Details
Stereochemistry | RACEMIC |
Molecular Formula | C13H10N2O4 |
Molecular Weight | 258.2295 |
Optical Activity | ( + / - ) |
Defined Stereocenters | 0 / 1 |
E/Z Centers | 0 |
Charge | 0 |
SHOW SMILES / InChI
SMILES
O=C1N(C2CCC(=O)NC2=O)C(=O)C3=CC=CC=C13
InChI
InChIKey=UEJJHQNACJXSKW-UHFFFAOYSA-N
InChI=1S/C13H10N2O4/c16-10-6-5-9(11(17)14-10)15-12(18)7-3-1-2-4-8(7)13(15)19/h1-4,9H,5-6H2,(H,14,16,17)
DescriptionSources: http://www.drugbank.ca/drugs/DB01041Curator's Comment: Description was created based on several sources, including
http://www.accessdata.fda.gov/drugsatfda_docs/label/2015/020785s051lbl.pdf
Sources: http://www.drugbank.ca/drugs/DB01041
Curator's Comment: Description was created based on several sources, including
http://www.accessdata.fda.gov/drugsatfda_docs/label/2015/020785s051lbl.pdf
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. 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. As a cancer treatment, the drug may act as a VEGF inhibitor. Thalidomide is used 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. Thalidomide is sold under the brand name Immunoprin, among others.
CNS Activity
Sources: https://www.ncbi.nlm.nih.gov/pubmed/22650377
Curator's Comment: Thalidomide, an inhibitor of TNF-α protein synthesis is readily capable of crossing the blood-brain barrier
Approval Year
Targets
Primary Target | Pharmacology | Condition | Potency |
---|---|---|---|
Target ID: Q96SW2 Gene ID: 51185.0 Gene Symbol: CRBN Target Organism: Homo sapiens (Human) Sources: http://www.drugbank.ca/drugs/DB01041 |
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Target ID: CHEMBL1825 Sources: http://www.drugbank.ca/drugs/DB01041 |
200.0 µM [IC50] | ||
Target ID: CHEMBL3251 Sources: http://www.drugbank.ca/drugs/DB01041 |
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Target ID: CHEMBL4142 Sources: http://www.drugbank.ca/drugs/DB01041 |
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Target ID: CHEMBL2094253 Sources: https://www.ncbi.nlm.nih.gov/pubmed/11909713 |
Conditions
Condition | Modality | Targets | Highest Phase | Product |
---|---|---|---|---|
Primary | THALOMID Approved UseTHALOMID in combination with dexamethasone is indicated for the treatment of patients with newly diagnosed multiple myeloma (MM).
THALOMID is indicated for the acute treatment of the cutaneous manifestations of moderate to severe erythema nodosum leprosum (ENL).
THALOMID is not indicated as monotherapy for such ENL treatment in the presence of moderate to severe neuritis.
THALOMID is also indicated as maintenance therapy for prevention and suppression of the cutaneous manifestations of ENL recurrence. Launch Date9.0046077E11 |
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Primary | THALOMID Approved UseTHALOMID in combination with dexamethasone is indicated for the treatment of patients with newly diagnosed multiple myeloma (MM).
THALOMID is indicated for the acute treatment of the cutaneous manifestations of moderate to severe erythema nodosum leprosum (ENL).
THALOMID is not indicated as monotherapy for such ENL treatment in the presence of moderate to severe neuritis.
