Thalimax 100mg


Description


Thalidomide, sold under the brand name Thalimax 100mg, among others, is an immunomodulatory drug and the prototype of the Thalimax 100mg class of drugs. Today, Thalimax 100mg is indicated primarily as a treatment of certain cancers (multiple myeloma) and of a complication of leprosy.
Thalimax 100mg is a prescription which is used under the guidance of healthcare providers.


Indication


Thalimax 100mg in concomitant use with dexamethasone is used for the therapy of patients with recently diagnosed multiple myeloma.
Thalimax 100mg is indicated for the acute treatment of the cutaneous manifestations of moderate to severe erythema nodosum leprosum (ENL).
Thalimax 50mgis also indicated as maintenance treatment for inhibition and elimination of the cutaneous manifestations of ENL relapsed.







Dosage


The dosage recommendation of following condition as follows:
Multiple Myeloma:
The usual dose is 200mg PO qHS in 28-day cycles
Administer dexamethasone 40mg on days 1-4,9-12,17-20 of 28 days.
Erythema Nodosum leprosum :
The initial usual dose is 100-300 mg PO qHS.
If more serious reaction then may have started at 400mg, follow until active symptoms subsided, at least 2 weeks then titrate down by 50 mg increment q 2-4 weeks.

Mechanism Of Action


In patients affect with erythema nodosum leprosum (ENL) the pharmacological is not fully understood. Available data from in vitro data and preliminary clinical trials advise which the immunologic effects of this compound can vary essentially under different conditions but may be like abolition of excessive tumor necrosis factor-alpha (TNF-a) production and down-modulation of selected cell surface adhesion molecules contains in leukocyte migration. For example, Thalidomide administration has been resulted to reduce circulating levels of TNF-a in patients with ENL, however, it has also been revealing to increase plasma TNF-a levels in HIV-seropositive patients. As a cancer treatment, the drug may work as a VEGF inhibitor.

ADME


Absorption:
Time to peak plasma concentration is 2.9 to 5.7 hours
Distribution:
Plasma protein binding is 55% and 66% for the (+) R and (-) S enantiomers, respectively
Metabolism:
Metabolized hepatically by enzymes of the cytochrome P450 enzyme system.
Elimination:
Excreted in the urine as unchanged drug is less than 0.7% of the dose.
Half-life of thalidomide is 5 to 7 hours.

Precautions


Before starting Thalimax 100mg 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 Thalimax 100mg. 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 Thalimax 100mg. 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.
Avoid breast feed while taking this medication.

Drug interaction


Combination of Thalimax 100mg with opioids, antihistamines, antipsychotics, anti-anxiety agents, other CNS depressants may lead to additive sedative effect.
Thalimax 100mg interaction with cardiovascular medication will cause an additive bradycardic effect and should be used with caution.
Interaction with bortezomib, amiodarone, cisplatin, docetaxel, paclitaxel, vincristine etc will cause peripheral neuropathy and should be used with caution.
Unknown condition when combination of hormonal contraceptives further increases the risk of thromboembolism with Thalimax 100mg

Pregnancy


Pregnancy category X.
Thalimax 100mg is contraindicated during pregnancy
Thalimax 100mg will causes embryo-fetal harm when administered to pregnant female.

Side Effects


Bradycardia, Seizures, Tumor Lysis, Hypersensitivity , Teratogenicity, Venous and arterial thromboembolism, Increased Mortality , Drowsiness and somnolence, Peripheral neuropathy, Dizziness and orthostatic hypotension, Neutropenia, Thrombocytopenia, Increased HIV viral load.

Missed Dose


Take the dose as soon as possible before next dose duration. Next dose time reaches then left off the missed dose and continue regular schedule.
Avoid taking double dose at same time.
Please consult the doctor for further information.



Lactation


Avoid breastfeeding during treatment with Thalimax 100mg.


Storage


Store at 200C – 250C. Protect the drug from light.


Contraindication


Hypersentivity Pregnancy - the drug cause risk to fetal


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