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Drug-induced anemia
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Drug-induced anemia

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Contributors: Eric Ingerowski MD, FAAP
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Synopsis

Condition of reduced red blood cells (RBCs) owing to shorter survival time and destruction of RBCs (extrinsic hemolytic anemia) or reduced production of RBCs due to marrow suppression (aplastic anemia), associated with toxins or drugs. Characterized by sudden-onset weakness, fatigue, pallor, dyspnea, headache, and cardiac irregularities. Caused by recent use or exposure to drugs or toxic substances known to induce anemia, including but not limited to alcohol, antiarrhythmics, antibiotics, anticoagulants, anticonvulsants, anti-inflammatory agents, antimalarials, antineoplastic drugs, antithyroid drugs, corticosteroids, diuretics, hypoglycemic agents, nonsteroidal anti-inflammatory agents, sedatives, and sulfonamides. May be chemotherapy induced or induced by toxins from spider, snake, wasp, or scorpion bites.  Also known to be caused by insecticides, chemical compounds, and metals (lead, copper, arsine).

Drug-induced immune hemolytic anemia occurs when certain medications trigger antibodies to attack red blood cells. Drugs that impair metabolism of folic acid or interfere with absorption of vitamin B12 may induce megaloblastic anemia.

Management first begins by withdrawing the causative agent (may involve changing to another medication). Depending on the type, severity, and bodily systems involved, treatment may include pharmacotherapy such as glucocorticoids, erythropoietin-stimulating agents (ESAs) and other drugs, recombinant erythropoietin, careful monitoring, and transfusion.

Codes

ICD10CM:
D64.81 – Antineoplastic chemotherapy induced anemia
D64.9 – Anemia, unspecified

SNOMEDCT:
428383000 – Anemia caused by medication

Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Updated: 03/15/2018
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Drug-induced anemia
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Drug-induced anemia : Fatigue, Exertional dyspnea, Tachycardia, Anemia, Pallor
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