Some medications can destroy blood-clotting cells called platelets or prevent bone marrow from producing enough. This can lead to a low platelet count called thrombocytopenia.
Drugs that may cause thrombocytopenia include heparin, acetaminophen (Tylenol), and some chemotherapy drugs.
Certain medications may cause thrombocytopenia. The condition may lead to severe complications and can be life threatening.
Drug-induced thrombocytopenia occurs when medications cause a low platelet level. Platelets are blood cells that help blood clot to slow or stop bleeding. If a person’s blood does not clot, they may bleed excessively.
A normal platelet count is
Without treatment, thrombocytopenia may cause severe internal or external bleeding, which can be life threatening.
There are
- Immune: In immune drug-induced thrombocytopenia, medications prompt the immune system to release antibodies that attack and destroy platelets.
- Nonimmune: Medication prevents the bone marrow from producing enough platelets in this type of drug-induced thrombocytopenia.
Various types of drugs can cause thrombocytopenia.
The following medications are among the
- the blood thinning medications abciximab (ReoPro) and heparin
- the antibiotic drugs penicillin, ceftriaxone (Rocephin), and rifampin (Rimactane)
- ibuprofen (Advil, Motrin, Brufen, Nurofen), a nonsteroidal anti-inflammatory drug (NSAID) that reduces inflammation, pain, and fever
- the antimalarial drugs quinine (Qualaquin) and quinidine
- carbamazepine (Carbatrol, Epitol, Tegretol), an epilepsy medication that treats partial seizures
- mirtazapine (Remeron, Remeron Soltab), an antidepressant drug
- oxaliplatin (Eloxatin), a chemotherapy drug that treats colon cancer
Drugs that may cause nonimmune drug-induced thrombocytopenia
- tamoxifen (Nolvadex, Soltamox), a selective estrogen receptor modulator (SERM) that treats breast cancer
- aspirin, an NSAID
- some chemotherapy drugs, including doxorubicin and arsenic trioxide
- methotrexate (Rasuvo, Otrexup), a disease-modifying antirheumatic drug (DMARD) that treats psoriasis and rheumatoid arthritis (RA)
- lovastatin (Mevacor, Altoprev), a statin that reduces cholesterol
- the antibiotic vancomycin (Vancocin)
A person may inherit the gene responsible for thrombocytopenia from their parents, or the condition may develop for other reasons. In some cases, the causes may remain unknown.
Often, other medical conditions are the cause of thrombocytopenia. These
- autoimmune diseases, including RA and lupus
- aplastic anemia, a blood disorder in which the bone marrow does not produce new blood cells
- conditions that cause blood clots, such as thrombotic thrombocytopenic purpura (TTP)
- some cancers, including lymphoma and leukemia
- a large spleen, which can store or remove too many platelets
- bacterial or viral infections that lower platelet levels
- certain types of surgery, as passing through tubing, artificial heart valves, and blood vessel grafts may damage platelets
Symptoms of thrombocytopenia include:
- long-lasting bleeding
- purpura, bleeding in the skin that causes discolored spots
- petechiae, blood leaking under the skin, which causes flat, red spots
- heavy menstrual bleeding
- blood in stool or urine
- bleeding gums
- nosebleeds
A person can
A person should follow their doctor’s instructions on how to stop taking medications. A doctor may advise a person to stop taking drugs in a specific order so that they can monitor how this affects a person’s symptoms. They may also prescribe alternative medications.
A person should not suddenly stop taking a medication unless their doctor advises it is safe.
People
Treatments include a diet rich in folate or vitamin B12, medications such as corticosteroids, and in severe cases, a blood platelet transfusion.
Without treatment, thrombocytopenia can lead to severe, life threatening complications, such as excessive bleeding.
A person may be able to reduce their risk of developing drug-induced thrombocytopenia via the following steps:
- Using over-the-counter (OTC) medications associated with the condition sparingly, including the NSAIDs ibuprofen and aspirin.
- Discussing alternative prescription medication options with a doctor.
- Consulting a doctor before taking new OTC medications or supplements.
- Limiting courses of high risk medications, such as heparin, under a doctor’s advisement.
- Attending regular follow-up appointments with a doctor to monitor platelet counts.
- Disclosing previous medical history, such as past surgeries, to doctors.
- Maintaining health-promoting lifestyle habits, such as staying physically active, avoiding excessive alcohol use, and smoking.
A person should contact a doctor if they have symptoms of thrombocytopenia, as treatment can help prevent complications from developing.
A person should contact a doctor
- dizziness or balance problems
- black or red stools
- difficulty getting out of bed that lasts longer than 24 hours
- bright red or dark vomit
Which drugs should patients avoid when diagnosed with thrombocytopenia?
A person
Individuals should disclose their diagnosis to other healthcare professionals, as other medications that can contribute to the condition include certain antibiotics, some antidepressants, certain cancer drugs, and others.
How long does it take to recover from drug-induced thrombocytopenia?
Recovery may depend on factors such as the type of medication that caused the condition, and whether a person has co-occurring conditions. People
What is the most likely cause of thrombocytopenia?
The
Various medications, including blood thinners, some antibiotics, chemotherapy drugs, and NSAIDs, can cause thrombocytopenia.
Medications may cause the condition by triggering an immune response that destroys platelets or disrupts platelet production.
A person should contact a doctor if they experience symptoms of thrombocytopenia. They should not suddenly stop taking medication unless their doctor advises that it is safe.