Untreated multiple myeloma in patients >65 or who are ineligible for high dose chemotherapy, in combination with either melphalan and prednisone, or cyclophosphamide and dexamethasone (Unlicensed indications): Erythema nodusum leprosum Lupus erythematosus, aphthous ulceration, stomatitis, graft-versus-host disease, AIDS-associated waste syndrome, rheumatoid arthritis and other acute inflammatory conditions
20 to 50     : Dose as in normal renal function
10 to 20     : Dose as in normal renal function
<10           : Dose as in normal renal function
DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES
CAPD                : Unlikely to be dialysed. Dose as in normal renal function
HD                     : Unlikely to be dialysed. Dose as in normal renal function
HDF/high flux   : Not dialysed. Dose as in normal renal function
CAV/VVHD      : Unknown dialysability. Dose as in normal renal function
IMPORTANT DRUG INTERACTIONS
Potentially hazardous interactions with other drugs Thalidomide enhances the effects of barbiturates, alcohol, chlorpromazine and reserpine Use with caution with other drugs that can cause peripheral neuropathy
ADMINISTRATION
Reconstition
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Route
Oral
Rate of Administration
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Comments
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OTHER INFORMATION
Major route of elimination is non-renal (i.e. by spontaneous non-enzymatic hydrolytic cleavage) therefore normal doses may be given in renal failure Has been used to treat uraemic pruritus in haemodialysis patients unresponsive to other therapy. (Silva SR. Thalidomide for the treatment of uraemic pruritus: a crossover randomised double-blind trial. Nephron. 1994; 67(3): 270–3.) Can cause unexplained hyperkalaemia. Use of thalidomide in patients with myeloma and renal failure may be associated with unexplained hyperkalaemia.