- Overview
- Properties
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- Related Genes
- Related Drugs
- Related Diseases
- Datasets
- Downloads/LinkOuts
Overview
| Generic Names: | N-Phthalimidoglutamic acid imide; N-Phthaloylglutamimide; N-Phthalylglutamic acid imide; Thalidomine USP26; alpha-phthalimidoglutarimide; thalidomide |
|---|---|
| Trade Names: | Algosediv; Asidon 3; Asmadion; Asmaval; Bonbrain; Bonbrrin; Calmore; Calmorex; Contergan; Corronarobetin; Distaval; Distaxal; Distoval; Ectiluran; Enterosediv; Gastrinide; Glupan; Glutanon; Grippex; Hippuzon; Imida-Lab; Imidan; Imidene; Isomin; Kedavon; Kevadon; Lulamin; Neaufatin; Neo; Neosedyn; Neosydyn; Nerosedyn; Neufatin; Neurodyn; Neurosedin; Neurosedym; Neurosedyn; Nevrodyn; Nibrol; Noctosediv; Noxodyn; Pangul; Pantosediv; Poly-Giron; Polygripan; Predni-Sediv; Pro-ban M; Profarmil; Psycholiquid; Psychotablets; Quetimid; Quietoplex; Sandormin; Sedalis; Sedalis sedi-lab; Sedimide; Sedin; Sedisperil; Sedoval; Shin-naito S; Shinnibrol; Sleepan; Slipro; Softenil; Softenon; Talargan; Talimol; Talismol; Telagan; Telargan; Telargean; Tensival; Thalin; Thalinette; Thalomid; Theophilcholine; Valgis; Valgraine; Yodomin |
| PharmGKB Accession Id: | PA451644 |
Description
A piperidinyl isoindole originally introduced as a non-barbiturate hypnotic, but withdrawn from the market due to teratogenic effects. It has been reintroduced and used for a number of immunological and inflammatory disorders. Thalidomide displays immunosuppresive and anti-angiogenic activity. It inhibits release of tumor necrosis factor-alpha from monocytes, and modulates other cytokine action. PubChem (source: Drug Bank)
Indication
For the acute treatment of the cutaneous manifestations of moderate to severe erythema nodosum leprosum (ENL). Also for use as maintenance therapy for prevention and suppression of the cutaneous manifestations of ENL recurrence. (source: Drug Bank)
ATC Therapeutic Category
- L04AX:Other immunosuppressants
Pharmacology, Interactions, and Contraindications
Mechanism Of Action
In patients with erythema nodosum leprosum (ENL) the mechanism of action is not fully understood. Available data from in vitro studies and preliminary clinical trials suggest that the immunologic effects of this compound can vary substantially under different conditions, but may be related to suppression of excessive tumor necrosis factor-alpha (TNF-a) production and down-modulation of selected cell surface adhesion molecules involved in leukocyte migration. For example, administration of thalidomide has been reported to decrease circulating levels of TNF-a in patients with ENL, however, it has also been shown to increase plasma TNF-a levels in HIV-seropositive patients. (source: Drug Bank)
Pharmacology
Thalidomide is an immunomodulatory agent with a spectrum of activity that is not fully characterized. Thalidomide is racemic — it contains both left and right handed isomers in equal amounts: one enantiomer is effective against morning sickness, and the other is teratogenic. The enantiomers are converted to each other in vivo. That is, if a human is given D-thalidomide or L-thalidomide, both isomers can be found in the serum. Hence, administering only one enantiomer will not prevent the teratogenic effect in humans. (source: Drug Bank)
Absorption, Distribution, Metabolism, Elimination & Toxicity
Biotransformation
Thalidomide itself does not appear to be hepatically metabolized to any large extent, but appears to undergo non-enzymatic hydrolysis in plasma to multiple metabolites. Thalidomide may be metabolized hepatically by enzymes of the cytochrome P450 enzyme system. The end product of metabolism, phthalic acid, is excreted as a glycine conjugate. (source: Drug Bank)
Protein Binding
55% and 66% for the (+)R and (−)S enantiomers, respectively. (source: Drug Bank)
Absorption
