide.
Thalomid 50 mg and 100 mg capsules contain 50 mg and 100 mg, respectively, of thalidomide
as the active ingredient.
Thalomid capsules also contain pregelatinised starch and magnesium stearate.
The capsule shell ingredients are listed above in the section 'What Thalomid looks
This medicine does not contain any lactose.
Thalomid is supplied in Australia by:
Celgene Pty Limited
Level 15, 60 City Road,
Southbank, VIC 3006.
Telephone: 1800 CELGENE (1800 235 4363)
® = Registered Trademark
This leaflet was updated in April 2019.
Australian Registration Number:
Thalomid (thalidomide) 50 mg capsules - AUST R 156729
Thalomid (thalidomide) 100 mg capsules - AUST R 156902
(Celgene Version 2.11.0)