Thalidomide, sold under the brand names Contergan and Thalomid among others, is a medication used to treat a number of cancers (including multiple myeloma), graft-versus-host disease, and a number of skin conditions including complications of leprosy.3 While it has been used in a number of HIV-associated conditions, such use is
associated with increased levels of the
virus.3 It is administered orally.
Common side effects include sleepiness, rash, and dizziness.3 Severe side effects include tumor lysis syndrome,
blood clots, and
peripheral neuropathy.4 Use in pregnancy may harm the fetus, including resulting in malformation of the limbs.3 In males who are taking the medication, contraception is essential if a partner could become pregnant.4 It is an immunomodulatory medication and works by a number of mechanisms, including stimulating T cells and decreasing TNF-α production.3
Thalidomide was first marketed in 1957 in West Germany, where it was available
over the counter.56 When first released, thalidomide was promoted for anxiety, trouble sleeping, "tension", and
morning sickness.67 While it was initially thought to be safe in pregnancy, concerns regarding birth defects arose in 1961, and the medication was removed from the market in Europe that year.65 The total number of embryos affected by use during pregnancy is estimated at 10,000, of which about 40% died around the time of birth.63 Those who survived had limb, eye, urinary tract, and heart problems.5 Its initial entry into the US market was prevented by Frances Kelsey at the FDA.7 The birth defects caused by thalidomide led to the development of greater drug regulation and monitoring in many countries.75
It was approved for medical use in the
United States in 1998.3 It is on the World Health Organization's List of Essential Medicines.8 It is available as a generic medication.4
