Incidence drug induced agranulocytosis. Medical search. Frequent questions

Thus a re-challenge with clozapine of a patient who previously has experienced a clozapine-induced myocarditis or cardiomyopathy is strongly discouraged, as discussed in the review of Nielsen et al. (biomedcentral.com)
Only a few national schizophrenia guidelines mention clozapine-induced myocarditis or individual titration schemes. (bvsalud.org)

We assessed adverse event reports for agranulocytosis, granulocytopenia, leukopenia, and neutropenia from the FDA Adverse Event Reporting System (FAERS) for a 1-year time period before (October 2014 to September 2015, pre-REMS) and after (October 2015 to September 2016, post-REMS) the implementation of the clozapine REMS program. (allenpress.com)
1 Although the label specifically mentions neutropenia, there are 3 additional hematologic abnormalities that are clinically similar but have different defining parameters: agranulocytosis, granulocytopenia, and leukopenia. (allenpress.com)
15 Buchmann N, Strous R D, Ulman A M, Lerner M, Kotler M. Olanzapine-induced leukopenia with human leukocyte antigen profiling. (thieme-connect.de)
Possible risk factors for leukopenia/neutropenia include pre-existing low white cell count (WBC) and history of drug-induced leukopenia/neutropenia. (medlibrary.org)
Patients with a pre-existing low WBC or a history of drug induced leukopenia/neutropenia should have their complete blood count (CBC) monitored frequently during the first few months of therapy and should discontinue quetiapine at the first sign of a decline in WBC in absence of other causative factors. (medlibrary.org)

Its use was discontinued when patients began exhibiting serious side effects including agranulocytosis, thrombocytopenia, arthritis, vasculitis and skin necrosis. (jetem.org)
List medications that can cause neutropenia and thrombocytopenia, and state drugs that are useful for neutropenia. (ashp.org)

Black patients receiving ACE inhibitors have a higher incidence of angioedema compared to nonblacks. (drugs-library.com)
In placebo-controlled trials, there was a significantly higher incidence of cerebrovascular adverse events in patients treated with oral risperidone compared to patients treated with placebo. (druglib.com)

5 Clozapine has several black box warnings regarding potential severe adverse drug reactions (ADRs), including hematologic abnormalities. (allenpress.com)
We report a case of clopidogrel-induced bone marrow toxicity manifesting with severe neutropenia in a patient treated with multiple coronary stents and provide suggestions for an alternative treatment. (hindawi.com)
The CAPRIE trial, which included 9.599 patients treated with clopidogrel, showed a low annual incidence (0.05%) of severe neutropenia, considered as neutrophil count below 0.45 × 10 9 /L [ 4 ]. (hindawi.com)
High-dose and long-term therapy with β-lactam antibiotics can induce severe neutropenia, with an ANC of less than 500 cells/µL. (consultant360.com)

Tardive dyskinesia, a syndrome consisting of potentially irreversible, involuntary, dyskinetic movements may develop in patients treated with neuroleptic (antipsychotic) drugs. (nih.gov)
Tardive dyskinesia, a syndrome consisting of potentially irreversible, involuntary, dyskinetic movements may develop in patients treated with antipsychotic drugs.Although the prevalence of the syndrome appears to be highest among the elderly, especially elderly women, it is impossible to rely upon prevalence estimates to predict, at the inception of antipsychotic drug treatment, which patients are likely to develop the syndrome. (drugs.com)
Whether antipsychotic drug products differ in their potential to cause tardive dyskinesia is unknown. (drugs.com)
We report the evidence for associations between pharmacogenetic (PGx) variants and antipsychotics outcomes, including antipsychotic response, antipsychotic-induced weight/BMI gain, metabolic syndrome, antipsychotic-related prolactin levels, antipsychotic-induced tardive dyskinesia (TD), clozapine-induced agranulocytosis (CLA), and drug concentration level (pharmacokinetics) in SSD patients. (cdc.gov)

Background Associations between aplastic anemia and numerous drugs, pesticides and chemicals have been reported. (haematologica.org)
Design and Methods This was a case-control, multicenter, multinational study, designed to identify risk factors for agranulocytosis and aplastic anemia. (haematologica.org)
Results The incidence of aplastic anemia was 1.6 cases per million per year. (haematologica.org)
Conclusions The incidence of aplastic anemia in Latin America countries is low. (haematologica.org)

Aurora N, Janin T, Bhanot R, Natesan S. Levamisole-induced leukocytoclastic vasculitis and neutropenia in a patient with cocaine use: an extensive case with necrosis of skin, soft tissue and cartilage. (jetem.org)