The absolute bioavailability has not yet been characterized in human subjects due to its poor aqueous solubility. In studies of both healthy volunteers and subjects with Hansen’s disease, the mean time to peak plasma concentrations (Tmax) ranged from 2.9 to 5.7 hours indicating that thalidomide is slowly absorbed from the gastrointestinal tract. (source: Drug Bank)
Toxicity
The R-configuration and the S-configuration are more toxic individually than the racemic mixture. The LD<sub>50</sub> could not be established in mice for racemic thalidomide, whereas LD<sub>50</sub> values for the R and S configurations are reported to be 0.4 to 0.7 g/kg and 0.5 to 1.5 g/kg, respectively. (source: Drug Bank)
Isomeric SMILES Code:
c1ccc2c(c1)C(=O)N(C2=O)C3CCC(=O)NC3=O (source: Drug Bank)
Curated Annotations (
)
-
rs4646487
at chr1:47051762
in
CYP4B1
Risk or phenotype-associated allele: T Phenotype: The CYP4B1:rs4646487 T variant was associated with toxicity in response to docetaxel and thalidomide. Study size: 47 Study population/ethnicity: Patients diagnosed with castration-resistant prostate cancer enrolled in a randomized phase II clinical trial comparing docetaxel to docetaxel with thalidomide. Significance metric(s):p = 0.008 Type of association: CO; TOX- Variant Name:
- CYP4B1:rs4646487 C>T; NM_000779.3:c.517C>T; NP_000770.2:p.Arg173Trp
- Related Drugs:
- docetaxel, thalidomide
- Related Diseases:
- Prostatic Neoplasms
- Evidence:
-
PMID:20038957
-
rs1402467
at chr2:108361240
in
SULT1C4
Risk or phenotype-associated allele: G Phenotype: The SULT1C2: rs1402467 G variant was associated with positive clincial response (partial or complete response) to treatment. Study size: 47 Study population/ethnicity: Patients diagnosed with castration-resistant prostate cancer enrolled in a randomized phase II clinical trial comparing docetaxel to docetaxel with thalidomide. Significance metric(s): p = 0.0083 Type of association: PD; CO- Variant Name:
- SULT1C2:rs1402467 C>G; NM_006588.2:c.15C>G; NP_006579.2:p.Asp5Glu
- Related Drugs:
- docetaxel, thalidomide
- Related Diseases:
- Prostatic Neoplasms
- Evidence:
-
PMID:20038957
-
rs6922548
at chr6:35461501
in
PPARD
Risk or phenotype-associated allele: G Phenotype: The PPAR delta SNP rs6922548 A>G was associated with positive clincial response (partial or complete response) to treatment. Study size: 47 Study population/ethnicity: Patients diagnosed with castration-resistant prostate cancer enrolled in a randomized phase II clinical trial comparing docetaxel to docetaxel with thalidomide. Significance metric(s): p = 0.0011 Type of association: PD; CO- Variant Name:
- PPARD:rs6922548 A>G;
- Related Drugs:
- docetaxel, thalidomide
- Related Diseases:
- Prostatic Neoplasms
- Evidence:
-
PMID:20038957
-
rs7769719
at chr6:35470503
in
PPARD
Risk or phenotype-associated allele: G Phenotype: The PPAR delta SNP rs7769719 A>G was associated with positive clincial response (partial or complete response) to treatment. Study size: 47 Study population/ethnicity: Patients diagnosed with castration-resistant prostate cancer enrolled in a randomized phase II clinical trial comparing docetaxel to docetaxel with thalidomide. Significance metric(s): p = 0.0055 Type of association: PD; CO- Variant Name:
- PPARD:rs7769719 A>G
- Related Drugs:
- docetaxel, thalidomide
- Related Diseases:
- Prostatic Neoplasms
- Evidence:
-
PMID:20038957
-
rs1883322
at chr6:35477784
in
PPARD
Risk or phenotype-associated allele: G Phenotype: The PPAR delta SNP rs1883322 A>G was associated with positive clincial response (partial or complete response) to treatment. Study size: 47 Study population/ethnicity: Patients diagnosed with castration-resistant prostate cancer enrolled in a randomized phase II clinical trial comparing docetaxel to docetaxel with thalidomide. Significance metric(s): p = 0.0061 Type of association: PD; CO- Variant Name:
- PPARD:rs1883322 A>G
- Related Drugs:
- docetaxel, thalidomide
- Related Diseases:
- Prostatic Neoplasms
- Evidence:
-
PMID:20038957
-
rs2016520
at chr6:35486756
in
PPARD
