Thalidomide

Say it: tha-LID-oh-mide · Brand names: Thalomid

Thalidomide is a pill that helps the immune system fight multiple myeloma and slows the growth of cancer cells.

What it is

Thalidomide is the first medicine in the immunomodulatory group. It helps immune cells attack myeloma cells and cuts down the blood vessels that feed the cancer. It is usually given with dexamethasone.

Often used for

• newly diagnosed multiple myeloma
• a skin problem caused by leprosy (erythema nodosum leprosum)

How you get it

Thalidomide is a capsule you take by mouth once a day, usually at bedtime. Your schedule may be different.

Common side effects and what helps

• Feeling sleepy or drowsy. Taking it at bedtime helps. Do not drive until you know how it affects you.
• Constipation. Drink plenty of fluids, eat high fiber foods, and ask about a stool softener.
• Numbness, tingling or burning in the hands or feet. Tell your team early, since this can become permanent.
• Dizziness, especially when standing up. Sit for a minute before you stand.
• Rash. Use gentle soap and moisturizer, and tell your team about any new rash.
• Swelling in the legs or feet. Raise your legs when you sit.
• Feeling tired or weak. Rest and short walks can help.

Call your care team right away if you have

• Pain, swelling, warmth or redness in one leg or arm, sudden shortness of breath, or chest pain, which can be signs of a blood clot
• A rash with blisters, peeling skin, sores in the mouth, or a rash with fever
• Fainting or a very slow heartbeat
• A seizure
• A fever of 100.4 degrees Fahrenheit (38 degrees Celsius) or higher, or chills
• Numbness or tingling that is getting worse

Before you start, tell your team

• If you are pregnant, may become pregnant, or are breastfeeding
• If you have had blood clots
• If you have nerve problems (neuropathy) or seizures
• If you have a slow heartbeat or heart problems
• If you have HIV
• All the medicines you take, including vitamins, herbs and supplements

Good to know

• This medicine can cause severe birth defects or death of an unborn baby. You can only get it through a special safety program. People who can become pregnant need pregnancy tests and must use two forms of birth control from 4 weeks before until 4 weeks after treatment. Men must use a latex or synthetic condom during sex with a partner who is or could become pregnant, even after a vasectomy.
• It raises the risk of blood clots, especially with dexamethasone. Most people take a blood thinner or aspirin.
• Nerve damage can happen and may not go away. Your team will ask about numbness and tingling at each visit.
• Alcohol, sleeping pills and some other medicines can make the drowsiness worse.
• Do not donate blood during treatment and for 4 weeks after. Men should not donate sperm during this time.

At home

• Take it with water at bedtime, at least 1 hour after your evening meal.
• Swallow capsules whole. Do not open, break or chew them.
• If you miss a dose, ask your care team what to do. Do not take two doses to make up for it.
• Store at room temperature, away from children. Do not share your medicine.
• Caregivers should wear gloves if they touch capsules, and anyone who is pregnant should not touch them.

Questions to ask

• What should I take to prevent blood clots?
• Is it safe for me to drive while on this medicine?
• What should I do if I get numbness or tingling?
• What birth control should I use?

Part of these treatment plans

• VTd

Side effect guides

• Fatigue (tiredness)
• Constipation
• Neuropathy (numbness and tingling)
• Skin rash (including EGFR-inhibitor rash)
• Sleep problems

Last updated: 2026-10-27. Medically reviewed by Veli Bakalov, MD, medical oncologist (October 2026). General education from Step by Step, the patient portal of HemeOncBuddy.