Many drugs can cause agranulocytosis and neutropenia. The mechanism of neutropenia can be varied depending on the drug. Many anti- neoplastic drugs cause agranulocytosis and neutropenia by bone marrow suppression. Neutropenia and agranulocytosis can also result from antibody or compliment mediated damage to the stem cells. Some drugs may cause increased peripheral destruction of white cells. About three fourth of all agranulocytosis in the United States is related to drugs. Procainamide, anti-thyroid drugs and sulfasalazine are at the top of the list of drugs causing this problem. Most agranulocytosis is related to the direct effect related to its dose. Phenothiazines, semi-synthetic penicillins, non-steroidal anti-inflammatory drugs (NSAIDs), aminopyrine derivatives, benzodiazepines, barbiturate, gold compounds, sulfonamides, and anti-thyroid medications are the most common causes of neutropenia and agranulocytosis.
List of drugs that causes agranulocytosis or neutropenia sorted as per probability
(Anti-neoplastic drugs are not included)
Dipyrone
Mianserin
Sulfasalazine
Co-trimoxazole
Anti-arrythmic agents
Procainamide
Ajmaline
Tocainide
Aprindine
Amiodarone
Penicillins
Amoxycillin
Aziocillin
Benzylpenicillin
Phenethicillin
Cloaxacillin and penicillin
Thiouracil derivatives
Methyl thiouracil
Propyl thiourcil
Phenylbutazone
Cimetidine
Penicillamine
Diclofenac
Carbamazepine
ACE-Inhibitors
Captopril
Enalapril
Hydrochlorothiazide with potassium sparing diuretics
Indomethacine
Cephalosporins
Cephalexin
Cepahazolin
Cefuroxime
Cefitaxime
Cephradine
Oxyphenbutazone
Nitrofurantoin
Salicylic acid derivatives
Clozapine
Carbimazone
Sulphonylurea derivatives
Glibenclamide
Tolbutamide
Methyldopa
Thiamazole
Nucleosides
Aminoglutethimide
Ibuprofen
Pentazocine
Levamizole
Promethazine
Chloramphinicol
Acetaminophen and combinations
Perazine
Mebhydrolin
Ranitidine
Imipramine
Miscellaneous drugs (relatively lower probability)
Phenytoin
Chlorthalidone
Sulphamethizole
Norfloxacin
Naproxen
Clomipramine
Trazodone
Omeprazole
Alimemazine
Pirenzepine
Ticlopidine
Ibopamine
Hydralazine
Nifedipine
Nalidixic acid
Doxycycline
Clindamycin
Gentamycin
Fusidic acid
Dapsone
Azapropazone
Propyphenazone
Sulindac
Piroxicam
Pirprofen
Niflumic acid
Allopurinol
Glafenine
Valproate
Levadopa with carbidopa
Chlorpramazine
Haloperidol
spironolactone
Zuclopenthixol
Zopiclone
Cinnarizine
Metronidazole
Pyrimethamine combinations
Thophylline
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Drugs causing agranulocytosis