Risk or phenotype-associated allele: G Phenotype: The PPAR delta SNP rs2016520 A>G was associated with positive clincial response (partial or complete response) to treatment. Study size: 47 Study population/ethnicity: Patients diagnosed with castration-resistant prostate cancer enrolled in a randomized phase II clinical trial comparing docetaxel to docetaxel with thalidomide. Significance metric(s): p = 0.0056 Type of association: PD; CO- Variant Name:
- PPARD:rs2016520 A>G; NM_006238.3:c.-87C>T
- Related Drugs:
- docetaxel, thalidomide
- Related Diseases:
- Prostatic Neoplasms
- Evidence:
-
PMID:20038957
-
rs3734254
at chr6:35502988
in
PPARD
Risk or phenotype-associated allele: T Phenotype: The PPAR delta SNP rs3734254 C>T was associated with positive clincial response (partial or complete response) to treatment. Study size: 47 Study population/ethnicity: Patients diagnosed with castration-resistant prostate cancer enrolled in a randomized phase II clinical trial comparing docetaxel to docetaxel with thalidomide. Significance metric(s): p = 0.0089 Type of association: PD; CO- Variant Name:
- PPARD:rs3734254 C>T
- Related Drugs:
- docetaxel, thalidomide
- Related Diseases:
- Prostatic Neoplasms
- Evidence:
-
PMID:20038957
-
rs1799931
at chr8:18302650
in
NAT2
Risk or phenotype-associated allele: G Phenotype: The NAT2:rs1799931 G variant was associated with toxicity in response to docetaxel and thalidomide. Study size: 47 Study population/ethnicity: Patients diagnosed with castration-resistant prostate cancer enrolled in a randomized phase II clinical trial comparing docetaxel to docetaxel with thalidomide. Significance metric(s): p = 0.003 Type of association: CO; TOX- Variant Name:
- NAT2:rs1799931 A>G; NM_000015.2:c.857G>A; NP_000006.2:p.Gly286Glu
- Related Drugs:
- docetaxel, thalidomide
- Related Diseases:
- Prostatic Neoplasms
- Evidence:
-
PMID:20038957
-
rs4148943
at chr10:73439513
in
CHST3
Risk or phenotype-associated allele: C Phenotype: The CHST3:rs4148943 C variant was associated with positive clincial response (partial or complete response) to treatment. Study size: 47 Study population/ethnicity: Patients diagnosed with castration-resistant prostate cancer enrolled in a randomized phase II clinical trial comparing docetaxel to docetaxel with thalidomide. Significance metric(s): p = 0.0001 Type of association: PD; CO- Variant Name:
- CHST3:rs4148943 C>T; NM_004273.3:c.*1278C>T
- Related Drugs:
- docetaxel, thalidomide
- Related Diseases:
- Prostatic Neoplasms
- Evidence:
-
PMID:20038957
-
rs4148945
at chr10:73439596
in
CHST3
Risk or phenotype-associated allele: C Phenotype: The CHST3:rs4148945 C variant was associated with positive clincial response (partial or complete response) to treatment and toxicity to docetaxel and thalidomide. Study size: 47 Study population/ethnicity: Patients diagnosed with castration-resistant prostate cancer enrolled in a randomized phase II clinical trial comparing docetaxel to docetaxel with thalidomide. Significance metric(s): p = 0.011 (response); p = 0.010 (TOX) Type of association: PD; CO; TOX- Variant Name:
- CHST3:rs4148945 C>T; NM_004273.3:c.*1361C>T
- Related Drugs:
- docetaxel, thalidomide
- Related Diseases:
- Prostatic Neoplasms
- Evidence:
-
PMID:20038957
-
rs4148947
at chr10:73440123
in
CHST3
Risk or phenotype-associated allele: C Phenotype: The CHST3:rs4148947 C variant was associated with positive clincial response (partial or complete response) to treatment. Study size: 47 Study population/ethnicity: Patients diagnosed with castration-resistant prostate cancer enrolled in a randomized phase II clinical trial comparing docetaxel to docetaxel with thalidomide. Significance metric(s): p = 0.0023 Type of association: PD; CO- Variant Name:
- CHST3:rs4148947 C>T; NM_004273.3:c.*1888T>C
- Related Drugs:
- docetaxel, thalidomide
- Related Diseases:
- Prostatic Neoplasms
- Evidence:
-
PMID:20038957
-
rs4148950
at chr10:73441712
in
CHST3
