thalidomide and weakness

[Neel]

Hi PPL,

My father has been on thalidomide for arnd last two months. He is taking 1 capsules of 100 mg daily at bed time. The problem is that he feel very weak/fatigue. His Hb is arnd 9-10. he hasnt felt this weak even at 7 Hb. I have noted that one of the side effect of thalidomide is weakness and therefore i think that it is due to the medication. Any way that he can feel better or anyway to counter this effect of thalidomide ?

Taking lower dosage of 50 mg, has been tried but taking lower dosage bring small red dots (few in numbers) on his legs and hands. His platelet count is arnd 30000 for last one month. Are these red spots rashes (side effects of thalidomide) or urpuras due to low platelet ?

Regards,

neel

[Neil Cuadra]

Neel,

If his level of fatigue has changed noticeably since he started taking thalidomide then that's evidence that it's a side effect. The doctor has the hard job of finding a dosage that will balance the positive and negative effects of the drug.

Your father's fatigue can also be a result of the MDS itself and not directly related to his hemoglobin level. Fatigue affects most MDS patients. One theory is that it's a result of elevated cytokines that are a typical aspect of the disease. It's hard to be physically active when you're sick, tired, and under treatment but patients tend to feel less fatigued if they can get up and move around. Even minimal exercise can help. Your father could try this if the doctor says OK.

The red dots are from low platelets. It's called petechiae.