Drug-induced neutropenia: Difference between revisions

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* [[Neutropenia]] caused by medications or recreational drugs
 
* Agranulocytosis refers to the complete absence of neutrophils or granulocytes (ANC of 0)
  
* Agranulocytosis refers to the complete absence of neutrophils or granulocytes (ANC of 0)
   
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|-
  
|-
 
| rowspan="7" |Antibiotics
  
| rowspan="7" |Antibiotics
−
|Semisynthetic penicillins (amoxicillin, ampicillin)
 +
|Semisynthetic penicillins ([[amoxicillin]], [[ampicillin]])
 
|Moderate
  
|Moderate
 
|Both
  
|Both
 
|-
  
|-
−
|Cephalosporins
 +
|[[Cephalosporins]]
 
|Moderate
  
|Moderate
 
|Both
 
|Both
 
|-
  
|-
−
|Vancomycin
+
|[[Vancomycin]]
 
|High
  
|High
 
|Both
 
|Both
 
|-
  
|-
−
|Macrolides
+
|[[Macrolides]]
 
|Low
  
|Low
 
|Neutropenia
 
|Neutropenia
 
|-
  
|-
−
|TMP-SMX
 +
|[[TMP-SMX]]
 
|High
  
|High
 
|Agranulocytosis
  
|Agranulocytosis
 
|-
  
|-
−
|Dapsone
 +
|[[Dapsone]]
 
|High
  
|High
 
|Agranulocytosis
  
|Agranulocytosis
 
|-
  
|-
−
|Chloramphenicol
 +
|[[Chloramphenicol]]
 
|High
  
|High
 
|Agranulocytosis
  
|Agranulocytosis
 
|-
  
|-
 
| rowspan="2" |Antifungals
  
| rowspan="2" |Antifungals
−
|Amphotericin
 +
|[[Amphotericin]]
 
|Low
  
|Low
 
|Neutropenia
 
|Neutropenia
 
|-
  
|-
−
|Flucytosine
 +
|[[Flucytosine]]
 
|Low
  
|Low
 
|Agranulocytosis
  
|Agranulocytosis
 
|-
  
|-
 
| rowspan="2" |Antimalarials
  
| rowspan="2" |Antimalarials
−
|Chloroquine
 +
|[[Chloroquine]]
 
|Low
  
|Low
 
|Agranulocytosis
  
|Agranulocytosis
 
|-
  
|-
−
|Quinine
 +
|[[Quinine]]
 
|Moderate
  
|Moderate
 
|Agranulocytosis
  
|Agranulocytosis
 
|-
  
|-
 
| rowspan="4" |Antiinflammatory agents
  
| rowspan="4" |Antiinflammatory agents
−
|Ibuprofen
 +
|[[Ibuprofen]]
 
|Low
  
|Low
 
|Agranulocytosis
  
|Agranulocytosis
 
|-
  
|-
−
|Diclofenac
 +
|[[Diclofenac]]
 
|Moderate
  
|Moderate
 
|Agranulocytosis
  
|Agranulocytosis
 
|-
  
|-
−
|Sulfasalazine
 +
|[[Sulfasalazine]]
 
|High
  
|High
 
|Agranulocytosis
  
|Agranulocytosis
 
|-
  
|-
−
|Gold salts
 +
|[[Gold salts]]
 
|
  
|
 
|Agranulocytosis
  
|Agranulocytosis
 
|-
  
|-
 
| rowspan="2" |Antithyroid drugs
  
| rowspan="2" |Antithyroid drugs
−
|Methimazole
 +
|[[Methimazole]]
 
|High
  
|High
 
|Agranulocytosis
  
|Agranulocytosis
 
|-
  
|-
−
|Propylthiouracil
 +
|[[Propylthiouracil]]
 
|Moderate
  
|Moderate
 
|Agranulocytosis
  
|Agranulocytosis
 
|-
  
|-
 
| rowspan="3" |Psychotropic agents
  
| rowspan="3" |Psychotropic agents
−
|Clozapine
 +
|[[Clozapine]]
 
|High
  
|High
 
|Agranulocytosis
  
|Agranulocytosis
 
|-
  
|-
−
|Phenothiazines (chlorpromazine)
 +
|Phenothiazines ([[chlorpromazine]])
 
|Moderate
  
|Moderate
 
|Agranulocytosis
  
|Agranulocytosis
 
|-
  
|-
−
|Tricyclic agents (amitriptyline)
 +
|Tricyclic agents ([[amitriptyline]])
 
|Low
  
|Low
 
|Agranulocytosis
  
|Agranulocytosis
 
|-
  
|-
 
| rowspan="4" |Antiepileptics
  
| rowspan="4" |Antiepileptics
−
|Carbamazepine
 +
|[[Carbamazepine]]
 
|Low
  
|Low
 
|Neutropenia
 
|Neutropenia
 
|-
  
|-
−
|Phenytoin
 +
|[[Phenytoin]]
 
|Moderate
  
|Moderate
 
|Agranulocytosis
  
|Agranulocytosis
 
|-
  
|-
−
|Valproate
 +
|[[Valproate]]
 
