Risk Minimisation Materials

Thalidomide Prescription Authorisation Form

A newly completed Prescription Authorisation Form must accompany each thalidomide prescription to confirm the patient has been counselled about the teratogenic risk of thalidomide and the required contraceptive methods, continues to use effective contraception, and in the case of a woman of child bearing potential, is having a pregnancy test every 4-weeks, before each prescription to ensure they are not pregnant. Completion of this information is mandatory for ALL patients.

For Healthcare Professionals