Thalidomide BMS® Prescription Authorisation Form
A newly completed Prescription Authorisation Form must accompany each Thalidomide BMS® prescription to confirm that the patient has been counselled about the teratogenic risk of Thalidomide BMS® and the required contraceptive methods, continues to use effective contraception and in the case of a woman of childbearing 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.