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Pharmacology: Immunomodulatory, antiangiogenic, and antineoplastic characteristics via multiple mechanisms, Selectively inhibits secretion of proinflammatory cytokines (potent inhibitor of tumor necrosis Section); enhances cell-mediated immunity by stimulating proliferation of anti-CD3 stimulated T cells (resulting in increased IL-2 and interferon gamma secretion); inhibits trophic signals to angiogenic factors in cells. Inhibits the growth of myeloma cells by inducing cell cycle arrest and cell death.
Pharmacokinetics: Absorption: Rapid.
Time to peak plasma: MDS or myeloma patients: 0.5 to 6 hours.
Distribution: Protein binding: Approximately 30%.
Excretion: Urine (approximately 82%; as unchanged drug).
Half-life elimination: 3 to 5 hours.
Moderate to severe renal impairment: Increased 3-fold.
Hemodialysis patients: Increased approximately 4.5-fold.
Hemodialysis effect: Approximately 30% of the drug in body is removed in a 4-hour hemodialysis session.
Special populations: Renal function impairment: The area under the curve was 56% greater in patients with multiple myeloma with mild renal impairment compared with those with normal renal function. There is a 3-fold increase in half-life and 66% to 75% decrease in drug clearance in patients with moderate and severe renal impairment compared with healthy subjects. Hemodialysis patients had a 4.5-fold increase in half-life and an 80% decrease in drug clearance compared with healthy subjects. Thirty percent of the drug in body was removed during a 4-hour hemodialysis session.
