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Drug Alert

The medications listed below are potentially toxic to CMT patients. Vincristine has been proven hazardous and should be avoided by all CMT patients, including those with no symptoms. The remainder of the medications listed below present varying degrees of potential risk for worsening CMT neuropathy.

Before taking any medication or changing medication, all CMT patients should make sure the treating physician is fully aware of their medical condition.

 

Definite High Risk (including asymptomatic CMT)

Vinca alkaloids (Vincristine)
Taxols (paclitaxel, docetaxel, cabazitaxel)

 Moderate to Significant Risk

Amiodarone (Cordarone)
Bortezomib (Velcade)
Cisplatin & Oxaliplatin
Colchicine (extended use)
Dapsone
Didanosine (ddI, Videx)
Dichloroacetate
Disulfiram (Antabuse)
Eribulin Mesylate (Halaven)
Gold salts
Ixabepilone (Ixempra)
Leflunomide (Arava)
Metronidazole/Misonidazole (extended use)
Nitrofurantoin (Macrodantin, Furadantin, Macrobid)
Nitrous oxide (inhalation abuse or Vitamin B12 deficiency)
Perhexiline (not used in U.S.)
Pyridoxine (Although megadoses [10 times or more the RDA] of Vitamin B6 may be harmful, high intakes of vitamin B6 from food sources have not been reported to cause adverse effects.)
Stavudine (d4T, Zerit)
Suramin
Thalidomide
Zalcitabine (ddC, Hivid)

Uncertain or Minor Risk

5-Fluoracil
Adriamycin
Almitrine (not in U.S.)
Chloroquine
Ciprofloxacin (Cipro)
Cytarabine (high dose)
Ethambutol
Etoposide (VP-16)
Fluoroquinolones
Gemcitabine
Griseofulvin
Hexamethylmelamine
Hydralazine
Ifosphamide
Infliximab
Isoniazid (INH)
Lansoprazole (Prevacid)
Mefloquine
Omeprazole (Prilosec)
Penicillamine
Phenytoin (Dilantin)
Podophyllin resin
Sertraline (Zoloft)
Statins
Tacrolimus (FK506, ProGraf)
Zimeldine (not in U.S.)
a-Interferon

Negligible or Doubtful Risk

Allopurinol
Amitriptyline
Chloramphenicol
Chlorprothixene
Cimetidine
Clioquinil
Clofibrate
Cyclosporin A
Enalapril
Gluthethimide
Lithium
Phenelzine
Propafenone
Sulfonamides
Sulphasalzine

 

A Note about Alcohol

Alcohol was removed from the neurotoxic drug list in July 2004. While people with CMT generally suffer no ill effects from the moderate consumption of alcohol, they should be particularly mindful of the fact that alcohol affects balance and coordination, and that overconsumption of alcohol is generally not recommend under any circumstances. If you have questions about alcohol and your health, consult your physician.

 

Neurotoxic Medications and Worsening of Neuropathy:

Apart from Vincristine, there is no proof that any of these drugs worsen CMT, but if you are concerned, there are plenty of alternatives.

One of our advisers described the situation like this to us:

“If a person unaffected by CMT – ie, at 100% “nerve” capacity – takes one of these drugs, and suffers some neuropathy, and  is reduced to 80 or 90% capacity, that is not significant.  But if a person with CMT – say at 50% capacity – loses 10% of function, then that’s a significant reduction in function”

Drugs List – updated 09-12-2015

 

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