Pomalidomide (POMALYST)

Multiple myeloma

Multiple myeloma

• Oral: 4 mg daily for 21 days out of a 28-day cycle. Continue until progression or unacceptable toxicity
• Given as monotherapy or in combination with chemotherapy or biologics

Available as 1mg, 2mg, 3mg, and 4mg capsules. Capsules should NOT be opened. Store at room temperature.

Immunomodulator

Take with or without food

If a dose is missed, patients should be instructed to take it as soon as they can if it is within 12 hours of the missed dose. If it is over 12 hours since the missed dose, patients should skip the missed dose and resume with the next scheduled dose.

Common: Anemia, Neutropenia, Thrombocytopenia, Fatigue, Infection.

Less Common: Pneumonia, Hepatotoxicity, Second primary malignancies, Hematuria, Incontinence, Deep vein thrombosis, Pulmonary embolism.

The adverse effects listed above are not exhaustive. Please refer to the relevant product monograph for full details.

Baseline before treatment: CBC, liver function tests, renal function tests.

During treatment: CBC (weekly for the first 8 weeks then monthly thereafter), liver function tests, renal function tests, clinical toxicity assessment for infection, bleeding, hypersensitivity, thromboembolism, secondary malignancies, pneumonitis, hepatitis, TLS, neurological and skin effects

• Controlled distribution program requirements regarding pregnancy tests for women of child-bearing potential: Before starting, during treatment and for at least 4 weeks after discontinuation.
  • If female of childbearing potential: Every week for 4 weeks during cycle 1: quantitative betahCG blood test.

• Cigarette smoking may reduce pomalidomide plasma levels due to CYP 1A2 induction and lead to reduced efficacy of pomalidomide.
• This drug can impact or be impacted by metabolic enzymes for absorption and excretion. Many drugs can also affect or be affected by these enzymes, so please consult with pharmacy to assess for interactions.
• Current drug interaction databases should be consulted for more information.

• Avoid in pregnancy and lactation.
• Patients must be enrolled in a medication surveillance program prior to starting treatment.
• Patients are at increased risk of deep vein thrombosis and pulmonary embolism. Patients should be started on prophylaxis. ASA 81mg po daily can be used in patients not currently taking anticoagulants.

BC Cancer. BC Cancer Drug Manual. Pomalidomide.  Vancouver, British Columbia: BC Cancer Agency. Available at: http://www.bccancer.bc.ca/drug-database-site/Drug%20Index/Pomalidomide_monograph.pdf. Updated August 1, 2017 Accessed February 2, 2024.

Lexicomp. Pomalidomide Monograph. In: Lexi-Drugs. Hudson, Ohio: Lexi-Comp, Inc. Available at: https://online-lexi-com.qe2a-proxy.mun.ca/lco/action/doc/retrieve/docid/patch_f/4147402?cesid=a1bgW9osgjz&searchUrl=%2Flco%2Faction%2Fsearch%3Fq%3Dpomalidomide%26t%3Dname%26acs%3Dfalse%26acq%3Dpomalidomide. Updated January 24, 2024. Accessed February 2, 2024.

Cancer Care Ontario. Pomalidomide Monograph. Drug Formulary. Toronto, Ontario: Cancer Care Ontario. Available at:https://www.cancercareontario.ca/en/drugformulary/drugs/monograph/44361 . Updated July 2023. Accessed January 22, 2024.

Celgene. POMALYST® Product Monograph. Mississauga, Ontario. Updated February 2, 2021.