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Pomalidomide (Oral route)

Pronunciation:

poe-ma-LID-oh-mide

Brand Names:

  • Pomalyst

Dosage Forms:

  • Capsule

Warnings:

Oral route(Capsule)

Pomalidomide is contraindicated in pregnancy. Pomalidomide is a thalidomide analogue. Thalidomide is a known human teratogen that causes severe life-threatening birth defects. For females of reproductive potential: Exclude pregnancy before start of treatment. Prevent pregnancy during treatment by the use of 2 reliable methods of contraception. Pomalidomide is available only under a restricted distribution program called POMALYST REMS. DVT and pulmonary embolism occur in patients with multiple myeloma treated with pomalidomide .

Uses of This Medicine:

Pomalidomide is used to treat multiple myeloma (cancer of the blood) in patients who have received at least 2 other medicines that did not work well. It interferes with the growth of multiple myeloma cells, which are eventually destroyed in the body. Pomalidomide is an antineoplastic (cancer medicine).

This medicine is only available under a restricted distribution program. You will have to read and sign papers that explain how the medicine is used when you pick up your prescription.

Before Using This Medicine:

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies—

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children—

Appropriate studies have not been performed on the relationship of age to the effects of pomalidomide in the pediatric population. Safety and efficacy have not been established.

Older adults—

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of pomalidomide in the elderly.

Pregnancy—

Pregnancy CategoryExplanation
All TrimestersXStudies in animals or pregnant women have demonstrated positive evidence of fetal abnormalities. This drug should not be used in women who are or may become pregnant because the risk clearly outweighs any possible benefit.

Breast-feeding—

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Other medicines—

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Abiraterone Acetate
  • Amiodarone
  • Atazanavir
  • Azithromycin
  • Boceprevir
  • Bosutinib
  • Captopril
  • Carbamazepine
  • Carvedilol
  • Ceritinib
  • Ciprofloxacin
  • Clarithromycin
  • Cobicistat
  • Conivaptan
  • Crizotinib
  • Cyclosporine
  • Dabrafenib
  • Diltiazem
  • Dronedarone
  • Eliglustat
  • Enoxacin
  • Enzalutamide
  • Erythromycin
  • Eslicarbazepine Acetate
  • Felodipine
  • Fluconazole
  • Fluvoxamine
  • Fosphenytoin
  • Idelalisib
  • Indinavir
  • Itraconazole
  • Ketoconazole
  • Lomitapide
  • Lopinavir
  • Mitotane
  • Nefazodone
  • Nelfinavir
  • Nilotinib
  • Phenobarbital
  • Phenytoin
  • Piperaquine
  • Pixantrone
  • Posaconazole
  • Primidone
  • Quercetin
  • Quinidine
  • Ranolazine
  • Rifabutin
  • Rifampin
  • Rifapentine
  • Ritonavir
  • Saquinavir
  • Siltuximab
  • Simeprevir
  • St John's Wort
  • Telaprevir
  • Telithromycin
  • Ticagrelor
  • Tipranavir
  • Tocophersolan
  • Ulipristal
  • Voriconazole

Other interactions—

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following is usually not recommended, but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

  • Grapefruit Juice
  • Tobacco

Other medical problems—

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Anemia (low red blood cells) or
  • Blood clots or
  • Bone marrow problems or
  • Deep vein thrombosis (blood clot in the leg) or
  • Neutropenia (low white blood cells) or
  • Peripheral neuropathy (nerve problem) or
  • Pulmonary embolism (blood clot in the lung) or
  • Thrombocytopenia (low platelets in the blood)—Use with caution. May make these conditions worse.
  • Kidney disease or
  • Liver disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

Proper Use of This Medicine:

Take this medicine exactly as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.

The medicine should come with a Medication Guide. Read and follow these instructions carefully. Ask your doctor or pharmacist if you have any questions.

Take this medicine with water and on an empty stomach, at least 2 hours before or 2 hours after a meal. Take this medicine at about the same time each day.

Do not break, chew, or open the capsules. If you accidentally open or handle the medicine in the capsule, wash your skin with soap and water right away.

Dosing—

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (capsules):
    • For multiple myeloma:
      • Adults—At first, 4 milligrams (mg) once a day. Your doctor may adjust your dose as needed. This medicine is usually taken on days 1 to 21 of a 28-day cycle. This schedule is repeated again every 28 days.
      • Children—Use and dose must be determined by your doctor.

Missed dose—

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

If you miss a dose of this medicine and it is less than 12 hours since your regular time, take it as soon as you can and take your next dose at the normal time. If you miss a dose and it is more than 12 hours since your regular time, skip the missed dose and take your next dose at the normal time. Do not use extra medicine to make up for a missed dose.

