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.

Two medical professionals discussing Drug-induced thrombocytopenia at a hospital. -2Share on Pinterest
Maskot/Getty Images

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 150,000 to 450,000 per microliter (µl) of blood. A platelet count below 150,000/µl is considered low.

Without treatment, thrombocytopenia may cause severe internal or external bleeding, which can be life threatening.

There are two types of drug-induced thrombocytopenia:

  • 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 most commonly reported causes of immune drug-induced thrombocytopenia:

Drugs that may cause nonimmune drug-induced thrombocytopenia include:

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 include:

Symptoms of thrombocytopenia include:

A person can often successfully recover from drug-induced thrombocytopenia if they stop taking the medications that caused it.

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 usually recover within a few days of stopping the medication that triggered their thrombocytopenia. However, platelet counts can remain low in some people for several weeks.

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 immediately if they experience:

  • 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 should avoid medications that thin the blood unless their doctor advises them to take them under careful monitoring. These include NSAIDs like ibuprofen and aspirin.

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 usually recover within a few days of discontinuing the medication.

What is the most likely cause of thrombocytopenia?

The most common causes of thrombocytopenia are certain medications and other medical conditions that affect the platelets.

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.