Pomalidomide (Pomalyst®)

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About This Drug

Pomalidomide is used to treat cancer. It is given orally (by mouth).

Possible Side Effects

  • A decrease in the number of white blood cells. This may raise your risk of infection.
  • A decrease in the number of red blood cells. This may make you tired and weak.
  • Nausea
  • Diarrhea (loose bowel movements)
  • Constipation (unable to move bowels)
  • Fever
  • Tiredness and weakness
  • Back pain
  • Upper respiratory infection
  • Trouble breathing

Note: Each of the side effects above was reported in 30% or greater of patients treated with pomalidomide. Not all possible side effects are included above.

Warnings and Precautions

  • Blood clots and events such as stroke and heart attack. A blood clot in your leg may cause your leg to swell, appear red and warm, and/or cause pain. A blood clot in your lungs may cause trouble breathing, pain when breathing, and/or chest pain.
  • Severe bone marrow suppression.
  • Changes in your liver function, which can cause liver failure and be life-threatening.
  • Allergic reactions, including anaphylaxis are rare but may happen in some patients. Signs of allergic reaction to this drug may be swelling of the face, feeling like your tongue or throat are swelling, trouble breathing, rash, itching, fever, chills, feeling dizzy, and/or feeling that your heart is beating in a fast or not normal way. If this happens, do not take another dose of this drug. You should get urgent medical treatment.
  • Severe allergic skin reaction. You may develop blisters on your skin that are filled with fluid or a severe red rash all over your body that may be painful.
  • Confusion and/or feeling dizzy, which may impair your ability to drive or use machinery. Use caution and tell your nurse or doctor if you feel dizzy or confused. 
  • Effects on the nerves are called peripheral neuropathy. You may feel numbness, tingling, or pain in your hands and feet. It may be hard for you to button your clothes, open jars, or walk as usual. The effect on the nerves may get worse with more doses of the drug. These effects get better in some people after the drug is stopped but it does not get better in all people. 
  • Tumor lysis syndrome: This drug may act on the cancer cells very quickly. This may affect how your kidneys work and can be life-threatening.
  • This drug may raise your risk of getting a second cancer.

Note: Some of the side effects above are very rare. If you have concerns and/or questions, please discuss them with your medical team.

Important Information

  • You will need to sign up for a special program called Pomalyst® REMS when you start taking this drug. Your nurse will help you get started.
  • Do not donate blood during your treatment and for 4 weeks after your treatment.
  • Men should not donate sperm during your treatment because this drug is present in semen and may cause harm to a baby.
  • Avoid smoking while taking pomalidomide as this may lower the levels of the drug in your body, which can make it less effective.

How to Take Your Medication

  • Swallow the medicine whole with water, with or without food. Do not chew, break, or open it.
  • Take this medicine as directed at the same time each day.
  • Missed dose: If you miss a dose, take it as soon as you think about it ONLY if it has been less than 12 hours since your regular time. If it has been more than 12 hours, skip the missed dose and contact your doctor. Take your next dose at the regular time. Do not take 2 doses at the same time and do not double up on the next dose.
  • If you vomit a dose, take your next dose at the regular time.
  • Handling: Wash your hands after handling your medicine; your caretakers should not handle your medicine with bare hands and should wear latex gloves.
  • If you get any of the content of a broken capsules on your skin or inside of your mouth, you should wash the area of the skin well with soap and water right away. Flush your mouth with flowing water. Call your doctor if you get a skin reaction.
  • This drug may be present in the saliva, tears, sweat, urine, stool, vomit, semen, and vaginal secretions. Talk to your doctor and/or your nurse about the necessary precautions to take during this time.
  • Storage: Store this medicine in the original container at room temperature.
  • Disposal of unused medicine: Do not flush any expired and/or unused medicine down the toilet or drain unless you are specifically instructed to do so on the medication label. Some facilities have take-back programs and/or other options. If you do not have a take-back program in your area, then please discuss with your nurse or your doctor how to dispose of unused medicine.

Treating Side Effects

  • Manage tiredness by pacing your activities for the day.
  • Be sure to include periods of rest between energy-draining activities.
  • To decrease the risk of infection, wash your hands regularly.
  • Avoid close contact with people who have a cold, the flu, or other infections.
  • Take your temperature as your doctor or nurse tells you, and whenever you feel like you may have a fever.
  • To help decrease bleeding, use a soft toothbrush. Check with your nurse before using dental floss.
  • Be very careful when using knives or tools.
  • Use an electric shaver instead of a razor.
  • Drink plenty of fluids (a minimum of eight glasses per day is recommended).
  • If you throw up or have loose bowel movements, you should drink more fluids so that you do not become dehydrated (lack of water in the body from losing too much fluid).
  • If you have diarrhea, eat low-fiber foods that are high in protein and calories and avoid foods that can irritate your digestive tracts or lead to cramping.
  • Ask your nurse or doctor about medicine that can lessen or stop your diarrhea and/or constipation 
  • To help with nausea and vomiting, eat small, frequent meals instead of three large meals a day. Choose foods and drinks that are at room temperature. Ask your nurse or doctor about other helpful tips and medicine that is available to help stop or lessen these symptoms.
  • If you are not able to move your bowels, check with your doctor or nurse before you use enemas, laxatives, or suppositories.
  • Keeping your pain under control is important to your well-being. Please tell your doctor or nurse if you are experiencing pain.
  • If you have numbness and tingling in your hands and feet, be careful when cooking, walking, and handling sharp objects and hot liquids.
  • If you get a rash do not put anything on it unless your doctor or nurse says you may. Keep the area around the rash clean and dry. Ask your doctor for medicine if your rash bothers you.

