Medical Alert Charcot-Marie-Tooth Association PO Box 105 Glenolden, PA 19036 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. (Note: This table is not a complete list of brand names, manufacturers, or labeled uses. There may be others, and patients should be aware that many drugs have off-label uses. Always check the ingredients before taking any medication.) Tel: 1-800-606-2682 Fax: 610-499-9267 www.cmtausa.org [email protected] Definite High Risk Generic Name Vincristine sulfate Amiodarone HCL Brand Name(s)/ Manufacturer(s) Oncovin/Eli Lilly; Vincasar PFS/Pfizer; Vincristine Sulfate Injection/Abbott, Mayne Labeled Uses Acute leukemia; malignant lymphomas and carcinomas Moderate to Significant Risk Cordarone/Wyeth-Ayerst Method(s) of Administration Intravenous Auranofin Ridaura/Prometheus Ventricular arrhythmias (fibrillation and tachycardia Rheumatoid arthritis Aurothioglucose Solganal/Schering Rheumatoid arthritis Intramuscular Bortezomib Velcade/Millenium Intravenous Cisplatin Cisplatin Injection/Abbot, American Pharmaceutical Partners, Baxter; Platinol-AQ/Bristol-Myers Squibb Colchicine Tablets/Abbot; Colchicine Injection/Bedford; Probenecid and ColchicineTablets/IVAX, Truxton Dapsone Tablets/Jacobus Multiple myeloma (bone cancer) Bladder, ovarian, and testicular carcinomas Gout prevention; gouty arthritis; (unlabeled use: hepatic cirrhosis due to alcohol) Oral, Intravenous Oral Videx/Bristol-Myers Squibb Bullous herpetiformis dermatitis; leprosy HIV infection Disulfiram Not FDA approved; in clinical trials Antabuse/Odyssey Chronic lactic acidosis Alcoholism Docetaxel Taxotere/Aventis Intravenous Eribulin Mesylate Halaven/Eisai Gold Salts (see specific drug names) Gold Sodium Thiomalate Ixabepilone Breast and prostrate carcinomas; lung cancer Metastatic breast cancer (patients who have received two prior chemotherapy regimens) Aurolate/Taylor Rheumatoid arthritis Intramuscular Ixempra/Bristol-Myers Squibb Intravenous Leflunomide Arava/Aventis Metastatic or locally advanced breast cancer Rheumatoid arthritis Colchicine* *risk with extended use Dapsone Didanosine; Dideoxyinosine (ddI) Dichloroacetate (DCA) CMTA Medical Alert Revised 05/12 Oral, Intravenous Oral Intravenous Oral Oral Intravenous Oral Page 1 of 6 Moderate to Significant Risk, cont. Generic Name Metronidazole* Charcot-Marie-Tooth Association PO Box 105 Glenolden, PA 19036 Tel: 1-800-606-2682 Fax: 610-499-9267 www.cmtausa.org [email protected] Brand Name(s)/ Manufacturer(s) Flagyl/Pfizer Labeled Uses Intestinal, vaginal and other bacterial infections; septicemia; peritonitis; endocarditis Cancer treatment; radiotherapy *risk with extended use Misonidazole* *risk with extended use Nitrofurantoin; Macrodantin Nitrous Oxide* *risk with inhalation abuse or vitamin B12 deficiency Oxaliplatin Perhexiline* *not used in US Pyridoxine* Urinary tract infections Oral General anesthesia Inhalation Eloxatin/Sanofi-Synthelabo Colorectal carcinoma Intravenous Pexsig/Sigma (Australia and New Zealand) Angina pectoris Oral Vitelle Nestrex/Fielding Vitamin B6 deficiency; antidote to druginduced neuropathy HIV infection Oral, Intravenous African sleeping sickness; river blindness; experimental cancer treatment (prostate) Breast, lung, ovarian and esophageal carcinomas Intravenous Erythema (reddening of the skin); nosodum leprosum (a rash associated with treatment of leprosy); many other off-label uses (mainly autoimmune disease and chemotherapy) HIV infection Oral Zerit/Bristol-Myers Squibb Suramin Awaiting FDA approval Paclitaxel Onxol/IVAX; Paclitaxel Injection/UDL, Bedford Taxol/Bristol-Myers Squibb Thalomid/Celgene Zalcitabine; Dideoxycytidine (ddC) Hivid/Roche 5-Fluorouracil; (5-FU) Adrucil/Pfizer; Fluorouracil injection/Baxter, Valeant, SoloPak, APP Adriamycin/Bedford; Adriamycin RDF/Pfizer Adriamycin (Doxorubicin HCL) Almitrine Atorvastatin *also a topical application in some formulations Nitrofurantoin Capsules/Sandoz; Macrobid/Proctor & Gamble; Furadantin/Elan *risk with megadoses Stavudine (d4T) Taxols (see specific drug names) Thalidomide Method(s) of Administration Oral, Intravenous* Uncertain or Minor Risk Vectarion/Not manufactured in US Lipitor/Pfizer CMTA Medical Alert