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Rarely used teratogenic drugs, with low exposure rates.

Thalidomide, the paradigm of teratogenic drug, was withdrawn from the market in the beginning of the 1970s. Its use was thereafter restricted to some forms of leprosy, and directly delivered to the consumers by health authorities. Nonetheless, more than thirty babies with thalidomide embryopathy were born in South America during the last 25 years, while the expected number was absolute zero. Nowadays, thalidomide is returning to the market in all countries of the world due to new and diverse indications, including some AIDS complications. Prevention of a new thalidomide embryopathy epidemic in underdeveloped populations is going to be very difficult.

Castilla EE, et al. (1996) Thalidomide, a current teratogen in South America. Teratology 54:273-277.