Risk or phenotype-associated allele: A Phenotype: The CHST3:rs4148950 A variant was associated with positive clincial response (partial or complete response) to treatment and toxicity to docetaxel and thalidomide. Study size: 47 Study population/ethnicity: Patients diagnosed with castration-resistant prostate cancer enrolled in a randomized phase II clinical trial comparing docetaxel to docetaxel with thalidomide. Significance metric(s):p = 0.024 (response); p = 0.006 (TOX) Type of association: PD; CO; TOX- Variant Name:
- CHST3:rs4148950 A>G; NM_004273.3:c.*3477G>A
- Related Drugs:
- docetaxel, thalidomide
- Related Diseases:
- Prostatic Neoplasms
- Evidence:
-
PMID:20038957
-
rs1871450
at chr10:73442020
in
CHST3
Risk or phenotype-associated allele: A Phenotype: The CHST3:rs1871450 A variant was associated with positive clincial response (partial or complete response) to treatment and toxicity to docetaxel and thalidomide. Study size: 47 Study population/ethnicity: Patients diagnosed with castration-resistant prostate cancer enrolled in a randomized phase II clinical trial comparing docetaxel to docetaxel with thalidomide. Significance metric(s): p = 0.048 (response); p = 0.006 (TOX) Type of association: PD; CO; TOX- Variant Name:
- CHST3:rs1871450 A>G; NM_004273.3:c.*3785G>A
- Related Drugs:
- docetaxel, thalidomide
- Related Diseases:
- Prostatic Neoplasms
- Evidence:
-
PMID:20038957
-
rs730720
at chr10:73442768
in
CHST3
Risk or phenotype-associated allele: A Phenotype: The CHST3:rs730720 A variant was associated with positive clincial response (partial or complete response) to treatment. Study size: 47 Study population/ethnicity: Patients diagnosed with castration-resistant prostate cancer enrolled in a randomized phase II clinical trial comparing docetaxel to docetaxel with thalidomide. Significance metric(s): p = 0.0034 Type of association: PD; CO- Variant Name:
- CHST3:rs730720 A>G; NM_004273.3:c.*4533C>T
- Related Drugs:
- docetaxel, thalidomide
- Related Diseases:
- Prostatic Neoplasms
- Evidence:
-
PMID:20038957
-
rs12418
at chr10:73443020
in
CHST3
Risk or phenotype-associated allele: A Phenotype: The CHST3:rs12418 A variant was associated with positive clincial response (partial or complete response) to treatment. Study size: 47 Study population/ethnicity: Patients diagnosed with castration-resistant prostate cancer enrolled in a randomized phase II clinical trial comparing docetaxel to docetaxel with thalidomide. Significance metric(s): p = 0.0005 Type of association: PD; CO- Variant Name:
- CHST3:rs12418 A>G; NM_004273.3:c.*4785G>A
- Related Drugs:
- docetaxel, thalidomide
- Related Diseases:
- Prostatic Neoplasms
- Evidence:
-
PMID:20038957
-
rs2301159
at chr13:102495729
in
SLC10A2
Risk or phenotype-associated allele: T Phenotype: The SLC10A2:rs2301159 T variant was associated with toxicity in response to docetaxel and thalidomide. Study size: 47 Study population/ethnicity: Patients diagnosed with castration-resistant prostate cancer enrolled in a randomized phase II clinical trial comparing docetaxel to docetaxel with thalidomide. Significance metric(s): p = 0.01 Type of association: CO; TOX- Variant Name:
- SLC10A2:rs2301159 C>T; NM_000452.2:c.*755C>T
- Related Drugs:
- docetaxel, thalidomide
- Related Diseases:
- Prostatic Neoplasms
- Evidence:
-
PMID:20038957
-
rs2238472
at chr16:16159100
in
ABCC6
Risk or phenotype-associated allele: G Phenotype: The ABCC6 rs2238472 G variant was associated with toxicity in response to docetaxel and thalidomide. Study size: 47 Study population/ethnicity: Patients diagnosed with castration-resistant prostate cancer enrolled in a randomized phase II clinical trial comparing docetaxel to docetaxel with thalidomide. Significance metric(s): p = 0.006 Type of association: CO; TOX- Variant Name:
- ABCC6:rs2238472 A>G; NM_001171.5:c.3803G>A; NP_001162.4:p.Arg1268Gln
- Related Drugs:
- docetaxel, thalidomide
- Related Diseases:
- Prostatic Neoplasms
- Evidence:
-
PMID:20038957
-
rs2292954
at chr16:88140624
in
SPG7
Risk or phenotype-associated allele: T Phenotype: The SPG7:rs2292954 T variant was associated with toxicity in response to docetaxel and thalidomide. Study size: 47 Study population/ethnicity: Patients diagnosed with castration-resistant prostate cancer enrolled in a randomized phase II clinical trial comparing docetaxel to docetaxel with thalidomide. Significance metric(s): p = 0.0004 Type of association: CO; TOX- Variant Name:
- SPG7:rs2292954 C>T; NM_003119.2:c.1507A>G; NP_003110.1:p.Thr503Ala
- Related Drugs:
- docetaxel, thalidomide
- Related Diseases:
- Prostatic Neoplasms
- Evidence:
-
PMID:20038957
-
rs12960
at chr16:88147829
in
RPL13,
SNORD68,
SPG7
Risk or phenotype-associated allele: G Phenotype: The SPG7:rs12960 G variant was associated with toxicity in response to docetaxel and thalidomide. Study size: 47 Study population/ethnicity: Patients diagnosed with castration-resistant prostate cancer enrolled in a randomized phase II clinical trial comparing docetaxel to docetaxel with thalidomide. Significance metric(s): p = 0.004 Type of association: CO; TOX- Variant Name:
- SPG7:rs12960 A>G; NM_003119.2:c.2063G>A; NP_003110.1:p.Arg688Gln
- Related Drugs:
- docetaxel, thalidomide
- Related Diseases:
- Prostatic Neoplasms
- Evidence:
-
PMID:20038957
-
rs2227291
at chrX:77155158
in
ATP7A
Risk or phenotype-associated allele: G Phenotype: The ATP7A:rs2227291 G variant was associated with toxicity in response to docetaxel and thalidomide. Study size: 47 Study population/ethnicity: Patients diagnosed with castration-resistant prostate cancer enrolled in a randomized phase II clinical trial comparing docetaxel to docetaxel with thalidomide. Significance metric(s): p = 0.006 Type of association: CO; TOX- Variant Name:
- ATP7A:rs2227291 C>G; NM_000052.4:c.2299G>C; NP_000043.3:p.Val767Leu
- Related Drugs:
- docetaxel, thalidomide
- Related Diseases:
- Prostatic Neoplasms
- Evidence:
-
PMID:20038957
The following genes are in curated knowledge about this drug.
| Gene | Relationship | Evidence | |
|---|---|---|---|
|
|
ABCC6 |
|
Publications, Variants |
|
|
ATP7A |
|
Publications, Variants |
|
|
CASP3 |
|
Publications |
|
|
CHEK1 |
|
Publications |
|
|
CHST3 |
|
Publications, Variants |
|
|
CRBN |
|
Publications |
|
|
CYP2D6 |
|
Publications |
|
|
CYP4B1 |
|
Publications, Variants |
|
|
DCLRE1B |
|
Publications |
|
|
ERCC6 |
|
Publications |
|
|
IL12B |
|
Publications |
|
|
LEP |
|
Publications |
|
|
LIG1 |
|
Publications |
|
|
NAT2 |
|
Publications, Variants |
|
|
PARP1 |
|
Publications |
|
|
PPARD |
|
Publications, Variants |
|
|
RPL13 |
|
Variants |
|
|
SLC10A2 |
|
Publications, Variants |
|
|
SNORD68 |
|
Variants |
|
|
SPG7 |
|
Publications, Variants |
|
|
SULT1C2 |
|
Publications |
|
|
SULT1C4 |
|
Variants |
|
|
TNF |
|
Publications |
|
|
TNFRSF17 |
|
Publications |
|
|
XRCC5 |
|
Publications |
A list of non-curated publications that mention this drug along with other genes is available.
Drug Targets
| Gene | Description | |
|---|---|---|
| NFKB1 |
|
(source: Drug Bank) |
| PTGS2 |
|
(source: Drug Bank) |
| TNF |
|
(source: Drug Bank) |
A list of non-curated publications that mention this drug along with other drugs is available.
Drug Interactions
| Drug | Description | |
|---|---|---|
| gentamicin |
|
Thalidomide increases the renal toxicity of the aminoglycoside (source: Drug Bank) |
| tobramycin |
|
Thalidomide increases the renal toxicity of the aminoglycoside (source: Drug Bank) |
Curated Information
The following diseases are in curated knowledge about this drug.
| Disease | Relationship | Evidence | |
|---|---|---|---|
|
|
Amyotrophic Lateral Sclerosis |
|
Publications |
|
|
Congenital Abnormalities |
|
Publications |
|
|
Multiple Myeloma |
|
Publications |
|
|
Neoplasms |
|
Publications |
|
|
Prostatic Neoplasms |
|
Publications, Variants |
|
|
Venous Thrombosis |
|
Publications |
Non-Curated Information
A list of non-curated publications that mention this drug along with other diseases is available.
Additional Datasets
These datasets are minimally curated and are sorted alphabetically by title.
LinkOuts
Common Searches
Search PubMed
Search Medline Plus
Search PubChem
Search CTD
Non-Curated Publications
A list of non-curated publications that mention this drug is available.
