BACK TOTOP Browse A-ZSearchBrowse A-ZABCDEFGHIJKLMNOPQRSTUVWXYZ0-9 E-mail FormEmail ResultsName:Email address:Recipients Name:Recipients address:Message: Print-FriendlyBookmarksbookmarks-menuNeuropathy secondary to drugsNeuropathy is injury to one or more peripheral nerves. These are nerves that are not in the brain or spinal cord. Neuropathy secondary to medicines causes a loss of sensation or movement in a part of the body due to nerve damage from taking a certain medicine, combination of medicines, or illicit (street) drugs.Loss of sensationNumbness and tingling are abnormal sensations that can occur anywhere in your body, but they are often felt in your fingers, hands, feet, arms, or le...ImageRead Article Now Book Mark Article Causes The damage is caused by the toxic effect of certain medicines or illicit (street) drugs on the peripheral nerves. There may be damage to the axon part of the nerve cell, which interferes with nerve signals. Or, the damage may involve the myelin sheath, which insulates the axons and increases the speed of transmission of signals through the axon.Most commonly, many nerves are involved (polyneuropathy). This usually causes sensation changes that begin in the outside parts of the body (distal) and move toward the center of the body (proximal). There may also be changes in movement, such as weakness. There may also be burning pain.DistalDistal refers to sites located away from a specific area, most often the center of the body. In medicine, it refers to parts of the body further awa...Read Article Now Book Mark Article ProximalProximal means nearer to the center (trunk of the body) or to the point of attachment to the body. If another reference point is given, such as the ...ImageRead Article Now Book Mark Article Many medicines and substances may lead to the development of neuropathy. Examples are listed below.Heart or blood pressure medicines:Amiodarone HydralazineMedicines used to fight cancer (chemotherapy medicines):CancerCancer is the uncontrolled growth of abnormal cells in the body. Cancerous cells are also called malignant cells.ImageRead Article Now Book Mark Article Cisplatin Docetaxel PaclitaxelMedicines used to fight infections:Chloroquine Dapsone Isoniazid (INH), used against tuberculosis TuberculosisPulmonary tuberculosis (TB) is a contagious bacterial infection that involves the lungs. It may spread to other organs.ImageRead Article Now Book Mark Article Metronidazole (Flagyl) Nitrofurantoin Thalidomide (used to fight leprosy)LeprosyLeprosy is a disease caused by the bacterium Mycobacterium leprae. This disease causes skin sores, nerve damage, and muscle weakness that gets worse...Read Article Now Book Mark Article Medicines used to treat autoimmune disease:Autoimmune diseaseAn autoimmune disorder occurs when the body's immune system attacks and destroys healthy body tissue by mistake. There are more than 80 autoimmune d...ImageRead Article Now Book Mark Article Etanercept (Enbrel) Infliximab (Remicade) Leflunomide (Arava) Tacrolimus Medicines used to treat seizures:Carbamazepine Phenytoin PhenobarbitalMedicines used to treat alcohol use disorder:DisulfiramMedicines to fight HIV/AIDS:Didanosine (Videx) Emtricitabine (Emtriva) Stavudine (Zerit) Tenofovir and emtricitabine (Truvada)Other medicines and substances that may cause neuropathy include:Colchicine (used to treat gout) Excess pyridoxine (Vitamin B6) Arsenic Gold Illicit drugs (such as methaqualone) Glue sniffing n-Hexane Nitrous oxide (laughing gas) Symptoms Symptoms may include any of the following:Numbness, loss of sensation NumbnessNumbness and tingling are abnormal sensations that can occur anywhere in your body, but they are often felt in your fingers, hands, feet, arms, or le...ImageRead Article Now Book Mark Article Tingling, abnormal sensations Abnormal sensationsNumbness and tingling are abnormal sensations that can occur anywhere in your body, but they are often felt in your fingers, hands, feet, arms, or le...ImageRead Article Now Book Mark Article Weakness Burning pain Loss of balance Trouble walkingSensation changes usually begin in the feet or hands and move inward to the legs or arms. Exams and Tests A brain and nervous system examination will be done.Other tests include: Blood and urine tests to check levels of the medicine (even normal blood levels of certain medicines may be toxic in older adults or certain other people) Electromyography (EMG) and nerve conduction tests (recording of electrical activity along the nerve) ElectromyographyElectromyography (EMG) is a test that checks the health of the muscles and the nerves that control the muscles.ImageRead Article Now Book Mark Article Nerve conduction testsNerve conduction velocity (NCV) is a test to see how fast electrical signals move through a nerve. This test is done along with electromyography (EM...ImageRead Article Now Book Mark Article Skin biopsy to measure nerve fibers (usually for small fiber neuropathy if EMG and nerve conduction tests are normal)Skin biopsyA biopsy is the removal of a small piece of tissue for lab examination.ImageRead Article Now Book Mark Article Treatment Treatment is based on the symptoms and how severe they are. The medicine causing the neuropathy may be stopped, reduced in dose, or changed to another