19 Schuld A, Kraus T, Hinze-Selch D, Haack M, Pollmächer T. Granulocyte colony-stimulating factor plasma levels during clozapine- and olanzapine-induced granulocytopenia. (thieme-connect.de)

Clinical studies have shown clozapine to be effective in suppressing both the positive and negative symptoms of schizophrenia and to be associated with an extremely low incidence of extrapyramidal side effects. (nih.gov)

The binding of ciprofloxacin to serum proteins is 20% to 40%, which is not likely to be high enough to cause significant protein binding interactions with other drugs. (theodora.com)

Medically reviewed by Drugs.com on Jul 24, 2023. (drugs.com)

9 , 10 A study conducted in Southern Brazil, from 1999 to 2000, reported an incidence of 2.4 cases per million per year. (haematologica.org)
Although a large number of agents have been studied for their therapeutic effects on TD, there is no definitive drug treat-ment for it (American Psychiatric Association, 2000). (brainkart.com)

In 1992, the Moroccan centre corresponding medical resident) concerning was admitted as the 34th national centre drug-related events. (who.int)

Labetalol HCl consistently, in dose-related fashion, blunted increases in exercise-induced blood pressure and heart rate, and in their double product. (guidelinecentral.com)

We expressed annual incidence rates among the general nal mucormycoses were excluded because results of a previ- population, by gender and age groups, as cases per 100,000 ous study showed that cases were mostly identified on the population, using data from the 1999 national population basis of false-positive test findings ( 12 ). (cdc.gov)

Among second-generation drugs, clozapine and quetiapine have been shown to carry mini-mal to no risk for EPS within the therapeutic dosage range. (brainkart.com)
The development of modern second generation antipsychotics such as olanzapine, risperidone, quetiapine, amisulpride, ziprasidone or aripiprazol, however, makes it possible to use the positive effects of this class of drugs without the risks of a clozapine treatment. (thieme-connect.de)
A syndrome of potentially irreversible, involuntary, dyskinetic movements may develop in patients treated with antipsychotic drugs, including quetiapine. (medlibrary.org)
Quetiapine may induce orthostatic hypotension associated with dizziness, tachycardia and, in some patients, syncope, especially during the initial dose-titration period, probably reflecting its α 1 -adrenergic antagonist properties. (medlibrary.org)
Syncope was reported in 1% (28/3265) of the patients treated with quetiapine, compared with 0.2% (2/954) on placebo and about 0.4% (2/527) on active control drugs. (medlibrary.org)
the incidence of increases at any time in diastolic blood pressure (≥10 mmHg) was 40.6% (136/335) for quetiapine and 24.5% (40/163) for placebo. (medlibrary.org)
the incidence of increases at any time in diastolic blood pressure (≥10 mmHg) was 46.7% (43/92) for quetiapine extended release and 36.0% (36/100) for placebo. (medlibrary.org)

Levothyroxine (LT4) is the drug of choice for patients who develop lithium-induced hypothyroidism or goiter (when discontinuation of lithium therapy is not feasible). (medscape.com)
Side-effects may occur, and these are particularly marked in those with a low iron burden and may require discontinuation of the drug (see Table 1). (hospitalpharmacyeurope.com)
the most frequent adverse reactions leading to discontinuation among paroxetine-treated women were: abdominal pain (0.3%), attention disturbances (0.3%), headache (0.3%), and suicidal ideation (0.3%).Common Adverse Reactions: Overall, based on investigators determinations about what events were likely to be drug-related, about 20% of women treated with paroxetine capsules reported at least adverse reaction in the three controlled studies. (drugcentral.org)
The management of NMS should include 1) immediate discontinuation of antipsychotic drugs and other drugs not essential to concurrent therapy, 2) intensive symptomatic treatment and medical monitoring, and 3) treatment of any concomitant serious medical problems for which specific treatments are available. (psychopharmacopeia.com)

[ 3 ] Major causes of acquired neutropenia are infection, drugs (through direct toxicity or immune effects), and autoimmunity. (medscape.com)
No data suggest any increase in toxicity of either drug when they are given together. (hospitalpharmacyeurope.com)
Other important considerations in the differential diagnosis include central anticholinergic toxicity, heat stroke, drug fever and primary central nervous system (CNS) pathology. (psychopharmacopeia.com)

