pomalidomide at a glance
Medicine class
Immunomodulatory anticancer treatment related to thalidomide.
Licensed role
Treatment of previously treated multiple myeloma in combination with other anticancer treatments.
Form
Hard capsules that must be swallowed whole.
Major precaution
A strict Pregnancy Prevention Programme applies because exposure during pregnancy is expected to cause severe birth defects.
What is pomalidomide used for?
The selected UK products are licensed for adults with multiple myeloma that has already been treated.
With bortezomib and dexamethasone after at least one previous treatment that included lenalidomide.
With dexamethasone for relapsed and refractory disease after at least two previous treatments that included lenalidomide and bortezomib, where the disease progressed on the most recent treatment.
How does pomalidomide work?
Pomalidomide binds to cereblon, changing how selected proteins are broken down inside cells. This promotes myeloma-cell death, alters immune activity involving T cells and natural killer cells, and reduces support for tumour growth and new blood-vessel formation.
pomalidomide preparations and strengths
Capsule
Route: Oral
Strengths: 1 mg, 2 mg, 3 mg, 4 mg
How to take pomalidomide
Follow the treatment calendar supplied by the specialist team.
Swallow capsules whole with water; do not open, crush, break or chew them.
They may be taken with or without food.
Press one end of the blister pocket when removing a capsule to reduce the risk of damage.
Never share capsules. Return unused capsules to a pharmacist.
Caregivers should wear disposable gloves when handling capsules or blisters. Anyone who is pregnant or might be pregnant should not handle them.
pomalidomide side effects
Common or expected effects
- Low white blood cells, red blood cells or platelets
- Infections, including chest infections
- Tiredness or fever
- Diarrhoea, constipation, nausea or vomiting
- Numbness, tingling or nerve pain
- Dizziness
- Swelling of the limbs
- Muscle spasms, weakness or bone pain
- Rash
Get urgent medical advice
- Fever or infection with low white blood cells
- Blood clot, including deep-vein thrombosis or pulmonary embolism
- Serious bleeding
- Severe allergic reaction
- Blistering or peeling skin reactions
- Interstitial lung disease or unexplained worsening breathlessness
- Severe liver injury or hepatitis B reactivation
- Progressive multifocal leukoencephalopathy, which may cause new neurological or behavioural changes
pomalidomide in pregnancy
Pomalidomide must not be used during pregnancy and is subject to a strict Pregnancy Prevention Programme. People who could become pregnant require effective contraception and supervised pregnancy testing; male patients must follow condom precautions because pomalidomide is present in semen. Contact the specialist team urgently if pregnancy occurs or is suspected during exposure.
pomalidomide while breastfeeding
It is unknown whether pomalidomide passes into human milk, and harmful effects in a breastfed infant are possible. The specialist team must decide whether breastfeeding or pomalidomide should be stopped, considering the benefits of each.
pomalidomide interactions
The oncology team should review all prescribed, pharmacy-bought and complementary products.
Strong CYP1A2 inhibitors, including ciprofloxacin, enoxacin and fluvoxamine
These can substantially increase pomalidomide exposure, so specialist review and treatment adjustment may be required.
Warfarin with dexamethasone
The effect on anticoagulation is uncertain, so closer monitoring may be needed.
Common questions about pomalidomide
Answers are fully visible for fast scanning and source review.
Can pomalidomide be taken with food?
Yes. The capsules may be taken with or without food and should be swallowed whole with water.
What should I do if I miss pomalidomide?
Do not take extra capsules. Skip the missed administration and continue with the next planned one on the prescribed calendar.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.