medicine. (Never change or stop any medicine without first talking to your health care provider.)Your provider may suggest the following medicines to help regulate pain:Over-the-counter pain medicines may be helpful for mild pain (neuralgia). Phenytoin, carbamazepine, gabapentin, pregabalin, duloxetine, or tricyclic antidepressants such as nortriptyline may reduce the stabbing pains some people experience. Topical agents such as capsaicin or Lidoderm cream can be useful for more limited areas of pain. Opioid pain medicines such as morphine or fentanyl aren’t effective for neuropathic pain.There are currently no medicines that can reverse the loss of sensation. If you have lost sensation, you may need to take safety measures to avoid injury.Ask your provider if there are exercises that can help relieve your symptoms. Outlook (Prognosis) Many people can partially or fully return to their normal function. The disorder does not usually cause life-threatening complications, but it can be uncomfortable or disabling. Possible Complications Complications may include:Inability to function at work or home because of permanent loss of sensation Pain with tingling in the area of the nerve injury Permanent loss of sensation (or rarely, movement) in an area of the body When to Contact a Medical Professional Contact your provider if you have a loss of sensation or movement of any area of the body while taking any medicine. Prevention Your provider will closely monitor your treatment with any medicine that may cause neuropathy. The goal is to keep the proper blood level of the medicine needed to control the disease and its symptoms while preventing the medicine from reaching toxic levels.Open ReferencesReferencesJones MR, Urits I, Wolf J, et al. Drug-induced peripheral neuropathy, a narrative review. Curr Clin Pharmacol. 2020;15(1):38-48. PMID: 30666914 pubmed.ncbi.nlm.nih.gov/30666914/.Katirji B. Disorders of peripheral nerves. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley and Daroff's Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 106.Mastaglia FL. Drug-induced disorders of the nervous system. In: Aminoff MJ, Josephson SA, eds. Aminoff's Neurology and General Medicine. 6th ed. Waltham, MA: Elsevier Academic Press; 2021:chap 32.Smith GA, Shy ME. Peripheral neuropathies. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 388.AllVideoImagesTogCentral nervous system and peripheral nervous system - illustration The central nervous system comprises the brain and spinal cord. The peripheral nervous system includes nerves outside the brain and spinal cord.Central nervous system and peripheral nervous systemillustrationCentral nervous system and peripheral nervous system - illustration The central nervous system comprises the brain and spinal cord. The peripheral nervous system includes nerves outside the brain and spinal cord.Central nervous system and peripheral nervous systemillustrationA Closer Look Diabetes - type 2 - InDepth(In-Depth)Restless legs syndrome and related disorders - InDepth(In-Depth)Lymphoma(Alt. 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Neuropathy secondary to drugsNeuropathy is injury to one or more peripheral nerves. These are nerves that are not in the brain or spinal cord. Neuropathy secondary to medicines causes a loss of sensation or movement in a part of the body due to nerve damage from taking a certain medicine, combination of medicines, or illicit (street) drugs.Loss of sensationNumbness and tingling are abnormal sensations that can occur anywhere in your body, but they are often felt in your fingers, hands, feet, arms, or le...ImageRead Article Now Book Mark Article Causes The damage is caused by the toxic effect of certain medicines or illicit (street) drugs on the peripheral nerves. There may be damage to the axon part of the nerve cell, which interferes with nerve signals. Or, the damage may involve the myelin sheath, which insulates the axons and increases the speed of transmission of signals through the axon.Most commonly, many nerves are involved (polyneuropathy). This usually causes sensation changes that begin in the outside parts of the body (distal) and move toward the center of the body (proximal). There may also be changes in movement, such as weakness. There may also be burning pain.DistalDistal refers to sites located away from a specific area, most often the center of the body. In medicine, it refers to parts of the body further awa...Read Article Now Book Mark Article ProximalProximal means nearer to the center (trunk of the body) or to the point of attachment to the body. If another reference point is given, such as the ...ImageRead Article Now Book Mark Article Many medicines and substances may lead to the development of neuropathy. Examples are listed below.Heart or blood pressure medicines:Amiodarone HydralazineMedicines used to fight cancer (chemotherapy medicines):CancerCancer is the uncontrolled growth of abnormal cells in the body. Cancerous cells are also called malignant cells.ImageRead Article Now Book Mark Article Cisplatin Docetaxel PaclitaxelMedicines used to fight infections:Chloroquine Dapsone Isoniazid (INH), used against tuberculosis TuberculosisPulmonary tuberculosis (TB) is a contagious bacterial infection that involves the