Medication Causes of Neutropenia

Aka: Medication Causes of Neutropenia, Neutropenia due to Medication, Drug-Induced Neutropenia, Drug-Induced Agranulocytosis

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, see below)
   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
   3. Anthracyclines (e.g. Doxorubicin, Daunorubicin)
   4. Taxanes (e.g. Paclitaxel, Docetaxel)
   5. Topoisomerase inhibitors (Etoposide)
   6. Platinum Chemotherapy (e.g. Cisplatin)
   7. Gemcitabine (Gemzar)
   8. Vinorelbine (Navelbine)
   9. [PubMed]
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 [PubMed]