Information for the public
Kidney problems
Myeloma can cause problems with your kidneys. If it does, you may be offered bortezomib and dexamethasone together with other medicines to help with this.
If bortezomib is unsuitable for you (for example, because of side effects), you may be offered thalidomide and dexamethasone together with other medicines.
You should not be offered a procedure called 'plasma exchange' for kidney problems caused by myeloma, either on its own or together with other treatments. This is because it does not work as well as the treatments listed above, and doesn't help people more when used together with other treatments.
Off-label medicines
At the time of publication, thalidomide combined with dexamethasone is recommended for 'off‑label' use when it is used to treat kidney problems caused by myeloma. Your doctor should tell you this and explain what it means for you.
In the UK, medicines are licensed to show that they work well enough and are safe enough to be used for specific conditions and groups of people. Some medicines can also be helpful for conditions or people they are not specifically for. This is called 'off‑label' use. Off‑label use might also mean the medicine is taken at a different dose or in a different way to the licence, such as using a cream or taking a tablet. There is more information about licensing medicines on NHS Choices.
Questions to ask about kidney problems
-
How can I tell if I'm starting to get kidney problems caused by myeloma?
-
How long will I have to have treatments for my kidney problems?
-
Will I have any problems if I don't take my medicine?
-
Might I have problems when I have finished taking my medicine?
-
Are there any risks with this treatment?
-
Could you tell me more about off-label medicines?
-
Are there any clinical trials of new treatments I could try?
-
Where can I (and my family/carers) find more information?