Nonchemotherapy drug-induced neutropenia and agranulocytosis: Could medications be the culprit?

Amy M. Pick, Kelly K. Nystrom

Research output: Contribution to journalReview article

17 Scopus citations


Drug-induced agranulocytosis is a severe complication that has been implicated with most classes of medications. Medications such as clozapine, trimethoprim-sulfamethoxazole and methimazole have been more commonly associated with agranulocytosis than other agents. Although the pathogenesis isn't fully elucidated, it appears to be two-fold with a direct toxicity to the myeloid cell line and immune-mediated destruction. Patients may be asymptomatic at the time neutropenia is discovered or may present with more severe complications such as sepsis. In approximately 5% of cases drug-induced agranulocytosis may be fatal. Management of drug-induced agranulocytosis includes the immediate discontinuation of the offending medication, initiation of broad-spectrum antibiotics and consideration of the use of granulocyte colony-stimulating factors in high-risk patients.

Original languageEnglish (US)
Pages (from-to)447-452
Number of pages6
JournalJournal of Pharmacy Practice
Issue number5
StatePublished - Oct 12 2014



  • agranulocytosis
  • drug induced
  • neutropenia
  • nonchemotherapy

ASJC Scopus subject areas

  • Pharmacology (medical)

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