Under this program, women in the childbearing age group must undergo pregnancy testing before starting therapy, and every 2-4 weeks during treatment. Patients must abstain from sexual intercourse, or use two highly effective contraceptive methods, during treatment. Males who have not had a vasectomy must abstain from sexual intercourse or use a condom while on treatment. All patients must continue these measures for at least one month following the last dose of the medication. Women should not breast-feed when taking thalidomide.
All patients sign a consent that explains the risks and precautions prior to starting therapy.
The most common side effects of thalidomide are sleepiness, fatigue, constipation, and a skin rash. Laxatives are usually prescribed routinely to prevent constipation, which can be severe. If a skin rash occurs, the drug should be discontinued, and restarted at a lower dose after the rash clears. If the rash is severe, the drug should be stopped and not used again. A less common but important side effect of thalidomide is nerve damage.