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Drugs that Cause Bone Marrow Depression

Unless otherwise noted, less than 3% of patients experienced this side effect when using the following drugs.
  • Accupril® (Parke-Davis) quinapril hydrochloride tablets
  • Accuretic™ (Parke-Davis) quinapril hcl/hydrochlorothiazide tablets
  • Adriamycin, USP, adriamycin
  • Aldoclor® (Merck) methyldopa-chlorothiazide
  • Aldoril® (Merck) methyldopa-hydrochlorothiazide
  • Altace® (King) ramipril
  • Azasan® (Salix) azathioprine tablets
  • Calcium disodium versenate (3M) edetate calcium disodium injection
  • Campath® (Berlex) alemtuzumab
  • Carbatrol® (Shire US) carbamazepine extended-release capsules
  • Cipro® (Bayer) ciprofloxacin
  • Clinoril® (Merck) sulindac
  • Cuprimine® (Merck) penicillamine
  • Doxil® (Tibotec) doxorubicin hcl liposome
  • Elspar® (Merck) asparaginase
  • Flexeril® (McNeil Consumer) cyclobenzaprine HCl
  • Methotrexate** (Abbott) (Brand names: Rheumatrex, Trexall)
  • Floxin® (Ortho-McNeil) ofloxacin tablets
  • FML-S® (Allergan) fluorometholone and sulfacetamide sodium ophthalmic suspension
  • Indocin® (Merck) Indomethacin
  • Lotrel (Novartis)
  • Mavik® (Abbott) Trandolapril Tablets
  • Mefoxin® (Merck) Cefoxitin
  • Norpramin® (Aventis) desipramine hydrochloride
  • Primaxin® (Merck) Imipenem and Cilastatin
  • Prinivil® (Merck) Lisinopril
  • Prinzide® (Merck) Lisinopril-Hydrochlorothiazide
  • Sulfamylon® (Mylan) Brand of MAFENIDE ACETATE CREAM
  • Sulfamylon® (Mylan) Mafenide Acetate
  • Surmontil® (Odyssey) trimipramine maleate
  • Tegretol (Novartis)
  • Ticlid® (Roche Laboratories) ticlopidine hydrochloride
  • Topamax® (Ortho-McNeil) topiramate
  • Valcyte® *(Roche Laboratories) valganciclovir hydrochloride
  • Vaseretic (Merck)
  • Vasotec (Merck)
  • Vfend® (Pfizer) voriconazole
  • Vivactil® (Odyssey) Protriptyline HCl,
* Between 3% and 5% of Valcyte users have bone marrow depression.

** Between 2.6% and 7% of Methotrexate users have bone marrow depression.

Feedback, Comments, and Questions




Subj: Bone marrow depression?
Date: 5/8/2010
I would like to know if any cases of bone marrow depression have been reported with QUTIAPINE FUMERATE
Dr Nina

AskDocWeb: Bone pain is listed as one of the infrequent side effects but there are no reports of bone marrow depression.

Quetiapine fumarate (Seroquel XR) is an atypical antipsychotic used in the treatment of major depressive disorder (MDD), schizophrenia, bipolar disorder, and as adjunctive antidepressant therapy to other antidepressants.


Subj: Phenobarbitone Tablets
Date: 10/27/2010
I would like to know if any cases of bone marrow depression have been reported with Phenobarbitone Tablets I.P.(GARDENAL)
JAYANTHI

AskDocWeb: Phenobarbitone is a brand name of Phenobarbital (INN), a barbiturate first marketed as Luminal and Solfoton. It is the most widely used anticonvulsant worldwide and the oldest still commonly used. Drugs.com lists "weak bones" as one of the common side effects of this drug.


Subj: Nifedipine GITS (Gastrointestinal Therapeutic System)
Date: 11/7/2010
Can nifidipine gits cause bone marrow depression?
Rhoda

AskDocWeb: Bone marrow depression is very rare with Nifedipine. It occurs in less than 0.01% of patients, but it is possible.


Subj: Does Lisinopril cause bone marrow depression?
Date: 8/27/2011
I have been taking Lisinopril and Lisinopril-HCTZ. Has this drug been know to cause bone marrow depression?
Shirley

AskDocWeb: There are some cases of bone marrow depression with Lisinopril but these are vary rare. This effect has also manifested as hemolytic anemia, leukopenia/neutropenia and thrombocytopenia.


Subj: Arthrotec-decflenoc?
Date: 9/12/2011
arthrotec-decflenoc? I have taken arthrotec for 6 yrs and have been recently diagnosed with myelofibrosis. It is worthwhile to stop taking arthrotec.
Terry

AskDocWeb: That is something you would need to discuss with your physician. Myelofibrosis is a form of leukemia that affects bone marrow. It is most common in people over the age of 50. The condition gradually changes bone marrow tissue into scar tissue, which inhibits the bone marrow's ability to create new blood cells. Many people with Myelofibrosis get progressively worse yet it is possible to live symptom-free for years. We wish you well Terry, good luck.


Heart patient
Date: 2/28/2012
I want to know if a heart pt taking pyrimethamine 50mg daily along with aspirin, clopidogril, atorvastatin, lisinopril, in how much time he z likely to develop bone marrow suppression... nd which drug among all above is supposed to increase its toxicity???
Sadi

AskDocWeb: According to doublecheckmd.com Lisinopril may cause bone marrow damage/destruction (with abnormal production of blood cells) and aplastic anemia (rare failure of bone marrow). Statistics of these effects have not yet been quantified. Since bone marrow in large bones produce blood cells, the side effects to watch for include abnormal bruising or signs of bleeding such as bleeding from the gums, nose, digestive tract, vagina (females), dizziness, faintness, loss of consciousness, and/or rash, which are signs of problems with blood clot formation. If any of these develop, notify your physician immediately.


Methotrexat and hydroxychloroquine?
Date: 5/28/2012
What about methotrexat and hydroxychloroquine? I thought that they can cause bone marrow supression as well.
Milena

AskDocWeb: Thanks Milena, you have added to the list. Like many other chemotherapy drugs the use of Methotrexate can cause suppression of bone marrow.

Although Hydroxychloroquine (Watson Laboratories) may have an effect on bone marrow that side effect is rare, less than one percent. And although the risk of bone-marrow depression is low, the consequences are significant so periodic blood counts are often recommended for those using that medication.


Bone marrow depression or anemia
9/1/2012
Can Hair-Fall Treatmant Medicines Cause Bone Marrow Depression or any type of Anemia?
RAHUL

AskDocWeb: None of the treatments for hair loss that we have researched list either of those as a side effect.


Combinations of medications
9/4/2012
Does Ceftriaxone in combination with Sulbactam cause bone marrow depression with marked reduction in RBC formation? Can drugs taken for the treatment of typhoid and combiflam (Paracetamol + Ibubrufen) taken for a month cause severe microcytic hypochromic anemia?
Dr A.

AskDocWeb: We don't know. Tracking the effects of all the various combinations of drugs is beyond the scope of this forum. With over 10,000 drugs on the market in the USA alone, that is a lot of possible combinations. You might try contacting the manufacturer of those drugs for a detailed list of drug interactions.

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