Editing Thalidomide (section)

==Adverse effects==
{{See also|List of thalidomide side effects}}
Thalidomide [[Teratogen|causes birth defects]].<ref name=UKlabel2017/><ref name=USlabel2017/><ref name="toxmech2009">{{Cite journal |vauthors=Smith SW |date=July 2009 |title=Chiral toxicology: it's the same thing...only different |journal=Toxicological Sciences |volume=110 |issue=1 |pages=4–30 |doi=10.1093/toxsci/kfp097 |pmid=19414517 |doi-access=free}}</ref><ref>Anastas, P. T.; Warner, J. C. Green Chemistry: Theory and Practice, p3</ref> The U.S. [[FDA|Food and Drug Administration]] (FDA) and other regulatory agencies have approved marketing of the drug only with an auditable [[risk evaluation and mitigation strategy]] that ensures that people using the drug are aware of the risks and avoid pregnancy; this applies to both men and women, as the drug can be transmitted in [[semen]].<ref name=toxmech2009/>{{Failed verification|date=September 2022|reason=source does not appear to say drug is transmitted in semen}}<ref name="bermas2019a" />

There is a high risk that thalidomide can cause excessive [[Thrombosis|blood clots]]. There is also a high risk that thalidomide can interfere with the production of several types of new blood cells, creating a risk of infection via [[neutropenia]], [[leukopenia]], and [[lymphopenia]], and risks that blood will not clot via [[thrombocytopenia]]. There is also a risk of [[anemia]] via lack of red blood cells.  The drug can also damage nerves, causing potentially irreversible [[peripheral neuropathy]].<ref name=UKlabel2017/><ref name=USlabel2017/>

Thalidomide has several adverse cardiovascular effects, including risk of [[heart attack]]s, [[pulmonary hypertension]], and changes in heart rhythm, such as [[syncope (medicine)|syncope]], [[bradycardia]], and [[atrioventricular block]].<ref name=UKlabel2017/><ref name=USlabel2017/>

Thalidomide can cause [[liver damage]] and severe skin reactions like [[Stevens–Johnson syndrome]]. It tends to make people sleepy, which creates risk when driving and operating other machinery. As it kills cancer cells, it can cause [[tumor lysis syndrome]]. Thalidomide can [[Amenorrhea|prevent menstruation]].<ref name=UKlabel2017/><ref name=USlabel2017/>

In addition, very common (reported in more than 10% of people) adverse effects include [[tremor]], dizziness, tingling, numbness, constipation, and [[peripheral edema]].<ref name=UKlabel2017/><ref name=USlabel2017/>

Common adverse effects (reported by 1–10% of people) include confusion, depressed mood, reduced coordination, heart failure, difficulty breathing, interstitial lung disease, lung inflammation, vomiting, dry mouth, rashes, dry skin, fever, weakness, and a sense of unwellness.<ref name=UKlabel2017/><ref name=USlabel2017/>

=== Interactions ===
There are no expected [[Pharmacokinetics|pharmacokinetic]] interactions between thalidomide and other medicines due to its neutral effects on [[P-glycoprotein]] and the [[cytochrome P450]] family.  It may interact with sedatives due to its sedative action and bradycardic agents, like beta-blockers, due to its bradycardia-inducing effects. The risk of [[peripheral neuropathy]] may be increased by concomitant treatment of thalidomide with other agents known to cause peripheral neuropathy.<ref name="TGA">{{Cite web |date=21 June 2013 |title=THALOMID® CAPSULES |url=https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent&id=CP-2010-PI-03581-3 |url-status=live |archive-url=https://web.archive.org/web/20150904052354/https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent&id=CP-2010-PI-03581-3 |archive-date=4 September 2015 |access-date=17 January 2014 |website=TGA eBusiness Services |publisher=Celgene Pty Limited |format=PDF}}</ref> The risk of [[venous thromboembolism]]s with thalidomide seems to be increased when patients are treated with [[oral contraceptives]] or other cytotoxic agents (including [[doxorubicin]] and [[melphalan]]) concurrently. Thalidomide may interfere with various contraceptives, and hence it is advised that women of reproductive age use at least two different means of contraception to ensure that no child will be conceived while they are taking thalidomide.<ref name=UKlabel2017/><ref name=USlabel2017/><ref name = TGA/>

===Overdose===
As of 2013, eighteen cases of overdoses had been reported with doses of up to 14.4&nbsp;grams, none of them fatal.<ref name = TGA/> No specific antidote for overdose exists and treatment is purely [[Supportive treatment|supportive]].<ref name = TGA/>