Hi All.
My husband was recently diagnosed with multiple myeloma and is on cyclophosphamide, thalidomide, and dexamethasone (CTD) and will hopefully start Velcade soon. However, he has trouble concentrating / focusing, is experiencing tremors, and has a persistent sore throat (the last 3 days).
Are these normal side effects, or cause for concern?
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Re: Concentration issues, tremors & sore throat from CTD
Welcome to the forum, Roxb.
Sorry to hear about the side effects your husband is experiencing.
The first two side effects you mention (trouble concentrating, and tremors) sound like they could be due to both the thalidomide and the dexamethasone.
Thalidomide is most known for causing drowsiness, and long-term use also can cause peripheral neuropathy. But agitation and confusion also are potential side effects. You can find a list of side effects of thalidomide and dexamethasone together (without cyclphosphamide) starting on page 8 of this document:
https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/020785s061lbl.pdf
Also, confusion is listed as one of the top three potential side effects of thalidomide in this overview of the medication:
https://medlineplus.gov/druginfo/meds/a699032.html#side-effects
Have you noticed whether the tremors correlate with when your husband gets his dexamethasone? I suspect he may be getting a rather high dose of the dex, and that may be causing his tremors.
Dexamethasone in general can really throw people for a loop. It causes bursts of energy and insomnia, and the disruption of sleep patterns then causes all kinds of (negative) ripple effects, including the well-known "dex crash". You'll find LOTS of discussions here in the forum about dex and its side effects; just use the forum search box to search on "dex" or "dexamethasone", or follow this link:
https://myelomabeacon.org/forum/search.php?keywords=dex+dexamethasone+decadron&terms=any&author=&sc=1&sf=titleonly&sr=topics&sk=t&sd=d&st=0&ch=300&t=0&submit=Search
If your husband's "sore throat" is really just hoarseness, then it, too, could be caused by the dex. Otherwise, it may be due to a throat infection that's taken hold because your husband is immunocompromised.
In any case, please be sure to let your husband's medical team know about the side effects they're experiencing. They should be kept abreast of the side effects so that adjustments can be made as necessary. Be especially diligent about potential signs of neuropathy or cardiac issues.
Good luck, and keep us posted on how your husband is doing.
Sorry to hear about the side effects your husband is experiencing.
The first two side effects you mention (trouble concentrating, and tremors) sound like they could be due to both the thalidomide and the dexamethasone.
Thalidomide is most known for causing drowsiness, and long-term use also can cause peripheral neuropathy. But agitation and confusion also are potential side effects. You can find a list of side effects of thalidomide and dexamethasone together (without cyclphosphamide) starting on page 8 of this document:
https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/020785s061lbl.pdf
Also, confusion is listed as one of the top three potential side effects of thalidomide in this overview of the medication:
https://medlineplus.gov/druginfo/meds/a699032.html#side-effects
Have you noticed whether the tremors correlate with when your husband gets his dexamethasone? I suspect he may be getting a rather high dose of the dex, and that may be causing his tremors.
Dexamethasone in general can really throw people for a loop. It causes bursts of energy and insomnia, and the disruption of sleep patterns then causes all kinds of (negative) ripple effects, including the well-known "dex crash". You'll find LOTS of discussions here in the forum about dex and its side effects; just use the forum search box to search on "dex" or "dexamethasone", or follow this link:
https://myelomabeacon.org/forum/search.php?keywords=dex+dexamethasone+decadron&terms=any&author=&sc=1&sf=titleonly&sr=topics&sk=t&sd=d&st=0&ch=300&t=0&submit=Search
If your husband's "sore throat" is really just hoarseness, then it, too, could be caused by the dex. Otherwise, it may be due to a throat infection that's taken hold because your husband is immunocompromised.
In any case, please be sure to let your husband's medical team know about the side effects they're experiencing. They should be kept abreast of the side effects so that adjustments can be made as necessary. Be especially diligent about potential signs of neuropathy or cardiac issues.
Good luck, and keep us posted on how your husband is doing.
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