Oral Intravenous Oral Breast, colorectal, gastric and pancreatic carcinomas Intravenous Leukemia; lymphomas; carcinomas Acute respiratory failure Elevated LDL cholesterol Intravenous Revised 05/12 Oral, Intravenous Oral Page 2 of 6 Uncertain or Minor Risk, cont. Generic Name Ciprofloxacin Brand Name(s)/ Manufacturer(s) Cipro; Cipro IV/Bayer Labeled Uses Charcot-Marie-Tooth Association PO Box 105 Glenolden, PA 19036 Tel: 1-800-606-2682 Fax: 610-499-9267 www.cmtausa.org [email protected] Chloroquine Cytarabine;* (Ara-C; Cytosine arabinoside) Aralen Phosphate/SanofiSynthelabo; Aralen Hydrochloride/SanofiSynthelabo Cytarabine Injection/Mayne, Bedford; Cytosar-U/Pfizer Bacterial infections, including skin, bone, blood, urinary, respiratory, and gastrointestinal tract infections; pneumonia; sinusitis; typhoid fever Amebiasis; malaria Method(s) of Administration Oral, Intravenous Oral Intravenous Leukemias Intravenous Cytarabine liposomal* DepoCyt/Enzon *risk with high doses Enoxacin Lymphomatous meningitis Intrathecal (Spinal infusion) Penetrex/Aventis Urinary tract infections; gonorrhea Tuberculosis Oral Small cell lung carcinoma Oral Small cell lung carcinoma; refractory testicular neoplasm Intravenous Elevated LDL cholesterol Pneumonia and bronchitis; sinus, respiratory tract, and urinary tract infections; sexually transmitted diseases Non-small cell lung cancer; pancreatic carcinoma Tineas (ringworm infections) of the skin, hair, and nails Oral Ovarian cancer Oral Hypertension Oral, Intravenous Testicular germ cell carcinoma; bone and soft tissue sarcomas Rheumatoid arthritis; Crohn’s disease Tuberculosis Intravenous Ethambutol Etoposide (VP-16) Fluoroquinolones (see specific drug names) Fluvastatin Ethambutol Tablets/Versa; Myambutol/Elan Etoposide Capsules/Mylan; VePescid/Bristol-Myers Squibb Etoposide for Injection/Abbot, Bedford, Gensia Sicor, SuperGen; Toposar/Pfizer; VePescid, Etopophos/Bristol-Myers Squibb Lescol/Reliant Gatifloxacin Tequin/Bristol-Myers Squibb; Tequin Injection/BristolMyers Squibb Gemcitabine Gemzar/Lilly Griseofulvin Grifulvin V/OrthoNeutrogena; Fulvicin U/F/Schering; Gris-PEG/Pedinol Hexalen/MGI Pharma Hexamethylmelamine (Altretamine) Hydralazine Ifosfamide Apresoline/IVAX; Hydra-zide/Par; Apresazide/Novartis; Marpres/Marnel Ifex/Bristol-Myers Squibb Infliximab Remicade/Centocor Isoniazid (INH) Nydrazid/Sandoz; Laniazid/Lannett CMTA Medical Alert Revised 05/12 Oral Oral, Intravenous Intravenous Oral Intravenous Oral, Intravenous Page 3 of 6 Uncertain or Minor Risk, cont Generic Name Lansoprazole Brand Name(s)/ Manufacturer(s) Prevacid/TAP Phramaceuticals Labeled Uses Ulcers; gastroesophageal reflux disease (GERD); ZolligerEllison Syndrome Infections, including skin, respiratory, and urinary tract infections; venereal diseases Bronchitis and urinary tract infections Elevated LDL cholesterol Charcot-Marie-Tooth Association PO Box 105 Glenolden, PA 19036 Tel: 1-800-606-2682 Fax: 610-499-9267 www.cmtausa.org [email protected] Levofloxacin Levaquin/Ortho-McNeil Lomefloxacin Maxaquin/Pfizer Lovastatin Mefloquine Lovastatin/Mylan, Par, Sandoz, Teva; Mevacor/Merck; Altocor/Andrx Lariam/Roche Moxifloxacin Avelox/Bayer Norfloxacin Noroxin/Merck Ofloxacin Floxin/Ortho-McNeil Omeprazole Prilosec/Proctor and Gamble; Zegerid/ Santarus Penicillamine Cuprimine/Merck; Depen/Wallace Phenytoin Dilantin/Pfizer; Phenytoin Sodium Injection/Baxter, Hospira, Sanofi Sparfloxacin Zagam/Bertek Trovafloxacin (Alatrofloxain) Trovan/Pfizer Podophyllin resin* Podocon-25/Paddock *high risk with excessive time exposure or unintended route (oral; deep injection) Pravastatin Rosuvastatin Pravachol; Pravigard/BristolMyers Squibb Crestor/AstraZeneca Sertraline Zoloft/Pfizer CMTA Medical Alert Method(s) of Administration Oral Oral, Intravenous Oral Oral Prevention and treatment of malaria Skin and respiratory tract infections Urinary tract infections; prostatitis; gonorrhea Urinary tract, skin, bone, and heart infections Ulcers; gastroesophageal reflux disease (GERD); ZolligerEllison Syndrome Rheumatoid arthritis; Wilson’s Disease (accumulation of copper in liver and other organs); cystinuria (kidney stones) Epilepsy; convulsions; seizures Oral