THALOMID is also indicated as maintenance therapy for prevention and suppression of the cutaneous manifestations of ENL recurrence. Launch Date9.0046077E11 |
Cmax
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
2 mg/L |
200 mg single, oral dose: 200 mg route of administration: Oral experiment type: SINGLE co-administered: |
THALIDOMIDE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: UNKNOWN |
AUC
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
19.8 mg × h/L |
200 mg single, oral dose: 200 mg route of administration: Oral experiment type: SINGLE co-administered: |
THALIDOMIDE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: UNKNOWN |
T1/2
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
6.17 h |
200 mg single, oral dose: 200 mg route of administration: Oral experiment type: SINGLE co-administered: |
THALIDOMIDE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: UNKNOWN |
Funbound
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
45% |
THALIDOMIDE plasma | Homo sapiens population: UNKNOWN age: UNKNOWN sex: UNKNOWN food status: UNKNOWN |
Doses
Dose | Population | Adverse events |
---|---|---|
400 mg/m2 1 times / day multiple, oral MTD Dose: 400 mg/m2, 1 times / day Route: oral Route: multiple Dose: 400 mg/m2, 1 times / day Co-administed with:: Carboplatin, i.v(1/21 days) Sources: Page: p.4397 |
unhealthy, 11 n = 10 Health Status: unhealthy Condition: Cancer Age Group: 11 Sex: M+F Population Size: 10 Sources: Page: p.4397 |
DLT: Somnolence... Dose limiting toxicities: Somnolence (20%) Sources: Page: p.4397 |
400 mg/m2 1 times / day multiple, oral MTD Dose: 400 mg/m2, 1 times / day Route: oral Route: multiple Dose: 400 mg/m2, 1 times / day Co-administed with:: Carboplatin, i.v(1/21 days) Sources: Page: p.4397 |
unhealthy, 11 n = 6 Health Status: unhealthy Condition: Cancer Age Group: 11 Sex: M+F Population Size: 6 Sources: Page: p.4397 |
DLT: Ataxia... Dose limiting toxicities: Ataxia (16.7%) Sources: Page: p.4397 |
150 mg 2 times / day multiple, oral MTD Dose: 150 mg, 2 times / day Route: oral Route: multiple Dose: 150 mg, 2 times / day Sources: Page: p.658 |
unhealthy, 57 n = 7 Health Status: unhealthy Condition: Hepatocellular carcinoma Age Group: 57 Sex: M+F Population Size: 7 Sources: Page: p.658 |
|
200 mg 2 times / day multiple, oral Studied dose Dose: 200 mg, 2 times / day Route: oral Route: multiple Dose: 200 mg, 2 times / day Sources: Page: p.658 |
unhealthy, 57 n = 2 Health Status: unhealthy Condition: Hepatocellular carcinoma Age Group: 57 Sex: M+F Population Size: 2 Sources: Page: p.658 |
DLT: Dyspnea... |
400 mg 1 times / day multiple, oral Recommended Dose: 400 mg, 1 times / day Route: oral Route: multiple Dose: 400 mg, 1 times / day Sources: Page: p.1 |
unhealthy Health Status: unhealthy Condition: Erythema nodosum leprosum Sources: Page: p.1 |
Disc. AE: Fetal damage, Deep vein thrombosis... AEs leading to discontinuation/dose reduction: Fetal damage Sources: Page: p.1Deep vein thrombosis Pulmonary embolism |
AEs
AE | Significance | Dose | Population |
---|---|---|---|
Somnolence | 20% DLT |
400 mg/m2 1 times / day multiple, oral MTD Dose: 400 mg/m2, 1 times / day Route: oral Route: multiple Dose: 400 mg/m2, 1 times / day Co-administed with:: Carboplatin, i.v(1/21 days) Sources: Page: p.4397 |
unhealthy, 11 n = 10 Health Status: unhealthy Condition: Cancer Age Group: 11 Sex: M+F Population Size: 10 Sources: Page: p.4397 |
Ataxia | 16.7% DLT |
400 mg/m2 1 times / day multiple, oral MTD Dose: 400 mg/m2, 1 times / day Route: oral Route: multiple Dose: 400 mg/m2, 1 times / day Co-administed with:: Carboplatin, i.v(1/21 days) Sources: Page: p.4397 |
unhealthy, 11 n = 6 Health Status: unhealthy Condition: Cancer Age Group: 11 Sex: M+F Population Size: 6 Sources: Page: p.4397 |
Dyspnea | 50% DLT |
200 mg 2 times / day multiple, oral Studied dose Dose: 200 mg, 2 times / day Route: oral Route: multiple Dose: 200 mg, 2 times / day Sources: Page: p.658 |
unhealthy, 57 n = 2 Health Status: unhealthy Condition: Hepatocellular carcinoma Age Group: 57 Sex: M+F Population Size: 2 Sources: Page: p.658 |
Deep vein thrombosis | Disc. AE | 400 mg 1 times / day multiple, oral Recommended Dose: 400 mg, 1 times / day Route: oral Route: multiple Dose: 400 mg, 1 times / day Sources: Page: p.1 |
unhealthy Health Status: unhealthy Condition: Erythema nodosum leprosum Sources: Page: p.1 |
Fetal damage | Disc. AE | 400 mg 1 times / day multiple, oral Recommended Dose: 400 mg, 1 times / day Route: oral Route: multiple Dose: 400 mg, 1 times / day Sources: Page: p.1 |
unhealthy Health Status: unhealthy Condition: Erythema nodosum leprosum Sources: Page: p.1 |
Pulmonary embolism | Disc. AE | 400 mg 1 times / day multiple, oral Recommended Dose: 400 mg, 1 times / day Route: oral Route: multiple Dose: 400 mg, 1 times / day Sources: Page: p.1 |
unhealthy Health Status: unhealthy Condition: Erythema nodosum leprosum Sources: Page: p.1 |
PubMed
Title | Date | PubMed |
---|---|---|
Randomized clinical trial of thalidomide, cyclosporine, and prednisone versus cyclosporine and prednisone as initial therapy for chronic graft-versus-host disease. | 2001 |
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Thalidomide in gastrointestinal disorders. | 2001 |
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Aza analogues of thalidomide: synthesis and evaluation as inhibitors of tumor necrosis factor-alpha production in vitro. | 2001 Apr |
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In vitro and in vivo kinetic interactions of the antitumour agent 5,6-dimethylxanthenone-4-acetic acid with thalidomide and diclofenac. | 2001 Apr |
