Drugs that cause isolated thrombocytopenia

Class	Implicated drugs
Antiinflammatory and analgesic	Acetaminophen Aceclofenac Aspirin Celecoxib Diclofenac	Fentanyl Ibuprofen Naproxen Oxaprozin Zolmitriptan
Antibiotic	Amoxicillin Ampicillin Aztreonam Cefadroxil Cefazolin Cefepime Cefpodoxime Ceftazidime Ceftriaxone Cephalexin Ciprofloxacin Clindamycin Daptomycin	Doxycycline Ethambutol Flucloxacillin Levofloxacin Linezolid Metronidazole Nafcillin Nitrofurantoin Oseltamivir Piperacillin Piperacillin-tazobactam Pyrazinamide	Quinine Rifampin Sulbactam Suramin Trimethoprim-sulfamethoxazole [both components] Vancomycin [also when used in orthopedic cement for joint replacement] Voriconazole
Anticancer	Alemtuzumab Atezolizumab Azacitidine Durvalumab Fluorouracil Ibrutinib Ipilimumab	Irinotecan Natalizumab Oxaliplatin Pembrolizumab Nivolumab Trastuzumab
Antithrombotic	Abciximab Argatroban Aspirin	Eptifibatide Heparin Tirofiban
Antidiabetic	Exenatide Rosiglitazone
Antihistamine	Cetirizine Diphenhydramine Fexofenadine
Antiseizure	Carbamazepine Ethosuximide Felbamate Lamotrigine	Oxcarbazepine Phenobarbital Phenytoin Valproic acid
Cardiovascular	Amiodarone Amlodipine Atenolol Bisoprolol Bumetanide Diltiazem Dobutamine	Felodipine Furosemide Lisinopril Losartan Olmesartan Papaverine Procainamide	Propranolol Quinidine Simvastatin Spironolactone Verapamil
Gastrointestinal	Esomeprazole Lansoprazole Nizatidine Ondansetron	Palonosetron Pantoprazole Ranitidine
Immunosuppressant/immunomodulatory	Cyclosporine Dexamethasone Hydroxychloroquine IVIG	Methylprednisolone Rituximab Tacrolimus
Psychiatric	Amitriptyline Bupropion Diazepam Haloperidol Lorazepam Mirtazapine	Olanzapine Paroxetine Quetiapine Sertraline Trazodone
Vaccines	COVID-19 vaccines Influenza vaccine (trivalent, inactivated) MMR vaccine
Other	Diazoxide Filgrastim Gold compounds	Leucovorin Propylthiouracil Protamine

Supporting data come from published reports, identification of drug-dependent platelet-reactive antibodies, or both.^[1] Certain foods and beverages (certain herbal teas, walnuts) can also cause thrombocytopenia. For most drugs, the mechanism is drug-induced immune thrombocytopenia (DITP) in which the antibodies are drug-dependent and require the drug to be present. Drug-dependent platelet-reactive antibodies have been detected by one or more laboratories for almost all of the drugs listed. The most commonly implicated drugs are shown in bold.^[2-4] DITP may occur with drugs not listed herein. Additional drugs may cause thrombocytopenia along with other cytopenias by other mechanisms such as bone marrow suppression.

References:

Drug-induced immune thrombocytopenia results of the testing for drug-dependent platelet-reactive antibodies by the BloodCenter of Wisconsin. https://www.ouhsc.edu/platelets/WEB%20Table%20Lab%202018.pdf (Accessed on September 27, 2024).
Arnold DA, Kukaswadia S, Nasi I, et al. A systematic evaluation of laboratory testing for drug-induced immune thrombocytopenia. J Thromb Haemost 2013; 11:169.
Mitta A, Curtis BR, Reese JA, George JN. Drug-induced thrombocytopenia: 2019 update of clinical and laboratory data. Am J Hematol 2019; 94:E76.
Nusrat S, Borogovac A, George JN, et al. Drug (vaccine)-induced thrombocytopenia 2021: Diversity of pathogenesis and clinical features. Am J Hematol 2022; 97:E162.

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Drugs that cause isolated thrombocytopenia

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