lungs. It may spread to other organs.ImageRead Article Now Book Mark Article Metronidazole (Flagyl) Nitrofurantoin Thalidomide (used to fight leprosy)LeprosyLeprosy is a disease caused by the bacterium Mycobacterium leprae. This disease causes skin sores, nerve damage, and muscle weakness that gets worse...Read Article Now Book Mark Article Medicines used to treat autoimmune disease:Autoimmune diseaseAn autoimmune disorder occurs when the body's immune system attacks and destroys healthy body tissue by mistake. There are more than 80 autoimmune d...ImageRead Article Now Book Mark Article Etanercept (Enbrel) Infliximab (Remicade) Leflunomide (Arava) Tacrolimus Medicines used to treat seizures:Carbamazepine Phenytoin PhenobarbitalMedicines used to treat alcohol use disorder:DisulfiramMedicines to fight HIV/AIDS:Didanosine (Videx) Emtricitabine (Emtriva) Stavudine (Zerit) Tenofovir and emtricitabine (Truvada)Other medicines and substances that may cause neuropathy include:Colchicine (used to treat gout) Excess pyridoxine (Vitamin B6) Arsenic Gold Illicit drugs (such as methaqualone) Glue sniffing n-Hexane Nitrous oxide (laughing gas) Symptoms Symptoms may include any of the following:Numbness, loss of sensation NumbnessNumbness and tingling are abnormal sensations that can occur anywhere in your body, but they are often felt in your fingers, hands, feet, arms, or le...ImageRead Article Now Book Mark Article Tingling, abnormal sensations Abnormal sensationsNumbness and tingling are abnormal sensations that can occur anywhere in your body, but they are often felt in your fingers, hands, feet, arms, or le...ImageRead Article Now Book Mark Article Weakness Burning pain Loss of balance Trouble walkingSensation changes usually begin in the feet or hands and move inward to the legs or arms. Exams and Tests A brain and nervous system examination will be done.Other tests include: Blood and urine tests to check levels of the medicine (even normal blood levels of certain medicines may be toxic in older adults or certain other people) Electromyography (EMG) and nerve conduction tests (recording of electrical activity along the nerve) ElectromyographyElectromyography (EMG) is a test that checks the health of the muscles and the nerves that control the muscles.ImageRead Article Now Book Mark Article Nerve conduction testsNerve conduction velocity (NCV) is a test to see how fast electrical signals move through a nerve. This test is done along with electromyography (EM...ImageRead Article Now Book Mark Article Skin biopsy to measure nerve fibers (usually for small fiber neuropathy if EMG and nerve conduction tests are normal)Skin biopsyA biopsy is the removal of a small piece of tissue for lab examination.ImageRead Article Now Book Mark Article Treatment Treatment is based on the symptoms and how severe they are. The medicine causing the neuropathy may be stopped, reduced in dose, or changed to another medicine. (Never change or stop any medicine without first talking to your health care provider.)Your provider may suggest the following medicines to help regulate pain:Over-the-counter pain medicines may be helpful for mild pain (neuralgia). Phenytoin, carbamazepine, gabapentin, pregabalin, duloxetine, or tricyclic antidepressants such as nortriptyline may reduce the stabbing pains some people experience. Topical agents such as capsaicin or Lidoderm cream can be useful for more limited areas of pain. Opioid pain medicines such as morphine or fentanyl aren’t effective for neuropathic pain.There are currently no medicines that can reverse the loss of sensation. If you have lost sensation, you may need to take safety measures to avoid injury.Ask your provider if there are exercises that can help relieve your symptoms. Outlook (Prognosis) Many people can partially or fully return to their normal function. The disorder does not usually cause life-threatening complications, but it can be uncomfortable or disabling. Possible Complications Complications may include:Inability to function at work or home because of permanent loss of sensation Pain with tingling in the area of the nerve injury Permanent loss of sensation (or rarely, movement) in an area of the body When to Contact a Medical Professional Contact your provider if you have a loss of sensation or movement of any area of the body while taking any medicine. Prevention Your provider will closely monitor your treatment with any medicine that may cause neuropathy. The goal is to keep the proper blood level of the medicine needed to control the disease and its symptoms while preventing the medicine from reaching toxic levels.Open ReferencesReferencesJones MR, Urits I, Wolf J, et al. Drug-induced peripheral neuropathy, a narrative review. Curr Clin Pharmacol. 2020;15(1):38-48. PMID: 30666914 pubmed.ncbi.nlm.nih.gov/30666914/.Katirji B. Disorders of peripheral nerves. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley and Daroff's Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 106.Mastaglia FL. Drug-induced disorders of the nervous system. In: Aminoff MJ, Josephson SA, eds. Aminoff's Neurology and General Medicine. 6th ed. Waltham, MA: Elsevier Academic Press; 2021:chap 32.Smith GA, Shy ME. Peripheral neuropathies. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 388.
