Thalidomide
Thalidomide is an immunomodulatory agent used primarily to treat multiple myeloma and erythema nodosum leprosum (a complication of leprosy). It works by targeting cereblon to modulate the immune system, reduce inflammation, and inhibit blood vessel formation. Due to its severe teratogenic effects, thalidomide is only available through restricted distribution programs.
An immunomodulatory drug used for multiple myeloma and leprosy complications, known for its immunomodulatory, anti-inflammatory, and antiangiogenic effects but requiring strict safety controls due to severe birth defect risks.
This medication carries a boxed (black box) warning — the strongest type of FDA warning. Review the full prescribing information before use.
Key facts at a glance
- ATC
- L04AX02
- RxNorm
- 10432
- Generic
- Thalidomide
- Class
- atc-l04a
- Brands
- Thalomid
- Availability
- rx
- Lactation
- unknown
- Routes
- oral
- Forms
- capsule
- Regions
- US, EU, CN, JP
- Monitoring
- —
This page is for informational purposes only.
Do not use this information to diagnose yourself or to replace a physician's advice. Always consult a qualified healthcare provider before starting, stopping, or changing any medication. If you believe you are experiencing a medical emergency, call your local emergency number immediately.
Thalidomide is primarily indicated for the treatment of multiple myeloma (typically in combination with dexamethasone) and for the management of erythema nodosum leprosum (ENL), an inflammatory complication of leprosy. It may also be used for other conditions including myelodysplastic syndromes and certain dermatological conditions under specialist supervision.
Thalidomide exerts its effects by binding to cereblon, a component of a cullin ring E3 ubiquitin ligase enzyme complex. This interaction leads to immunomodulatory effects including modulation of cytokine production and T-cell function, anti-inflammatory properties, and antiangiogenic activity (inhibition of new blood vessel formation), which contributes to its therapeutic effects in cancer and inflammatory conditions.
Thalidomide is a known teratogen and causes severe, life-threatening birth defects. It is absolutely contraindicated in pregnancy, and strict contraception requirements apply for patients of reproductive potential. Common side effects include peripheral neuropathy, sedation, constipation, and increased risk of venous thromboembolism (blood clots). Due to its risk profile, thalidomide is only available through restricted distribution programs requiring prescriber certification and patient enrollment.
Official drug label
WellAlly may earn a referral fee from linked resources at no extra cost to you. Editorial content is never influenced by commercial relationships.
This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.
This content is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you have about a medical condition, and never disregard professional medical advice or delay seeking it because of something you read here.
If you think you may have a medical emergency, call your local emergency number or go to the nearest emergency department immediately.
Medically reviewed by WellAlly Editorial Team Last reviewed July 26, 2026. · Read our editorial policy