II. Causes: Thrombocytopenia
- Chemotherapeutic agents
- Alkylating Agents
- Antimetabolites
- Interferon alpha
- Fludarabine
- Oxaliplatin
- Bleomycin
- Rituximab
- Trastuzumab
- Antibiotics
- Sulfonamides (e.g. Trimethoprim-Sulfamethoxazole or Bactrim)
- Penicillins
- Cephalosporins
- Rifampin
- Vancomycin
- Fluoroquinolones
- Linezolid
- Ganciclovir
- Cardiovascular Agents
- Captopril
- Thiazide Diuretics (Hydrochlorothiazide, Chlorthalidone)
- Spironolactone
- Furosemide (Lasix)
- Amiodarone
- Abciximab (ReoPro)
- Glycoprotein IIB/IIIA Inhibitor (Eptifibatide or Integrilin, Tirofiban)
- Digoxin
- Methyldopa
- Procainamide
- Cinchona alkaloids (Quinidine, Quinine, Tonic Water)
- H2 Antagonists
- Neurologic agents (esp. antiepileptic agents)
- Psychiatric Agents
- Rheumatologic Agents
- Acetaminophen (autoimmune mechanism)
- NSAIDs (e.g. Ibuprofen, Naproxen, Indomethacin, piroxicam, diclofenac)
- Gold Salts
- Sulfasalazine (Azulfidine)
- Endocrine Agents
- Herbals
- Immunizations
- Miscellanous Agents
III. Causes: Platelet impaired function
- Common causes
- Other causes
- Antidepressants
- Antihistamines
- Azatadine
- Brompheniramine
- Clemastine fumarate
- Clofibrate
- Dipyridamole
- Furosemide (Lasix)
- Ginkgo Biloba
- Nitrofurantoin (Furadantin)
- Propranolol
- Sulfinpyrazone
IV. Course
- Platelet Count rarely falls below 20,000/uL in Drug induced Thrombocytopenia
- Onset within 3 to 10 days of starting the medication
- Expect recovery in 7-14 days after discontinuation of medication
- Consider alternative Thrombocytopenia Causes when Thrombocytopenia persists after stopping suspected medication
V. Management
- Discontinue offending agent and recheck Platelet Count in 1 week
- Consider drug-specific antiplatelet Antibody testing when patient is on multiple medications that may cause Thrombocytopenia
- See Thrombocytopenia
- See Thrombocytopenia Causes
VI. Resources
- Platelets on the Web
VII. References
- Merrill and Gillen (2016) Crit Dec Emerg Med 30(3): 3-8
- Kenney (2009) Arch Pathol Lab Med 133(2): 309-14 [PubMed]
- Gauer (2022) Am Fam Physician 106(3): 288-98 [PubMed]