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Thalidomide use: past history and current implications for practice. | 2001 Apr |
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The irreplaceable image. Thalidomide in refractory myeloma patients: early changes in bone marrow cellularity. | 2001 Apr |
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Salvage therapy with thalidomide in multiple myeloma patients relapsing after autologous peripheral blood stem cell transplantation. | 2001 Apr |
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Thalidomide treatment of resistant or relapsed multiple myeloma patients. | 2001 Apr |
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Differential effects of thalidomide on angiogenesis and tumor growth in mice. | 2001 Apr |
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Treatment of severe esophageal Crohn's disease with thalidomide. | 2001 Apr |
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[Teratology, 40 years after the thalidomide tragedy]. | 2001 Feb |
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Pharmacotherapeutic options in inflammatory bowel disease: an update. | 2001 Feb |
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Scleroderma. | 2001 Feb |
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Efficacy of long-term treatment with thalidomide in children and young adults with Crohn disease: preliminary results. | 2001 Feb |
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Differential effect of thalidomide and dexamethasone on the transcription factor NF-kappa B. | 2001 Jan |
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Severe cutaneous ulceration following treatment with thalidomide for GVHD. | 2001 Jan |
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[New concepts about atopic dermatitis]. | 2001 Jan-Feb |
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Clinical aspects and management of AIDS-related Kaposi's sarcoma. | 2001 Jul |
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Thalidomide and immunomodulatory derivatives augment natural killer cell cytotoxicity in multiple myeloma. | 2001 Jul 1 |
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Extended survival in advanced and refractory multiple myeloma after single-agent thalidomide: identification of prognostic factors in a phase 2 study of 169 patients. | 2001 Jul 15 |
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Thalidomide and prednisolone inhibit growth factor-induced human retinal pigment epithelium cell proliferation in vitro. | 2001 Jul-Aug |
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Thalidomide-induced amenorrhoea: two cases. | 2001 Jun |
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[Thalidomide and cancer--revival of a drug]. | 2001 Jun |
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Alpha-glucosidase inhibitors with a 4,5,6,7-tetrachlorophthalimide skeleton pendanted with a cycloalkyl or dicarba-closo-dodecaborane group. | 2001 Jun |
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Disease controlling antirheumatic therapy in spondyloarthropathy. | 2001 Jun |
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Thalidomide dose proportionality assessment following single doses to healthy subjects. | 2001 Jun |
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Color Doppler ultrasonography of the superior mesenteric artery for prenatal ultrasonographic diagnosis of a left-sided congenital diaphragmatic hernia. | 2001 Jun |
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Effectors of inflammation in actinic prurigo. | 2001 Jun |
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Deep venous thrombosis and thalidomide therapy for multiple myeloma. | 2001 Jun 21 |
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Inhibition of NF-kappa B activity by thalidomide through suppression of IkappaB kinase activity. | 2001 Jun 22 |
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[Thalidomide and thrombosis: three observations]. | 2001 Jun 9 |
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Thalidomide-induced sensory neuropathy. | 2001 Mar |
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Targeting of vasculature in cancer and other angiogenic diseases. | 2001 Mar |
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[The return of thalidomide]. | 2001 Mar |
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Prognostic factors and current practice in treatment of myelofibrosis with myeloid metaplasia: an update anno 2000. | 2001 Mar |
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Cutaneous lupus erythematosus. | 2001 Mar |
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Thalidomide: near complete regression of extramedullary bulk in refractory multiple myeloma. | 2001 Mar 10 |
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Systemic lupus erythematosus. | 2001 Mar 31 |
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[Comparative treatment between thalidomide and transfer factor in severe atopic dermatitis]. | 2001 Mar-Apr |
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[Sarcoidosis: thalidomide treatment in ten patients]. | 2001 May |
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Enantioseparation of aminoglutethimide and thalidomide by high performance liquid chromatography or supercritical fluid chromatography on mono-2 and mono-6-O-pentenyl-beta-cyclodextrin-based chiral stationary phases. | 2001 May |
