In addition to embryo-fetal toxicity,<unk>  carries black box warnings for hematologic toxicity (including neutropenia and thrombocytopenia) and thromboembolism. Serious side effects include thrombosis, pulmonary embolus, hepatotoxicity, and bone marrow toxicity resulting in neutropenia and thrombocytopenia. Myelosuppression is the major dose-limiting toxicity, which is not the case with thalidomide.<unk>  may be associated with adverse effects as second primary malignancy, severe cutaneous reactions, hypersensitivity reactions, tumor lysis syndrome, tumor flare reaction, hypothyroidism, and hyperthyroidism. Teratogenicity<unk>  is related to thalidomide, which is known to be teratogenic. Tests in monkeys suggest that<unk>  is likewise teratogenic. It cannot be prescribed for women who are pregnant or who may become pregnant during therapy. For this reason, the drug is only available in the United States through a restricted distribution system in conjunction with a risk evaluation and mitigation strategy. Females who may become pregnant must use at least two forms of reliable contraception during treatment and for at least four weeks after discontinuing treatment with<unk> . Venous thromboembolism<unk> , like its parent compound thalidomide, may cause venous thromboembolism, a potentially serious complication with their use. High rates of venous thromboembolism have been found in patients with multiple myeloma who received thalidomide or<unk>  in conjunction with dexamethasone, melphalan, or doxorubicin. Stevens-Johnson syndrome In March 2008, the U.S. Food and Drug Administration (FDA) included<unk>  on a list of twenty prescription drugs under investigation for potential safety problems. The drug was investigated for possibly increasing the risk of developing Stevens–Johnson syndrome, a life-threatening skin condition. FDA ongoing safety review In 2011, the FDA initiated an ongoing review of clinical trials that found an increased risk of developing cancers such as acute myelogenous leukemia and B-cell lymphoma, though it did not advise patients to discontinue treatment with<unk> .
Lenalidomide
Ruxolitinib
Pomalidomide
Vincristine
Bortezomib
Rituximab
Ibrutinib
Alemtuzumab