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Pharmacy and Medications

Medications Side Effects

11/12/2010

Question:

What medications have the side effect of causing pulmonary fibrosis?

Answer:

Thank you for contacting NetWellness. Few drugs have pulmonary fibrosis as a side effect and of those that do, it generally is a side effect seen in only a small number of patients. Some drugs where it is more common are amiodarone, which is used to prevent arrhythmias, and chemotherapy agents used in some cancers such as carmustine, lomustine, and bleomycin. Usually doctors will monitor patients using these medications by taking chest x-rays and performing tests to measure lung function before giving the drug and while the patient is on the drug to make sure patients are not developing this serious side effect.

Most drugs that have pulmonary fibrosis as a side effect either have it listed as an effect that occurs in less than 1% of those taking it, or it is listed as an uncommon side effect. These include antibiotics such as nitrofurantoin and sulfasalazine. Drugs that decrease the immune system such as methotrexate, Cellcept, Remicade, and Humira also have a few case reports of patients developing pulmonary fibrosis. A drug used in Parkinson’s disease, bromocriptine, and drugs used for inflammation such as leflunomide and pencillamine, also have some cases of patients developing this side effect. Finally several chemotherapy drugs used to treat cancer such as busulfan, gemcitabine, cyclophosphamide, chlorambucil, and melphalan also have pulmonary fibrosis listed as a possible side effect.

Since pulmonary fibrosis is usually a rare side effect, this list may not include every medication that has a report of pulmonary fibrosis. If you have concerns about the medications you are on, speak to your pharmacist who can review your particular medications.  He or she can also look to see if the medications you are on are associated with other lung-related problems besides pulmonary fibrosis.

Even with a serious disease such as pulmonary fibrosis listed as a side effect, generally a medication is only prescribed if the prescriber believes the benefits of taking a medication outweigh the risks. If you are having problems with your lungs or breathing and have not yet seen a doctor, please do so. Pulmonary fibrosis is not very common, and other lung diseases may cause similar symptoms, so see a doctor to help determine what is causing your symptoms. Also be sure to speak with your doctor before stopping any medication due to concerns about side effects since many of the drugs listed above are used for serious conditions and suddenly stopping these medications may make these conditions worse.

Submitted by Kelly Jackson, PharmD Candidate, The Ohio State University College of Pharmacy

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Response by:

Sarah Hudson-DiSalle, PharmD, RPh
Specialty Practice Pharmacist of Outpatient Pharmacy
College of Medicine
The Ohio State University