Analyses of seventeen placebo-controlled trials (modal duration of 10 weeks), largely in patients taking atypical antipsychotic drugs, revealed a risk of death in drug-treated patients of between 1.6 to 1.7 times the risk of death in placebo-treated patients. (nih.gov)
Observational studies suggest that, similar to atypical antipsychotic drugs, treatment with conventional antipsychotic drugs may increase mortality. (nih.gov)
Atypical antipsychotic drugs have been associated with metabolic changes that include hyperglycemia/diabetes mellitus, dyslipidemia, and body weight gain. (psychopharmacopeia.com)

The extent to which the findings of increased mortality in observational studies may be attributed to the antipsychotic drug as opposed to some characteristic(s) of the patients is not clear. (nih.gov)
If a patient requires antipsychotic drug treatment after recovery from NMS, the potential reintroduction of drug therapy should be carefully considered. (psychopharmacopeia.com)

Use is contraindicated in patients with hepatic impairment including hepatic cirrhosis as drug exposure is increased (see Contraindications). (pdr.net)

In using VASOTEC consideration should be given to the fact that another angiotensin converting enzyme inhibitor, captopril, has caused agranulocytosis, particularly in patients with renal impairment or collagen vascular disease, and that available data are insufficient to show that VASOTEC does not have a similar risk (see WARNINGS ). (rxlist.com)

Increasing the dose does not increase the diuresis and may increase the incidence of drowsiness and/or paresthesia. (drugcite.com)
Weight loss induced by enhanced diuresis should not exceed 1 kg/day. (medicines.org.uk)

If signs of hypersensitivity or other serious reactions occur, discontinue use of this drug. (drugcite.com)
If use is unavoidable, closely monitor for adverse reactions and consider dose reduction of BCRP substrate drug (refer BCRP substrate prescribing information). (medscape.com)
3 Acute or transient neutropenia most often is a result of cytotoxic drug therapies or idiosyncratic drug-induced reactions. (consultant360.com)
Reports of clozapine adverse drug reactions (ADRs) sent to the global pharmacovigilance database (VigiBase™) were analyzed from introduction to December 31, 2022. (bvsalud.org)

[ 8 ] While reports suggested either (1) lack of lithium effects on cAMP synthesis or (2) lithium-induced inhibition of cAMP synthesis, later work in a strain of rat thyroid follicular cells (FRTL-5) and a cell line of Chinese hamster ovary fibroblasts stably transfected with the human thyrotropin receptor (CHO-TSHR) showed significant potentiation by lithium of the cAMP response to exogenous thyrotropin. (medscape.com)
Beta 2 -receptor blockade was demonstrated by inhibition of the isoproterenol-induced fall in diastolic blood pressure. (guidelinecentral.com)

Comment: Concomitant administration increases risk of agranulocytosis. (medscape.com)

Psychiatrists tend to focus on the well-known side effects like agranulocytosis and the development of metabolic syndrome when monitoring a clozapine-treated patient, yet the cardiac risk should not be underestimated as we try to demonstrate in our case report. (biomedcentral.com)

The appearance of hypotension after the initial dose of PRINIVIL does not preclude subsequent careful dose titration with the drug, following effective management of the hypotension. (wikidoc.org)

3 Levamisole-induced vasculitis has since become an increasingly recognized complication of cocaine use. (jetem.org)
Sayadi L, Laub D. Levamisole-induced vasculitis. (jetem.org)

Clozapine-induced cardiomyopathy should be taken into account when monitoring patients treated with this antipsychotic and regular electrocardiograms should be performed in order to detect possible alterations as soon as possible. (biomedcentral.com)

In clinically useful doses, lithium induces a marked decrease in the release of preformed thyroid hormone (TH) from the thyroid. (medscape.com)
In clinically stable asymptomatic patients with left ventricular dysfunction (ejection fraction ≤ 35 percent), VASOTEC decreases the rate of development of overt heart failure and decreases the incidence of hospitalization for heart failure (see CLINICAL PHARMACOLOGY , Heart Failure , Mortality Trials for details and limitations of survival trials ). (rxlist.com)

There is some evidence that concomitant therapy with sulfasalazine and corticosteroids may not be more effective than either drug alone, but some subgroups of patients may have a better response to combined therapy (e.g., those with disease localized in the colon). (drugs.com)

2 These side effects predominantly occurred in women and had a mean age of incidence of 44 years when used as an immunomodulatory agent. (jetem.org)
Hydroxychloroquine is an immunomodulatory drug that has been used for 60 years to treat malaria and autoimmune diseases such as systemic lupus erythematosus and inflammatory arthritis, and potential new uses and benefits continue to emerge. (ccjm.org)