|Low
  
|Low
 
|Neutropenia
 
|Neutropenia
 
|-
  
|-
−
|Ethosuximide
 +
|[[Ethosuximide]]
 
|Low
  
|Low
 
|Neutropenia
 
|Neutropenia
 
|-
  
|-
 
| rowspan="5" |Cardiovascular drugs
  
| rowspan="5" |Cardiovascular drugs
−
|Antiarrhythmic agents (procainamide, flecainide)
 +
|Antiarrhythmic agents ([[procainamide]], [[flecainide]])
 
|High
  
|High
 
|Agranulocytosis
  
|Agranulocytosis
 
|-
  
|-
−
|ACE inhibitors
 +
|[[ACE inhibitors]]
 
|Moderate
  
|Moderate
 
|Agranulocytosis
  
|Agranulocytosis
 
|-
  
|-
−
|Propranolol
 +
|[[Propranolol]]
 
|Low
  
|Low
 
|Agranulocytosis
  
|Agranulocytosis
 
|-
  
|-
−
|Digoxin
 +
|[[Digoxin]]
 
|Moderate
  
|Moderate
 
|Agranulocytosis
  
|Agranulocytosis
 
|-
  
|-
−
|Ticlopidine
 +
|[[Ticlopidine]]
 
|High
  
|High
 
|Agranulocytosis
  
|Agranulocytosis
 
|-
  
|-
 
| rowspan="4" |Diuretics
  
| rowspan="4" |Diuretics
−
|Thiazides
 +
|[[Thiazides]]
 
|Low
  
|Low
 
|Neutropenia
 
|Neutropenia
 
|-
  
|-
−
|Furosemide
 +
|[[Furosemide]]
 
|Low
  
|Low
 
|Neutropenia
 
|Neutropenia
 
|-
  
|-
−
|Spironolactone
 +
|[[Spironolactone]]
 
|Low
  
|Low
 
|Agranulocytosis
  
|Agranulocytosis
 
|-
  
|-
−
|Acetazolamide
 +
|[[Acetazolamide]]
 
|Low
  
|Low
 
|Neutropenia
 
|Neutropenia
 
|-
  
|-
 
| rowspan="3" |Other
  
| rowspan="3" |Other
−
|Deferiprone
 +
|[[Deferiprone]]
 
|Moderate
  
|Moderate
 
|Agranulocytosis
  
|Agranulocytosis
 
|-
  
|-
−
|Levamisole
 +
|[[Levamisole]]
 
|Moderate
  
|Moderate
 
|Agranulocytosis
  
|Agranulocytosis
 
|-
  
|-
−
|Rituximab
 +
|[[Rituximab]]
 
|Moderate
  
|Moderate
 
|Agranulocytosis
  
|Agranulocytosis

Latest revision as of 10:49, 27 February 2024

  • Neutropenia caused by medications or recreational drugs
  • Agranulocytosis refers to the complete absence of neutrophils or granulocytes (ANC of 0)
Class Drug Frequency reported Nature of reaction
Antibiotics Semisynthetic penicillins (amoxicillin, ampicillin) Moderate Both
Cephalosporins Moderate Both
Vancomycin High Both
Macrolides Low Neutropenia
TMP-SMX High Agranulocytosis
Dapsone High Agranulocytosis
Chloramphenicol High Agranulocytosis
Antifungals Amphotericin Low Neutropenia
Flucytosine Low Agranulocytosis
Antimalarials Chloroquine Low Agranulocytosis
Quinine Moderate Agranulocytosis
Antiinflammatory agents Ibuprofen Low Agranulocytosis
Diclofenac Moderate Agranulocytosis
Sulfasalazine High Agranulocytosis
Gold salts Agranulocytosis
Antithyroid drugs Methimazole High Agranulocytosis
Propylthiouracil Moderate Agranulocytosis
Psychotropic agents Clozapine High Agranulocytosis
Phenothiazines (chlorpromazine) Moderate Agranulocytosis
Tricyclic agents (amitriptyline) Low Agranulocytosis
Antiepileptics Carbamazepine Low Neutropenia
Phenytoin Moderate Agranulocytosis
Valproate Low Neutropenia
Ethosuximide Low Neutropenia
Cardiovascular drugs Antiarrhythmic agents (procainamide, flecainide) High Agranulocytosis
ACE inhibitors Moderate Agranulocytosis
Propranolol Low Agranulocytosis
Digoxin Moderate Agranulocytosis
Ticlopidine High Agranulocytosis
Diuretics Thiazides Low Neutropenia
Furosemide Low Neutropenia
Spironolactone Low Agranulocytosis
Acetazolamide Low Neutropenia
Other Deferiprone Moderate Agranulocytosis
Levamisole Moderate Agranulocytosis
Rituximab Moderate Agranulocytosis
  1. ↑ Christopher Gibson, Nancy Berliner; How we evaluate and treat neutropenia in adults. Blood 2014; 124 (8): 1251–1258. doi: https://doi.org/10.1182/blood-2014-02-482612
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