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Medication Causes of Neutropenia

Aka: Medication Causes of Neutropenia, Neutropenia due to Medication, Drug-Induced Neutropenia, Drug-Induced Agranulocytosis
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  1. See Also
    1. Neutropenia
    2. Neutropenia Causes
  2. Pathophysiology
    1. Drugs are second most common cause of Neutropenia
    2. Induce hypoproliferation via marrow injury
  3. Causes: Most common
    1. Chemotherapeutics (standard effect)
    2. Thyroid inhibitors (Antithyroid Drugs)
    3. Trimethoprim-Sulfamethoxazole (Septra, Bactrim)
    4. Sulfasalazine
    5. Clomipramine
    6. Dipyrone
    7. Concurrent Analgesic use is predisposing factor
  4. Causes: Chemotherapeutics (most common causes)
    1. See Alkylating Agents
    2. See Antimetabolite Chemotherapy
  5. Causes: Antibiotics
    1. Chloramphenicol
    2. Penicillins and Cephalosporins
    3. Vancomycin
    4. Sulfonamide
    5. Gentamicin
    6. Clindamycin
    7. Doxycycline
    8. Minocycline
    9. Metronidazole
    10. Nitrofurantoin
    11. Rifampin
    12. Isoniazid
    13. Ethambutol
    14. Dapsone
    15. Ciprofloxacin
    16. Antimalarial medications (e.g. Chloroquine)
    17. Mebendazole
    18. Terbinafine
    19. Griseofulvin
  6. Causes: Neuropsychotropics
    1. Phenothiazine (e.g. chlorpromazine)
    2. Meprobamate
    3. Barbiturates
    4. Clozapine (Clozaril)
    5. Risperidone (Risperdal)
    6. Imipramine or Desipramine
    7. Thiothixene (Navane)
    8. Haloperidol (Haldol)
    9. Valproic Acid (Depakote)
    10. Phenytoin (Dilantin)
    11. Carbamazepine (Tegretol)
    12. Ethosuximide (Zarontin)
  7. Causes: Cardiovascular Medications
    1. Ticlopidine
    2. Antiarrhythmics
      1. Procainamide
      2. Quinidine
      3. Propafenone
    3. Antihypertensives
      1. Captopril
      2. Propranolol
      3. Hydralazine
      4. Methyldopa
  8. Causes: Analgesics
    1. NSAIDs (Ibuprofen, Indomethacin, Sulindac, Tolmetin)
    2. Acetylsalicylic acid (Aspirin)
  9. Causes: Miscellaneous
    1. Allopurinol
    2. Colchicine
    3. Antithyroid Drugs (e.g. Propylthiouracil)
    4. Antihistamines (e.g. Cimetidine, Brompheniramine)
    5. Quinine
    6. Heavy Metals
      1. Gold
      2. Arsenic
      3. Mercury
  10. References
    1. Lee (1999) Wintrobe's Hematology, Lippincott, p. 1862-9
    2. van der Klauw (1999) Arch Intern Med 159(4):369-74

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