Lower respiratory tract infections Pneumonia; abdominal, pelvic, and skin infections Removal of benign growths and warts, esp. external genital and perianal exophytic warts caused by human papillomavirus (HPV) Elevated LDL cholesterol Elevated LDL cholesterol Depression; panic attacks; obsessivecompulsive disorder; PTSD; social disorder Oral Revised 05/12 Oral, Intravenous Oral Oral, Intravenous Oral Oral Oral, Intravenous Oral, Intravenous Topical Oral Oral Oral Page 4 of 6 Uncertain or Minor Risk, cont Generic Name Simvastatin Charcot-Marie-Tooth Association Statins (see specific drug names) Tacrolimus (FK506) PO Box 105 Glenolden, PA 19036 Tel: 1-800-606-2682 Fax: 610-499-9267 Zimeldine (not in US) Brand Name(s)/ Manufacturer(s) Zocor/Merck Labeled Uses Elevated LDL cholesterol Note: Statins are generally prescribed to control cholesterol and triglyceride levels and to prevent coronary events. Prograf/Fujisawa Prevention of liver, Oral, Intravenous kidney, and other organ transplant rejection (Withdrawn from market) Depression α-Interferon Roferon/Roche; Intron; Rebetron/Schering; Infergen/InterMune; Alferon/Hemispherx Allopurinol Zyloprim/Prometheus; Aloprim/Nabi Amitriptyline Elavil/Zeneca Chloramphenicol www.cmtausa.org [email protected] Chlorprothixene Cimetidine Clioquinol Clofibrate Hepatitis B and C; warts caused by human papillomavirus (HPV); Kaposi’s sarcoma; renal cell carcinoma; multiple myeloma (bone cancer); malignant melanoma (skin cancer); Non-Hodgkin’s lymphoma Intramuscular, intralesional, or subcutaneous injection Gout; gouty arthritis; kidney and urinary tract stones Depression Oral, Intravenous Cloramphenicol Sodium Succinate/American Pharmaceutical Partners; Chloromycetin/Monarch Taractan/Roche Meningitis; typhoid fever Intravenous Psychosis Tagamet/GlaxoSmithKline; Cimetadine Hydrocloride Injection/American Regent, Hospira, Endo Clioquinol is an ingredient in numerous formulations (often in combination with hydrocortisone) used to treat bacterial and fungal infections of the skin Atromid/Wyeth-Ayerst Gastric and duodenal ulcers; gastroesophageal reflux Dermatitis; folliculitis; eczema; athlete’s foot; jock itch; ringworm Oral, Intramuscular Oral, Intravenous Negligible or Doubtful Risk Cyclosporin A Sandimmune; Neoral/Novartis Enalapril Vasotec/Biovail; Enalaprilat Injection/Abbott, Baxter, Bedford, Faulding Superceded by other drugs; not currently in use Lithium Carbonate/Rugby, Roxane; Lithobid/Solvay; Eskalith/GlaxoSmithKline Nardil/Pfizer Gluthethimide Lithium Phenelzine Method(s) of Administration Oral CMTA Medical Alert Oral Topical (powders, creams, ointments) Hyperlipidaemias (high cholesterol and triglyceride levels) Prevention of rejection of organ transplants; severe cases of psoriasis and rheumatoid arthritis Hypertension; congestive heart failure Insomnia Oral Bipolar disorder (manic/depressive disorder) Oral Depression Oral Revised 05/12 Oral, Intravenous Oral, Intravenous Oral Page 5 of 6 Negligible or Doubtful Risk, cont. Generic Name Propafenone Charcot-Marie-Tooth Association PO Box 105 Glenolden, PA 19036 Tel: 1-800-606-2682 Fax: 610-499-9267 www.cmtausa.org [email protected] Brand Name(s)/ Manufacturer(s) Propafenone HCL/Watson; Rythmol/Abbott Sulfacetamide Numerous brand names and manufacturers Sulfabenzamide Numerous brand names and manufacturers Sulfadiazine Tablets/Eon, Raway, UDL Azulfidine/Pfizer Sulfadiazine Sulphasalazine Sulfathiazole Sulphamethoxazole Sulfisoxazole (sulfafurazole) Sulfonamides (see specific drug names) Numerous brand names and manufacturers Proloprim; Septra/Monarch; Trimpex/Roche Labeled Uses Atrial fibrillation; ventricular arrhythmias Acne; seborrheic dermatitis; eye and vaginal infections Vaginitis Method(s) of Administration Oral Topical Topical Toxoplasmosis Oral Rheumatoid arthritis; ulcerative colitis Oral Vaginitis Topical Urinary tract Oral, Intravenous infections; otitis media (middle ear infection) Gantrisin/Roche Urinary tract Oral infections; otitis media (middle ear infection) Note: Although listed here, the use of sulfonamides to treat infections has decreased due to the increase in drug-resistant bacteria. CMTA Medical Alert Revised 05/12 Page 6 of 6