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Neurotoxic Medications

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.

Please be aware that this list is taken from a US website, and some of the drugs may not be available in the UK, or may be marketed under different names.

Click here to view expanded Medical Alert table.

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.) NIH Fact Sheet
  • 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

Drug Interaction Warning: Antidepressants

The November/December 1995 NAMI Advocate warned of a potentially fatal drug interaction. It involves selective serotonin reuptake inhibitor antidepressants such as Prozac, Zoloft, Paxil and Luvox.

Apparently, a drug interaction between these antidepressants and dextromethorphan and/or pseudoephedrine, found in over-the-counter cold remedies, can cause excessive serotonergic activity. Signs of this “serotonin syndrome” include changes in mental status, hypertension, restlessness, myoclonus (sudden muscle contraction), hyperreflexia (accentuated reflexes), diaphoresis (profuse perspiration), shivering and tremor.

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.

Click here for an in-depth summary of a study on neurotoxic medications and how they affect CMT patients.

 

 

Many thanks to Charcot-Marie-Tooth Association (www.cmtausa.org) for allowing us to share their information with you.

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