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Thalidomide (Thalomid)
Available:
50 mg capsules
Dose:
100 to 300 mg daily at bedtime
Cost:
$1,017.00/month
Indications:
Treatment of resistant cutaneous (skin only) lupus,
Beh�et�s disease, or pyoderma gangrenosum
Side
effects: The most notorious side effect of this drug is
severe birth defects in babies born to mothers taking
thalidomide. Drowsiness, nerve damage, nausea, constipation,
rash, changes in mood, dry mouth, headaches, changes in heart
rate, swelling of the limbs, and dry skin have all been
reported. Low white blood cells, irregular menstrual periods,
changes in blood sugar, and altered thyroid function are less
frequently seen.
Monitoring:
Baseline blood counts and blood chemistries can be
performed and repeated only as needed. Women of child-bearing
potential should use this medication with extreme caution if
at all. If electing to use thalidomide, baseline serum or
urine pregnancy tests should be performed and repeated every
month while taking thalidomide and for 4 weeks after
discontinuing. Baseline nerve conduction studies should also
be performed and repeated every 6-12 months.
Important
points to know: Notify your provider if you develop any
numbness, tingling, or burning of the hands or feet, as well
as for any rash, unexplained fever, change in heart rate, or
low blood pressure. Alcohol should be avoided altogether or
at least minimized while taking this medication. If women of
child-bearing potential elect to use this medication, reliable
birth control and monitoring as outlined above is mandatory.
While expensive, thalidomide may be obtained at a minimal
expense from the participating drug company by filling out
paperwork.
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