The precise mechanism of action for<unk>  is not known, although efforts to identify<unk> 's teratogenic action generated 2,000 research papers and the proposal of 15 or 16 plausible mechanisms by 2000. As of 2015, the main theories were inhibition of the process of angiogenesis, its inhibition of cereblon, a ubiquitin ligase, and its ability to generate reactive oxygen species which in turn kills cells. In 2018, results were first published which suggested that<unk> 's teratogenic effects are mediated through degradation of the transcription factor, SALL4, an as yet unverified finding.<unk>  also binds to and acts as an antagonist of the androgen receptor (AR) and hence is a nonsteroidal antiandrogen (NSAA) of some capacity. In accordance, it can produce gynecomastia and sexual dysfunction as side effects in men.<unk>  is provided as a racemic mixture of two enantiomers; while there are reports that only one of the enantiomers may cause birth defects, the body converts each enantiomer into the other through mechanisms that are not well understood.
Thalidomide
Pomalidomide
Vincristine
Lenalidomide
Mercaptopurine
Febuxostat
Ifosfamide
Ixazomib