Drugs Used to Treat Thrombocytopenia

Patients with thrombocytopenia have too few platelets circulating in their blood streams. Platelets play a key role in blood coagulation, and a microliter of blood drawn from a healthy individual should contain between 150,000 and 400,000 platelets. Drug therapy, infections, injuries or genetic disorders can cause thrombocytopenia, and the condition can manifest as the underproduction of platelets, the destruction of too many platelets or a dysfunction of the spleen, which regulates platelets levels. Several medications can help people with thrombocytopenia.

Ceasing Drug Treatment

• Many medications can cause thrombocytopenia as a side effect. Taking patients off these therapies often allows patients to replace their depleted platelets. Drugs known to put users at risk for experiencing thrombocytopenia include the diuretic hydrochlorothiazide, supplemental estrogens, gold, the antibiotic sulfamethoxazole-trimethoprim (e.g., Bactrim from Mutual) and interferon (e.g., Avonex from Biogen; Rebif from Serono).

Corticosteroids

• When patients with thrombocytopenia do require pharmaceutical treatments, doctors typically prescribe corticosteroids as a first option. Given orally or intravenously, corticosteroids such as prednisone reduce the activity of patients' immune systems, which can prove beneficial when a patient's case of thrombocytopenia primarily involves the destruction of too many platelets. Patients receiving corticosteroids need to watch for side effects such as mood swings, increased infections, increased blood pressure, fluid retention, reduced bone mass and easy bruising or bleeding.

Danazol

• Usually used to treat endometriosis, fibrolytic breast disease or angioedema (i.e., swelling under the skin), danazol can help some patients with thrombocytopenia who do not respond to corticosteroid therapy. The Merck Manual notes that danazol tablets have the same therapeutic effect as a corticosteroid. Danazol has a much different side effects profile, however. Patients taking danazol can experience acne and oily skin, reduced breast size, vaginal dryness, skin flushing, sweating, vomiting, headaches and stomach aches.

Immunoglobulin

• A Mayo Clinic brochure on thrombocytopenia notes that patients who require rapid elevations of their platelet counts can benefit from receiving intravenous injections of immunoglobulin. The substance, which people's bodies produce naturally, blocks the action of antibodies that have formed after a person's immune system has begun misidentifying platelets as disease-causing agents. Allergic reactions and flu-like symptoms can occur rarely among people who receive immunoglobulin injections.

Immunosuppressants

• Strong suppressors of the immune system represent a final pharmaceutical choice for treating thrombocytopenia. Both the Merck Manual and the Mayo Clinic brochure identify cyclophosphamide and, occasionally, azathioprine (e.g., Imuran from Prometheus) as the immunosuppressants most often prescribed for this purpose. Cyclophosphamide and azathioprine are chemotherapy drugs, meaning they destroy cells in addition to suppressing the immune system. Patients receiving oral or injected cyclophosphamide can experience hair loss, weight loss, blisters, fever, bloody urine, tarry stools and fatigue. Patients taking azathioprine tablets can experience nausea, diarrhea, muscle pain, blurred vision, mouth sores, jaundice and stomach pain.