Precautions of Pomalidomide
Prescription and Administration Requirements
Pomalidomide requires strict prescription control and patients must strictly follow the prescribed regimen. Do not crush, chew, or open the capsules.
Pregnancy and Reproductive Safety
Pomalidomide is a thalidomide analog and is contraindicated during pregnancy. Females of reproductive potential must avoid pregnancy for at least 4 weeks before starting treatment, during treatment, during dose interruption, and for at least 4 weeks after completing treatment. They must use two reliable methods of contraception or practice complete abstinence from heterosexual intercourse during these periods.
Two negative pregnancy tests are required before treatment initiation: the first test within 10–14 days and the second within 24 hours before dosing. Pregnancy monitoring should be performed weekly during the first month of treatment, then monthly in women with regular menstrual cycles and every 2 weeks in those with irregular cycles.
Male Patients’ Precautions
Male patients taking pomalidomide must not donate sperm. They must use a latex or synthetic condom if engaging in sexual activity with a reproductive‑potential female.
Blood Donation Restriction
Patients must not donate blood during treatment and for 1 month after stopping pomalidomide to prevent fetal exposure via transfusion to pregnant women.
Risk Management and Monitoring
Pomalidomide must be prescribed under a pregnancy prevention risk management program. Treatment regimens should be adjusted based on venous and arterial thromboembolic risk, and thromboprophylaxis is recommended for at‑risk patients. Hematological changes, especially neutrophil counts, and liver function must be monitored monthly during treatment.
General Safety Instructions
Do not use pomalidomide if expired or if the appearance has changed. Keep this medicine out of the reach of children.
Drug Interactions of Pomalidomide
Interactions with CYP1A2 Inhibitors
Concomitant use with strong CYP1A2 inhibitors (e.g., fluvoxamine, ciprofloxacin) may increase pomalidomide plasma concentrations and toxicity risk. Coadministration is not recommended; if unavoidable, pomalidomide dose reduction is advised.
Interactions with CYP1A2 Inducers
Coadministration with CYP1A2 inducers (e.g., carbamazepine, rifampicin, phenytoin, phenobarbital) may decrease plasma concentrations of pomalidomide.
Combination Therapy for Multiple Myeloma
Combination with other thalidomide analogs plus dexamethasone is not recommended outside of well‑managed clinical trials.