Sixty-five percent of the dose is recovered in the urine as unchanged drug and 11% of the dose appears as the metabolite adipic acid. (globalrph.com)
Both the risk of developing the syndrome and the likelihood that it will become irreversible are believed to increase as the duration of treatment and the total cumulative dose of antipsychotic drugs administered to the patient increase. (drugs.com)
Clozapine is associated with a dose-dependent seizure risk at a rate higher than that seen with most other antipsychotic drugs. (psychopharmacopeia.com)

US Food and Drug Administration (FDA) approved indications include treatment-resistant schizophrenia as well as suicidal behavior in schizophrenia or schizoaffective disorder. (allenpress.com)

7 Hummer M, Kurz M, Barnas C, Saria A, Fleischhacker W W. Clozapine-induced transient white blood count disorders. (thieme-connect.de)

The incidence of CAEs was significantly higher than with placebo. (educationaldoseillustrator.com)

In general, first-generation antipsychotics are more likely to cause EPS than second-generation antipsychotics when the drugs are used at usual therapeutic doses. (brainkart.com)

Since some of its side-effects, e.g. agranulocytosis, which occurs in nearly 1% of all treated patients, can be life-threatening clozapine is not considered a first-line antipsychotic and should only be administered after two failed treatment attempts with other antipsychotics [ 2 ]. (biomedcentral.com)

BPaL was approved in accordance with the Limited Population Pathway for Antibacterial and Antifungal Drugs (LPAD) for development of drugs targeting infections that lack effective therapies. (cdc.gov)
Step edit is defined as an approach to prescription drug management where patients are required to try one or more drug therapies before receiving access to a drug originally prescribed. (rexultihcp.com)

Agranulocytosis is defined as having an absolute neutrophil count (ANC) below 500/μL. (allenpress.com)
The falls in neutrophil counts recover spontaneously once the drug is discontinued. (hospitalpharmacyeurope.com)
In this case, the normalization of the patient's neutrophil count after cessation of ampicillin-sulbactam points to β-lactam-induced neutropenia. (consultant360.com)
We believe that our patient's acute neutrophil count recovery after cessation of the β-lactam agent-in this case, within one day-could be a result of myeloid maturation arrest rather than an idiosyncratic drug-induced neutropenia. (consultant360.com)

Vulnerability to infection is extremely high in patients with agranulocytosis, which is the virtual absence of neutrophils in peripheral blood, with ANC typically lower than 100/μL. (medscape.com)

Antipsychotic-induced EPS occur both acutely and after chronic treatment. (brainkart.com)
In the absence of myeloid precursors, as in idiosyncratic drug-induced cases, the blood count recovery is unlikely to occur in less than 14 days. (consultant360.com)

Neutrophils play a vital role in protecting against infection, so the duration and severity of neutropenia directly correlate with the total incidence of all infections, including those that are life threatening. (medscape.com)

Data obtained by magnetic resonance imaging (MRI) using the T(2)(*) technique to measure cardiac iron show that the drug is superior to DFO at removing iron from the heart. (hospitalpharmacyeurope.com)
6) This beneficial effect on the heart is also shown by improved cardiac function (eg, left ventricular ejection fraction in patients receiving the drug for one year or more). (hospitalpharmacyeurope.com)
In Italy,(7) the UK and Cyprus,(8) its use has been associated with a substantial reduction in iron-induced cardiac damage and mortality. (hospitalpharmacyeurope.com)

The LATIN study is an international case-control study designed to identify risk factors for agranulocytosis and AA, including drugs, other diseases, and environmental factors, using a methodological approach similar to that used in previous studies. (haematologica.org)
High incidence of autoimmune diseases and potential complications, including the development of lymphoma have been demonstrated in this dermatosis. (scielo.br)

If coadministration is necessary, monitor patients closely at frequent intervals and consider a dosage reduction of dihydrocodeine until stable drug effects are achieved. (pdr.net)

To reduce the development of drug-resistant bacteria and maintain the effectiveness of CIPRO® XR and other antibacterial drugs, CIPRO XR should be used only to treat or prevent infections that are proven or strongly suspected to be caused by bacteria. (theodora.com)

Coadministration of apalutamide, a strong CYP3A4 inducer, with drugs that are CYP3A4 substrates can result in lower exposure to these medications. (medscape.com)

Avoid or Use Alternate Drug. (medscape.com)

Over the course of a typical 10-week controlled trial, the rate of death in drug-treated patients was about 4.5%, compared to a rate of about 2.6% in the placebo group. (nih.gov)

Be careful and be sure to specify the information on the section Dosage (Posology) and method of administration in the instructions to the drug Adequet directly from the package or from the pharmacist at the pharmacy. (pillintrip.com)

