Agranulocytosis causes
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [3]
Overview
Causes
A large number of drugs[1] have been associated with agranulocytosis, including Albendazole, Metoclopramide, spironolactone, antiepileptics, antithyroid drugs (carbimazole, methimazole, and propylthiouracil), antibiotics (Amoxicillin, chloramphenicol, co-trimoxazole andpenicillin); cytotoxic drugs, hydroxychloroquine; gold; NSAIDs (diflunisal, indomethacin, naproxen, phenylbutazone, metamizole), mebendazole; the antidepressant mirtazapine, tolbutamide, Hydrocodone bitartrate and acetaminophen and some antipsychotics Chlorpromazine, Cirofloxacin (the atypical antipsychotic quetiapine, clozapine[2]). Clozapine users in the US and Canada must be nationally registered for monitoring of low WBC and absolute neutrophil counts (ANC).
Although the reaction is generally idiosyncratic rather than proportional, experts recommend that patients using these drugs be told about the symptoms of agranulocytosis-related infection, such as a sore throat and a fever.
The Centers for Disease Control recently traced outbreaks of agranulocytosis among cocaine users, in the US and Canada between March 2008 and November 2009, to the presence of levamisole in the drug supply. The Drug Enforcement Administration reported that, as of February 2010, 71% of seized cocaine lots coming into the US contained levamisole as a cutting agent.[3] Levamisole is an antihelminthic (i.e. deworming) drug used in animals. The reason for adding levamisole to cocaine is unknown,[4] although it can be due to their similar melting points and solubilities.
Drug Causes
- Cefadroxil
- Cefotaxime sodium
- Ceftazidime
- Cefaclor
- Chlordiazepoxide
- Dapsone
- Isoniazid
- Lacosamide
- Meropenem
- Meprobamate
- Penicillamine
- Sulfasalazine
References
- ↑ Systematic Review: Agranulocytosis Induced by Nonchemotherapy Drugs, Ann Intern Med. 2007;146:657-665
- ↑ Diaz, Jaime. How Drugs Influence Behavior. Englewood Cliffs: Prentice Hall, 1996.
- ↑ U.S. Department of Justice, National Drug Intelligence Center, National Drug Threat Assessment 2010, Colombian Cocaine Producers Increase Use of a Harmful Cutting Agent, February 2010.
- ↑ "Agranulocytosis Associated with Cocaine Use --- Four States, March 2008--November 2009." Centers for Disease Control: Morbidity and Mortality Weekly Report. December 18, 2009/Vol. 58/No. 49 [1] Cited in Hsu, Jeremy. "Majority of U.S. Cocaine Supply Cut with Veterinary Deworming Drug." Popsci.com. December 18, 2009. [2]