Drug General Information (ID: DDI2I0RHEW)
Drug Name			Dienestrol (topical)		Drug Info		Pomalidomide		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Estrogens				Antineoplastics/Immunosuppressants
Structure

Mechanism of Dienestrol (topical)-Pomalidomide Interaction (Severity Level: Major)
Additive thrombogenic effects Click to Show/Hide Mechanism Graph
Drug Name		Dienestrol (topical)				Pomalidomide
Mechanism		Thrombogenic effects				Thrombogenic effects
Key Mechanism Factor 1
		Factor Name		Thrombogenic effects
		Factor Description		Drug-induced thrombosis disrupts the balance between thrombogenic factors and protective mechanisms and tends to produce thrombosis. Drug-induced thrombosis usually causes venous thrombotic events, and arterial thrombotic events are also noted as a result of drug administration
Mechanism Description		Additive thrombogenic effects by the combination of Dienestrol (topical) and Pomalidomide

Recommended Action
Management		Agents that are known to cause thrombosis should be used with caution in multiple myeloma patients receiving pomalidomide. Prophylactic antithrombotic measures should be considered after assessing underlying risk factors such as health history and concomitant medications. Patients should be advised to seek medical attention if they develop potential signs and symptoms of thromboembolism such as chest pain shortness of breath rapid pulse pain, swelling, and/or discoloration in an arm or leg and numbness or weakness on one side of the body.

References
1	Product Information. Fareston (toremifene). Schering Laboratories, Kenilworth, NJ.
2	Product Information. Pomalyst (pomalidomide). QLT Phototherapeutics Inc, Vancouver, AZ.
3	Therapeutic Research Faculty "Natural Medicines Comprehensive Database."