Pomide

Indications

Pomalidomide is a cancer medicine used to treat multiple myeloma, a cancer of the plasma cells in the bone marrow, usually together with Dexamethasone and sometimes other medicines, when earlier treatments have stopped working. In some countries it is also used for Kaposi sarcoma.

How It Works

Pomalidomide is an immunomodulatory medicine, related to Thalidomide. It acts in several ways: it directly slows the growth of myeloma cells and causes them to die, it boosts the activity of certain immune cells (T-cells and natural killer cells) that attack cancer, and it reduces the formation of new blood vessels that tumours need to grow.

Dosage and Administration

Take exactly as prescribed by the cancer specialist. It is taken by mouth once a day, usually for the first 21 days of each 28-day cycle, with or without food, at about the same time each day. Swallow the capsules whole with water; do not open, break or chew them. The dose may be changed depending on blood counts and side effects.

Interactions

Strong CYP1A2 inhibitors such as Fluvoxamine and Ciprofloxacin can raise its level, so the dose may need reducing. Smoking may lower its level. Medicines that increase the risk of blood clots, such as hormonal contraceptives or Erythropoietin, need care. Tell your doctor about all medicines and herbal products you take.

Contraindications

• Pregnancy
• Women who could become pregnant unless all pregnancy prevention conditions are met
• Men who cannot follow the required contraception measures
• Allergy to Pomalidomide, Thalidomide, Lenalidomide or any ingredient

Side Effects

Common side effects include low blood counts (neutrophils, platelets and red cells), infections including pneumonia, tiredness, weakness, constipation, diarrhoea, nausea, back pain, muscle cramps, swelling of the legs, breathlessness, dizziness, nerve damage causing tingling or numbness, and rash. It increases the risk of blood clots in the legs and lungs. New cancers and liver problems have been reported.

Get urgent medical help if you have fever, chills or other signs of infection, unusual bleeding or bruising, chest pain, sudden breathlessness, pain or swelling in a leg, signs of stroke such as sudden weakness or trouble speaking, yellowing of the skin or eyes, or a severe skin reaction with blistering or peeling.

Pregnancy and Lactation

Pomalidomide is expected to cause severe birth defects or death of an unborn baby. It must never be taken during pregnancy. Women who can become pregnant must follow a strict pregnancy prevention programme with reliable contraception before, during and after treatment, and have regular pregnancy tests. Men must use condoms during treatment and for the period advised afterwards, and must not donate sperm. Do not breastfeed during treatment.

Precautions and Warnings

Blood counts are checked often, especially in the first months. Most patients need a medicine to prevent blood clots. Do not donate blood during treatment and for some time afterwards. Do not share your capsules; return unused capsules to the pharmacy. Carers should wear gloves if handling damaged capsules. Dizziness or tiredness may affect driving.

Overdose

Overdose may cause severe lowering of blood counts. There is no specific antidote; seek medical help straight away for monitoring and supportive care.

Therapeutic Class

Antineoplastic agent, immunomodulatory drug

Storage

Store below 30°C in a dry place, away from light, in the original pack and out of the reach of children.