Thalidomide is used along with dexamethasone to treat multiple myeloma in people who have been recently found to have this disease. It is also used alone or with other medications to treat and prevent skin symptoms of erythema nodosum leprosum (ENL; episodes of skin sores, fever, and nerve damage that occur in people with Hansen’s disease [leprosy]). Thalidomide is in a class of medications called immunomodulatory agents. It treats multiple myeloma by strengthening the immune system to fight cancer cells. It treats ENL by blocking the action of certain natural substances that cause swelling.

Side Effects Of Thalidomide

Thalidomide may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

  • drowsiness
  • confusion
  • anxiety
  • depression or mood changes
  • difficulty falling asleep or staying asleep
  • bone, muscle, joint, or back pain
  • weakness
  • headache
  • change in appetite
  • weight changes
  • nausea
  • constipation
  • dry mouth
  • dry skin
  • pale skin
  • uncontrollable shaking of a part of the body
  • swelling of the hands, feet, ankles, or lower legs
  • difficulty achieving or maintaining an erection

Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately or get emergency medical treatment:

  • rash
  • itching
  • hives
  • blistering and peeling skin
  • swelling of the face, throat, tongue, lips, or eyes
  • hoarseness
  • difficulty swallowing or breathing
  • fever, sore throat, chills, cough, or other signs of infection
  • slow or fast heartbeat
  • seizures
  • Thalidomide may cause nerve damage that can be severe and permanent. This damage may occur any time during or after your treatment. Your doctor will examine you regularly to see how thalidomide has affected your nervous system. If you experience any of the following symptoms, stop taking thalidomide and call your doctor immediately: numbness, tingling, pain, or burning in the hands and feet.

Thalidomide may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

Warnings & Precautions

Before taking thalidomide:

  • tell your doctor and pharmacist if you are allergic to thalidomide or any other medications.
  • tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention the medications listed in the WARNINGS and PRECAUTIONS section and any of the following: antidepressants; barbiturates such as pentobarbital (Nembutal), phenobarbital, and secobarbital (Seconal); chlorpromazine; didanosine (Videx); medications for anxiety, mental illness, or seizures; certain chemotherapy medications for cancer such as cisplatin (Platinol), paclitaxel (Abraxane, Taxol), and vincristine; reserpine (Serpalan); sedatives; sleeping pills; and tranquilizers. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
  • tell your doctor if you have or have ever had human immunodeficiency virus (HIV), an acquired immunodeficiency syndrome (AIDS), a low level of white blood cells in your blood, or seizures.
  • tell your doctor if you are breastfeeding.
  • you should know that thalidomide may make you drowsy. Do not drive a car, operate machinery, or do other activities that require you to be fully alert until you know how this medication affects you.
  • ask your doctor about the safe use of alcoholic beverages while you are taking thalidomide. Alcohol can make the side effects of thalidomide worse.
  • you should know that thalidomide may cause dizziness, lightheadedness, and fainting when you get up too quickly from a lying position. To help avoid this problem, get out of bed slowly, resting your feet on the floor for a few minutes before standing up.
  • you should know that thalidomide is present in your blood and body fluids. Anyone who may come into contact with these fluids should wear gloves or wash any exposed areas of skin with soap and water.

Thalidomide Dosage

Thalidomide comes as a capsule to take by mouth. Thalidomide is usually taken with water once a day at bedtime and at least 1 hour after an evening meal. If you are taking thalidomide to treat ENL, your doctor may tell you to take it more than once a day, at least 1 hour after meals. Take thalidomide at around the same time(s) every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take thalidomide exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Keep the capsules in their packaging until you are ready to take them. Do not open the capsules or handle them more than necessary. If your skin comes into contact with broken capsules or powder, wash the exposed area with soap and water.

The length of your treatment depends on how your symptoms respond to thalidomide and whether your symptoms return when you stop taking the medication. Your doctor may need to interrupt your treatment or reduce your dose if you experience certain side effects. Do not stop taking thalidomide without talking to your doctor. When your treatment is complete your doctor will probably decrease your dose gradually.


Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your body’s response to thalidomide.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.


All information has been provided courtesy of MedLinePlus from the National Library of Medicine and from the FDA.