Hematology and Oncology Book

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Medication Causes of Macrocytic AnemiaAka: Medications Affecting Folate Metabolism, Medications Affecting Cobalamin, Medication Causes of Marrow Toxicity, Drug-Induced Macrocytic Anemia

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  1. See Also
    1. Macrocytic Anemia
  2. Macrocytic Megaloblastic Anemia (Affect B12 or Folate)
    1. Folate Related Changes
      1. Oral Contraceptive Use
      2. Pyrimethamine (Daraprim)
      3. Triamterene
      4. Alcohol
      5. Methotrexate
      6. Anticonvulsants
        1. Phenytoin (Dilantin)
        2. Primidone (Mysoline)
        3. Phenobarbital
      7. Antibiotics
        1. Sulfasalazine (Azulfidine)
        2. Sulfamethoxazole
        3. Trimethoprim (e.g. Bactrim or Septra)
        4. Pentamidine
    2. Vitamin B12 Related Changes
      1. Gastric acid-blocking agents
        1. Proton Pump Inhibitors (e.g. Omeprazole)
        2. Histamine H2-receptor blockers (e.g. Ranitidine)
        3. References
          1. Bradford (1999) Pharmacother 33:641
      2. Colchicine
      3. Neomycin sulfate
      4. Nitrous oxide
      5. Para-aminosalicylic Acid
  3. Macrocytic non-Megaloblastic Anemia (Marrow Toxins)
    1. Methotrexate
    2. Daunorubicin
    3. Adriamycin
    4. Benzene and derivatives (e.g. trinitrotoluene)
    5. Purine antagonists
      1. 6-Mercaptopurine
      2. Thioguanine
      3. Azathioprine (Imuran)
      4. Acyclovir (Zovirax)
    6. Pyrimidine antagonists
      1. Fluorouracil (Adrucil)
      2. Floxuridine (FUDR)
      3. Azidouridine
      4. Zidovudine (Retrovir)
    7. Ribonucleotide Reduction Inhibitors
      1. Hydroxyurea
      2. Cytosine arabinoside
    8. Alkylating Agents
      1. Cyclophosphamide (Cytoxan)
      2. Busulfan
  4. References
    1. Lee (1999) Wintrobe's Hematology, Lippincott, p. 1453
    2. Brigden (1995) Postgrad Med 97(5):171

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