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Is infliximab effective for induction of remission in patients with ulcerative colitis? | 2001 May |
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Thalidomide in multiple myeloma: lack of response of soft-tissue plasmacytomas. | 2001 May |
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Transcending conventional therapies: the role of biologic and other novel therapies. | 2001 May |
|
Approach to corticosteroid-dependent and corticosteroid-refractory Crohn's disease. | 2001 May |
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Synthesis and immunological activity of water-soluble thalidomide prodrugs. | 2001 May |
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Thalidomide and its dermatologic uses. | 2001 May |
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Novel approaches to the treatment of chronic graft-versus-host disease. | 2001 May |
|
Thalidomide inhibits granulocyte responses in healthy humans after ex vivo stimulation with bacterial antigens. | 2001 May |
|
Pilot study using the combination of methotrexate and thalidomide in the treatment of rheumatoid arthritis. | 2001 May-Jun |
Sample Use Guides
MM: 200 mg orally once daily. The recommended dose of
dexamethasone is 40 mg/day on days 1-4, 9-12, and 17-20
every 28 days.
• ENL: 100 to 300 mg/day for an episode of cutaneous ENL.
Up to 400 mg/day for severe cutaneous ENL.
Route of Administration:
Oral
In Vitro Use Guide
Sources: https://www.ncbi.nlm.nih.gov/pubmed/22011961
The minimum dose of thalidomide used (1 uM) inhibited TNF-α production in HTLV-1-infected subjects in vitro.
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Classification Tree | Code System | Code | ||
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FDA ORPHAN DRUG |
43890
Created by
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FDA ORPHAN DRUG |
80194
Created by
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FDA ORPHAN DRUG |
30788
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WHO-ATC |
L04AX02
Created by
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FDA ORPHAN DRUG |
115598
Created by
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FDA ORPHAN DRUG |
43790
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NDF-RT |
N0000008663
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WHO-VATC |
QL04AX02
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FDA ORPHAN DRUG |
90795
Created by
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EU-Orphan Drug |
EU/3/01/067
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NDF-RT |
N0000008663
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FDA ORPHAN DRUG |
585417
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FDA ORPHAN DRUG |
110197
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FDA ORPHAN DRUG |
72092
Created by
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NCI_THESAURUS |
C129820
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FDA ORPHAN DRUG |
114998
Created by
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NCI_THESAURUS |
C1742
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FDA ORPHAN DRUG |
121898
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FDA ORPHAN DRUG |
187204
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FDA ORPHAN DRUG |
94995
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NCI_THESAURUS |
C574
Created by
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FDA ORPHAN DRUG |
32188
Created by
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EMA ASSESSMENT REPORTS |
THALIDOMIDE CELGENE (AUTHORIZED: MUTIPLE MYELOMA)
Created by
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NCI_THESAURUS |
C54677
Created by
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FDA ORPHAN DRUG |
82594
Created by
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LIVERTOX |
NBK548371
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Code System | Code | Type | Description | ||
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50-35-1
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527179
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10432
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4Z8R6ORS6L
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DTXSID9022524
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1652500
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4Z8R6ORS6L
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74947
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D013792
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5426
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66847
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DB01041
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7327
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CHEMBL468
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THALIDOMIDE
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SUB10958MIG
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9513
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C870
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200-031-1
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762
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2616
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M10673
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PRIMARY | Merck Index | ||
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3586
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PRIMARY |
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