[nickymParticipant]

Help, my Husband has just started Pomalidamide 4 mgs daily etc. he has had 3 days so far and has come out in a horrible red rash over head, neck, shoulders and patches over the rest of the body. He is taking Piriton. He has been taken off Allopurinol but rash getting worse. Please has anyone else experienced this and what did the Consultant do?

[ellenModerator]

I’m sorry that no one has, as yet, replied to your post, it may be that no one on the forum has had a rash with pomalidomide. I hope you don’t mind if I reply, my name is Ellen and I am one of the Myeloma Information Specialists at Myeloma UK.

Pomalidomide, like many other drugs including allopurinol, can cause skin rashes and in some cases these can be quite severe. If the rash is severe then your husband’s haematologist may decide to stop the pomalidomide temporarily and start it off again at a lower dose, gradually increasing it to monitor for symptoms. Hopefully the Piriton will begin to work and ease the situation but it may be necessary to stop the pomalidomide.

I hope this has been of some help, but if you have any further questions, or would like to talk things through, please feel free to call the Myeloma Infoline on 0800 980 3332 – I or one of my colleagues can clarify things for you further. Alternatively you can email directly to askthenurse@myeloma.org.uk

With best wishes

Ellen

[jillsParticipant]

Hi,

My Mum had a rash when she start pomalidomide – the hospital gave her Piriton and she took that once a day which seemed to do the trick. Took a day or so to settle down once she started the Piriton so hopefully it will work with your husband, if not as Ellen says get the doctor to consider reducing the dose. Mum continued taking the Piriton all the time she was on pomalidomide – took it at night as it can make you a bit drowsy.

Hope things are improving,

Jill

[nickymParticipant]

Thank you Ellen and Jill. Husbands consultant is on holiday at the moment but back Monday. An appointment has been made for Tuesday to go back and re access treatment. Registrar very helpful and discussed with other Heamotology consultant at hospital, they decided to stop the pomalidamide until he sees his own consultant. She stressed that it was only an interim solution and possibly would go back on it  but a smaller dose. Rash has disappeared now as they got the dermatologist to have a look and they prescribed a steroid cream and diprobase plus a different anti histamine (once a day) and piriton at night. I will update after the appointment on Tuesday.

Can’t help but worry as had so many treatment over the years and last one, bloods said working, bone marrow said no. That was after 6 months of bendamustine and thalidamide. Previously, 5 years ago this treatment worked well and paraprotiens were unrecordable for a long time and it took  over 4 years before more treatment was needed.

[nickymParticipant]

Hi All

Just an update on Husbands treatment. The consultant has prescribed a much lower dose, 1mg instead of the 4 mg daily of pomalidamide. The dose will be increased gradually, but he is going to be monitored on a weekly basis. He has to take anti histamines alongside this and a short burst each week of prednisolone. He hasn’t started as yet as he is awaiting the hospital pharmacy to phone to say the  pomalidamide has been delivered to them and ready for collection. Fingers crossed it works.

[janwParticipant]

Hi,

I wondered whether your husband is also taking an antibiotic with his pomalidamide? I ask because
I’ve just started on my first relapse treatment of VCD and during the end of the first two weeks I developed a full pin head body rash, with an angry red skin and raised temperature. I felt as though I was burning up from inside and ended up in hospital for an overnight stay because my infection markers were also increased as well as my temperature. My consultant stopped the Allopurinol, together with the antibiotic co-trimoxazole and the rash gradually faded. However, there was a possibility that the toxicity of Velcade was also responsible for the rash which apparently can affect 8 – 18% of patients. There was a question over whether the steroids during the first and second week contained the rash, but during the third rest week when there were no steroids then perhaps the rash would reappear during the second cycle.

During my second cycle, I was advised to restart the antibiotic during the second week and within a few hours of taking the drug the pin head rash appeared again, together with an angry red skin and my temperature instantly raised to almost 38 c. My throat started to swell and I had tingling around my mouth. Interestingly in my first treatment with CDT in 2010, I also took the same antibiotic without any reaction which is quite strange. I wait to see my consultant next week who will look at changing the antibiotic.

I hope your husband is able to continue with pomalidamide and that his rash is manageable and preventable with the use of antihistamines and prednisone.

All the best.
Jan

[nickymParticipant]

Hi Jan.

Thanks for your comments. My husband is only on Aciclovir ( hope I have spelling is correct) to deter shingles. He has in the past had the ones you mention, however, tolerated them well. The rash was definitely Pomalidamide. He has now been on the reduced dose for just over 2 weeks and no sign of a rash. The Heamatologist  is going to increase it to 2 mg. next cycle alongside still taking antihistamines. It sounds as if your rash is an allergic reaction to the antibiotics. I do wonder sometimes about the amount of antibiotics that are prescribed for my Husband in a prophylactic role and the issue re bugs becoming resistant to them. Over the years he’s had loads due to infections not only orally but intravenously as well.

There is no way of telling if the pomalidamide is working yet as not had paraprotiens levels etcetera checked. Mind you the blood results from the 6 months of bendamustine suggested that it had reduced the myeloma activity significantly, until a  one marrow biopsy was done. The results showed that there was no change in the bone marrow. This cancer is waiting game like many others once treatment starts, then if successful its the same again isn’t it as eventually it will return. I do hope your treatment goes well and you get good results once they have sorted out your rash/allergy. Take care of yourself and once again thanks for your reply.

All the best

Nicky

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