Storage—

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using This Medicine:

It is very important that your doctor check your progress while you are using this medicine to see if it is working properly and to check for unwanted effects. Blood tests may be needed to check for unwanted effects.

Using this medicine while you are pregnant can harm your unborn baby. Pregnancy tests are required before and during therapy. Women who are sexually active must use 2 forms of effective birth control together to avoid pregnancy. You should begin using birth control 4 weeks before you start therapy. Continue the birth control during therapy, even if the dose is stopped for a short time, and for at least 4 weeks after your last dose. Talk to your doctor about the most effective forms of birth control for you and your partner. Call your doctor right away if you think you are pregnant.

Men who are sexually active must protect their female partner from getting pregnant. Pomalidomide will appear in the semen so male patients must not donate semen. If you are sexually active, you must use a latex or synthetic condom every time you have sex with a woman who could get pregnant even if you have had a vasectomy. Use a condom for sex during therapy, even if the dose is stopped for a short time, and for up to 28 days after your last dose. Call your doctor right away if you think your sexual partner may be pregnant.

Do not donate blood while you take this medicine and for at least 1 month after your last dose.

This medicine may cause blood clots that require immediate medical attention. Check with your doctor right away if you have shortness of breath, chest pain, or leg pain or swelling. These could be symptoms of blood clots.

Pomalidomide can temporarily lower the number of white blood cells in your blood, increasing the chance of getting an infection. It can also lower the number of platelets, which are necessary for proper blood clotting. If this occurs, there are certain precautions you can take, especially when your blood count is low, to reduce the risk of infection or bleeding:

  • If you can, avoid people with infections. Check with your doctor immediately if you think you are getting an infection or if you get a fever or chills, cough or hoarseness, lower back or side pain, or painful or difficult urination.
  • Check with your doctor immediately if you notice any unusual bleeding or bruising, black, tarry stools, blood in the urine or stools, or pinpoint red spots on your skin.
  • Be careful when using a regular toothbrush, dental floss, or toothpick. Your medical doctor, dentist, or nurse may recommend other ways to clean your teeth and gums. Check with your medical doctor before having any dental work done.
  • Do not touch your eyes or the inside of your nose unless you have just washed your hands and have not touched anything else in the meantime.
  • Be careful not to cut yourself when you are using sharp objects such as a safety razor or fingernail or toenail cutters.
  • Avoid contact sports or other situations where bruising or injury could occur.

This medicine may cause nerve damage. Check with your doctor right away if you have tingling, burning, numbness, or pain in your hands or feet. These could be symptoms of a nerve condition called peripheral neuropathy.

This medicine may cause you to feel dizzy or confused. Do not drive, use machines, or do anything else that could be dangerous until you know how this medicine affects you.

Avoid cigarette smoking while using this medicine. The blood level may be lower than normal if you smoke.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Side Effects of This Medicine:

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common
Abdominal or stomach pain
black, tarry stools
bladder pain
bleeding gums
bloating or swelling of the face, arms, hands, lower legs, or feet
blood in the urine or stools
bloody nose
body aches or pain
burning, numbness, tingling, or painful sensations
chest pain
chills
cloudy urine
confusion
constipation
cough
decreased or increased urination
depression
difficult, burning, or painful urination
difficulty with breathing
dizziness
dry mouth
ear congestion
fast or irregular heartbeat
fever
frequent urge to urinate
headache
incoherent speech
increased thirst
loss of appetite
loss of voice
lower back or side pain
metallic taste
muscle pain or cramps
muscle weakness
nasal congestion
nausea or vomiting
numbness or tingling in the hands, feet, or lips
pain
pale skin
pinpoint red spots on the skin
rapid weight gain
runny nose
shakiness in the legs, arms, hands, or feet
sneezing
sore throat
tightness in the chest
trembling or shaking of the hands or feet
troubled breathing with exertion
ulcers, sores, or white spots in the mouth
unsteadiness or awkwardness
unusual bleeding or bruising
unusual weight gain or loss
weakness in the arms, hands, legs, or feet
Less common
Anxiety
dizziness or lightheadedness
fainting
pain, redness, or swelling in the arm or leg
sudden shortness of breath or troubled breathing
Incidence not known
Difficulty in passing urine (dribbling)
weakness or heaviness of the legs
yellow eyes or skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
Back pain
blurred vision
decreased appetite
difficulty with moving
dry skin
flushed, dry skin
fruit-like breath odor
increased hunger
increased sweating
joint pain
lack or loss of strength
muscle spasms or stiffness
night sweats
rash
trouble sleeping
Incidence not known
Feeling of constant movement of self or surroundings
sensation of spinning

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.


Last Updated: 11/4/2014

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