Erythema nodosum leprosum

Mode of action for immunosuppression is unclear; inhibition of neutrophil chemotaxis and decreased monocyte phagocytosis may occur; may cause 50% to 80% reduction of tumor necrosis factor – alpha.

Food may delay but does not appear to substantially affect the extent of absorption of thalidomide. Thalidomide crosses the placenta in humans. The principal metabolic pathway of thalidomide appears to be nonenzymatic spontaneous hydrolysis. The mean elimination half-life of thalidomide following a single 200-mg oral dose ranges from 3–6.7 hours.

Hypersensitivity to thalidomide or any component of the formulation, neuropathy (peripheral), pregnancy , women in childbearing years, sexually active males not using latex condom, risk to fetus from semen of male patients taking thalidomide unknown.

X

Avoided.

Somnolence (37.5%), rash (20.8%), headache (12.5%), impotence (8.2%), deep thrombophlebitis, orthostatic hypotension, pulmonary embolism, peripheral neuropathy, Stevens-Johnson syndrome, toxic epidermal necrolysis, teratogenesis.

Initial, 100-300 mg orally once daily at bedtime; MAX 400 mg/day (may be given in divided doses)