Food and Drug Interactions

  • There are no known interactions of pomalidomide with food.
  • Check with your doctor or pharmacist about all other prescription medicines and over-the-counter medicines and dietary supplements (vitamins, minerals, herbs and others) you are taking before starting this medicine as there are known drug interactions with pomalidomide. Also, check with your doctor or pharmacist before starting any new prescription or over-the-counter medicines, or dietary supplements to make sure that there are no interactions.

When to Call the Doctor

Call your doctor or nurse if you have any of these symptoms and/or any new or unusual symptoms:

  • Fever of 100.4 F (38 C) or higher
  • Chills
  • Tiredness that interferes with your daily activities
  • Feeling dizzy or lightheaded
  • Easy bleeding or bruising
  • Your leg or arm is swollen, red, warm and/or painful
  • Chest pain or symptoms of a heart attack. Most heart attacks involve pain in the center of the chest  that lasts more than a few minutes. The pain may go away and come back. It can feel like pressure, squeezing, fullness, or pain. Sometimes pain is felt in one or both arms, the back, neck, jaw, or stomach. If any of these symptoms last 2 minutes, call 911.
  • Symptoms of a stroke such as sudden numbness or weakness of your face, arm, or leg, mostly on one side of your body; sudden confusion, trouble speaking or understanding; sudden trouble seeing in one or both eyes; sudden trouble walking, feeling dizzy, loss of balance or coordination; or sudden, bad headache with no known cause. If you have any of these symptoms for 2 minutes, call 911.
  • Wheezing or trouble breathing
  • Coughing up yellow, green, or bloody mucus
  • Nausea that stops you from eating or drinking and/or is not relieved by prescribed medicines
  • Diarrhea, 4 times in one day or diarrhea with lack of strength or a feeling of being dizzy
  • No bowel movement in 3 days or when you feel uncomfortable
  • Lasting loss of appetite or rapid weight loss of five pounds in a week
  • Pain that does not go away, or is not relieved by prescribed medicines
  • Signs of possible liver problems: dark urine, pale bowel movements, bad stomach pain, feeling very tired and weak, unusual itching, or yellowing of the eyes or skin
  • Signs of tumor lysis: confusion or agitation, decreased urine, nausea/vomiting, diarrhea, muscle cramping, numbness and/or tingling, seizures
  • Signs of allergic reaction: swelling of the face, feeling like your tongue or throat are swelling, trouble breathing, rash, itching, fever, chills, feeling dizzy, and/or feeling that your heart is beating in a fast or not normal way. If this happens, call 911 for emergency care.
  • Numbness, tingling, or pain your hands and feet
  • Flu-like symptoms: fever, headache, muscle and joint aches, and fatigue (low energy, feeling weak)
  • A new rash or a rash that is not relieved by prescribed medicines
  • If you think you may be pregnant or may have impregnated your partner

Reproduction Warnings

  • Pregnancy warning: This drug can have harmful effects on the unborn baby. Women of child bearing potential should use 2 effective methods of birth control, one of which must be a highly effective method of birth control, beginning 4 weeks before treatment starts, during your cancer treatment, including dose interruptions, and for at least 4 weeks after treatment. A highly effective method of birth control includes tubal ligation, intra-uterine device (IUD), hormonal (birth control pills, injections, patch and/or implants) or a partner’s vasectomy. Let your doctor know right away if you think you may be pregnant.
  • Two negative pregnancy tests are required in women of child-bearing potential prior to starting treatment.
  • You will need to have routine pregnancy tests while you are taking this drug.
  • Men with female partners of childbearing potential should use effective methods of birth control  during your cancer treatment and for at least 4 weeks after your cancer treatment. You should always wear a condom even if you have undergone a successful vasectomy. Let your doctor know right away if you think you may have impregnated your partner. 
  • Breastfeeding warning: Women should not breastfeed during treatment because this drug could enter the breast milk and cause harm to a breastfeeding baby.
  • Fertility warning: In women, this drug may affect your ability to have children in the future. Talk with your doctor or nurse if you plan to have children. Ask for information on egg banking.

Revised June 2019

This patient information was developed by Via Oncology, LLC © 2019. This information is not intended to be used as a substitute for professional medical advice, diagnosis, or treatment. You should not rely entirely on this information for your health care needs. Ask your own doctor or health care provider any specific medical questions that you have.

CLIENT acknowledges that the Via Pathways and Via Portal are information management tools only, and that Via Oncology, LLC has not represented the Via Pathways or Via Portal as having the ability to diagnose disease, prescribe treatment, or perform any other tasks that constitute the practice of medicine. The clinical information contained in the Via Pathways and Via Portal are intended as a supplement to, and not a substitute for, the knowledge, expertise, skill, and judgment of physicians, pharmacists and other healthcare professionals involved with patient care at CLIENT facilities.