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A medication known as pomalidomide suppresses the immune system and is used to treat multiple myeloma, a blood illness that mostly affects adults over the age of 18. Myeloma, also known as multiple myeloma, is a bone marrow malignancy that can affect various body parts such as the ribs, pelvis, spine, and skull. It is a medication used in targeted therapy as well as immunotherapy. It operates in several ways. It aids in the immune system's attack and elimination of cancer cells as well as the destruction or inhibition of cancer cell development. It may, however, also impede the growth of new blood vessels, which cancer cells require to multiply and spread. FDA approval occurred in 2013.
BRAND NAMES
Pomalyst – It contains the active ingredients of pomalidomide. It is available in the form of capsules used to treat the multiple myeloma.
Imnovid – It contains the active ingredients of pomalidomide. It is available in the of capsules.
MECHANISM OF ACTION
Pomalidomide is an immunomodulator with antineoplastic properties. It has been demonstrated to decrease the growth and cause apoptosis in several cancer cells. Pomalidomide boosts T cell and natural killer cell immunity while inhibiting monocytes' production of pro-inflammatory cytokines such as TNF-alpha and IL-6. The major target of pomalidomide is considered to be the protein cereblon. It binds to this target, inhibiting ubiquitin ligase function. It is also a transcriptional inhibitor of COX2.
PHARMACOKINETICS
ABSORPTION
After oral administration of pomalidomide the Tmax is 2 to 3 hours.
DISTRIBUTION
The apparent mean volume of distribution of pomalidomide is 62-138L
METABOLISM
The metabolism are 26-fold less active than the parent compound. Pomalidomide is hepatically metabolized by CYP1A2 and CYP3A4. Minor contributions from CYP2C19 and CYP2D6 have been observed in vitro.
EXCRETION
Pomalidomide is excreted through urine and feces
PHARMACODYNAMICS
Pomalidomide an analogue of thalidomide, is an immune modulatory antineoplastic agent. It is more potent than thalidomide and lenalidomide.
DOSAGE AND ADMINISTRATION
Pomalidomide is available as a capsule to be taken orally. It is taken once per day, with or without meals, on days 1 through 21 of a 28-day cycle. This 28-day regimen may be repeated as directed by your doctor.
DRUG INTERCATIONS
Drug interaction of pomalidomide may includes
Cancer drugs – adalimumab – avelumab
Immune modulatory medicine – baricitinib, fingolimod and leflunomide
Vaccines – BCG vaccine, measles virus vaccine
Anti-psychotic medication - clozapine
CONTRAINDICATIONS
patients should be informed of the possible risk to the foetus if this medication is used during pregnancy or if the patient gets pregnant while taking this medication.
SIDE EFFECTS
Side effects of pomalidomide may includes
- Vomiting
- Constipation
- Anxiety
- Muscle pain
- Nausea
- Weight changes
- Diarrhea
- Dry skin
Serious side effects may include
- Itching
- Rash
- Hives
- Hoarseness
- Peeling skin
- Difficulty breathing
- Swelling of the eyes
- Dark urine
- Pale skin
- Seizures
- Nose bleed
OVERDOSE
Symptoms of overdose may includes
- Neutropenia
- Anemia
- Constipation
- Nausea
- Diarrhea
- Dyspnea
- Upper-respiratory tract infections
- Back pain
- Pyrexia.
TOXICITY
In patients treated with pomalidomide monotherapy, the hematologic toxicities neutropenia, anemia and thrombocytopenia occur.
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