Following intramuscular administration of prochlorperazine edisylate, the drug has an onset of action within ten to twenty minutes and a duration of action of three to four hours. (drugs.com)

Our Geodon Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication. (rxlist.com)
Even as efficacy of drug regimens has improved, side effects and length of treatment have continued to be challenges in treating patients with drug-resistant TB [ 3 , 4] . (cdc.gov)
Dapsone remains the main drug for treatment, but it requires monitoring of possible side effects, some potentially lethal. (scielo.br)

16 Guest I, Sokoluk B, MacCrimmon J, Utrecht J. Examination of possible toxic and immune mechanisms of clozapine-induced agranulocytosis. (thieme-connect.de)

In August 2019, FDA approved the use of pretomanid 200mg in combination with bedaquiline and linezolid (BPaL) in adults with pulmonary extensively drug resistant (XDR), treatment-intolerant, or nonresponsive multidrug-resistant (MDR) tuberculosis (TB) [5 ]. (cdc.gov)
On August 14, 2019, the Food and Drug Administration (FDA) approved use of pretomanid with bedaquiline and linezolid (BPaL) as a treatment regimen for pulmonary MDR TB additionally resistant to at least one fluoroquinolone or injectable medication and for pulmonary MDR TB that is treatment-intolerant/nonresponsive (TI/NR MDR TB). (cdc.gov)
Other subsets of SUD include hematological and pulmonary causes, including agranulocytosis leading to sepsis, deep vein thrombosis leading to pulmonary embolisms, and aspiration pneumonia leading to sepsis. (medscape.com)

The latter induces a decrease in the activity of type I 5'-deiodinase enzyme. (medscape.com)

Multidrug-resistant tuberculosis (MDR TB) , caused by MTB that is resistant to at least isoniazid (INH) and rifampin (RIF), has traditionally required longer, more intensive treatment than drug-susceptible disease, including 15-21 months of treatment after culture conversion with 4-7 drugs that are less effective, more toxic, and more costly in treating MDR TB than is a standard first-line regimen in treating drug-susceptible TB [ 1 ]. (cdc.gov)

Three iron-chelating drugs, deferoxamine, deferiprone and deferasirox, are now available within the European Union (see Table 1). (hospitalpharmacyeurope.com)
Combined therapy in which deferiprone is given daily and DFO on a few days each week has been found to be effective in patients for whom either drug alone, for whatever reason, is inadequate. (hospitalpharmacyeurope.com)

Thyrotoxicosis can also be observed in lithium-treated patients, but it is rare, with an incidence rate of approximately 2-7 cases per 1000 person-years. (medscape.com)
14 This report focuses on the risk factors and incidence rate of AA. (haematologica.org)
CIPRO XR tablets are formulated to release drug at a slower rate compared to immediate-release tablets. (theodora.com)

13 Claas F H, Abbott P A, Witvliet M D, D'Amaro J, Barnes P M, Krupp P. No direct clinical relevance of the human leucocyte antigen (HLA) system in clozapine-induced agranulocytosis. (thieme-connect.de)

Anatomy1

Diseases8

Chemicals and Drugs23

Analytical, Diagnostic and Therapeutic Techniques and Equipment4

Phenomena and Processes1

Anthropology, Education, Sociology and Social Phenomena1

Information Science1

Health Care3

Geographicals1

Clozapine-induced myocarditis2

Leukopenia5

Thrombocytopenia2

Higher incidence2

Severe4

Tardive dyskinesia4

Aplastic anemia4

Neutropenia in a patient1

Granulocytopenia1

Extrapyramidal side ef1

Interactions1

20231

20002

19921

Exercise-induced1

Annual incidence1

Quetiapine7

Discontinuation4

Toxicity3

Atypical3

Antipsychotic drug2

Hepatic1

Renal Impairment1

Diuresis2

Reactions4

Inhibition2

Increases1

Metabolic1

Titration1

Vasculitis2

Patients treated1

Clinically2

Concomitant1

Immunomodulatory2

Dose3

Schizophrenia1

Transient1

Significantly1

Doses1

Antipsychotics1

Therapies2

Neutrophil4

Peripheral1

Occur2

Neutrophils1

Cardiac3

Diseases2

Reduction1

Antibacterial drugs1

Coadministration1

Avoid or Use Alternate Drug1

Placebo1

Dosage1

Onset1

Side effects3

Immune1

Pulmonary3

Decrease1

Toxic1

Deferiprone2

Rate3

Clinical1