An immune-modifying medicine for myeloma
Pomalidomide
A specialist immune-modifying medicine used to treat myeloma, a cancer of the bone marrow.
What is Pomalidomide?
Pomalidomide is a specialist immune-modifying medicine used to treat myeloma, a cancer of the plasma cells in the bone marrow, usually after other treatments have been tried. It is taken by mouth, often combined with a steroid. Its most important risks are serious birth defects, so it is given only under a strict pregnancy-prevention programme; a raised risk of blood clots, which means clot-preventing treatment is usually needed; and low blood counts, which require regular blood tests. It is prescribed and supervised by a specialist cancer team.
Education and reference only. This is a plain-language guide to Pomalidomide — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Pomalidomide is a medicine of the immunomodulator group, used by cancer specialists to treat myeloma — a cancer that affects plasma cells in the bone marrow. It is usually used when myeloma has come back or has not responded to earlier treatments, and it is often combined with a steroid. It is taken by mouth in cycles. Because of its serious risks, particularly the risk of severe harm to an unborn baby, it is supplied only through a tightly controlled programme and is prescribed and monitored by a specialist team.
How it works
Pomalidomide works in several ways against myeloma. It has a direct effect on the myeloma cells, helping to stop them growing and survive, and it also adjusts the immune system so that the body's own defences work better against the cancer. It additionally affects the blood supply that tumours rely on. Because it is related to thalidomide, it shares thalidomide's most serious danger — causing severe birth defects — which is why pregnancy must be strictly avoided. It is given in repeated treatment cycles, usually alongside a steroid, with regular checks.
Company & origin
Originated / developed by: Specialist manufacturer.
A specialist immune-modifying medicine used in the UK to treat myeloma, a cancer of the bone marrow, usually after other treatments.
Practical use
How to take Pomalidomide
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Take it by mouth as prescribed, in the treatment cycles set by your specialist team, often with a steroid.
- Follow the pregnancy-prevention programme exactly, including contraception and pregnancy tests, as it can cause severe birth defects.
- Take any clot-preventing medicine you are given, as pomalidomide raises the risk of blood clots.
- Attend all blood tests, as it can lower your blood counts, and report any signs of infection, bleeding or unusual tiredness.
- Report any leg swelling or pain, chest pain or breathlessness urgently, as these can signal a blood clot.
Weighing it up
Advantages & disadvantages of Pomalidomide
Advantages
- An effective treatment option for myeloma, including when it has returned or not responded to earlier treatment.
- Taken by mouth at home in cycles, rather than as an infusion.
- Works in several ways, including directly on the cancer and by adjusting the immune system.
Disadvantages
- Can cause serious birth defects, so it requires a strict pregnancy-prevention programme.
- Raises the risk of blood clots, usually needing clot-preventing treatment alongside it.
- Commonly lowers the blood counts, increasing the risk of infection, bleeding and anaemia.
Practical use
Good to know
Three risks dominate. The most serious is that pomalidomide can cause severe birth defects, so it is supplied only under a strict pregnancy-prevention programme: this means reliable contraception, regular pregnancy tests, and careful rules for both women and men, because it can also be passed in semen. Second, it raises the risk of blood clots in the legs and lungs, so clot-preventing treatment is usually given alongside it, and any leg swelling, chest pain or breathlessness must be reported urgently. Third, it commonly lowers the blood counts, increasing the risk of infection, bleeding or anaemia, so regular blood tests are essential and signs of infection should be reported. It is a specialist medicine taken in cycles under close supervision. Tiredness, tummy upset and a higher infection risk are common, and the team will give you clear instructions on safe handling and what to watch for.
Who should not take it / use with caution
- It must not be used in pregnancy, as it causes serious birth defects, and it requires a strict pregnancy-prevention programme.
- People who have had a serious allergic reaction to pomalidomide should not take it.
- It is not suitable for anyone unable to follow the pregnancy-prevention and monitoring requirements.
- It is used with caution in people at high risk of blood clots or with significant kidney or liver problems, under specialist guidance.
Monitoring
- Regular blood tests to check the blood counts and adjust treatment.
- Pregnancy tests and contraception checks as part of the pregnancy-prevention programme.
- Watching for signs of blood clots and infection throughout treatment.
Side effects
- Low blood counts, leading to a higher risk of infection, bleeding or anaemia.
- Tiredness, tummy upset such as constipation or diarrhoea, and a higher risk of infection.
- Blood clots in the legs or lungs, which need urgent attention.
- Rarely but seriously, severe allergic or skin reactions, or serious infections, which need urgent medical care.
Key interactions
- It is used carefully with other medicines that raise the risk of blood clots or affect the blood counts.
- Some medicines can change the level of pomalidomide in the body, so a full medicines list is needed.
- Live vaccines are generally avoided, and other medicines are reviewed by the specialist team.
Available as: Capsules taken by mouth.
Answers
Pomalidomide: frequently asked questions
What is pomalidomide used for?
It is a specialist medicine used to treat myeloma, a cancer of the plasma cells in the bone marrow, usually after other treatments, and is often taken with a steroid.
Why is there a pregnancy-prevention programme?
Pomalidomide can cause serious birth defects, so it is supplied only under a strict programme that includes reliable contraception, regular pregnancy tests and careful rules for both women and men.
Why do I need a blood thinner with it?
Pomalidomide raises the risk of blood clots in the legs and lungs, so clot-preventing treatment is usually given alongside it. Report any leg swelling, chest pain or breathlessness urgently.
Why do I need regular blood tests?
It commonly lowers the blood counts, which increases the risk of infection, bleeding and anaemia, so regular blood tests are needed to check your levels and adjust treatment.
How is it taken?
It is taken by mouth as capsules in repeated treatment cycles set by your specialist team, usually together with a steroid, under close supervision.
Authoritative sources
- BNF
- NICE CKS
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