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Probable Case of Ibuprofen‐Induced Neutropenia
Author(s) -
Murphy Catherine E
Publication year - 2013
Publication title -
journal of pharmacy practice and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.222
H-Index - 22
eISSN - 2055-2335
pISSN - 1445-937X
DOI - 10.1002/j.2055-2335.2013.tb00237.x
Subject(s) - medicine , neutropenia , ibuprofen , filgrastim , piperacillin/tazobactam , incidence (geometry) , febrile neutropenia , gentamicin , adverse drug reaction , surgery , drug , piperacillin , antibiotics , chemotherapy , pharmacology , physics , microbiology and biotechnology , pseudomonas aeruginosa , biology , bacteria , optics , genetics
ABSTRACT Background Approximately 6% of admissions to Australian hospitals are due to adverse drug events. This incidence increases to around 30% of admissions for elderly Australians. Neutropenia associated with ibuprofen is documented as a haematological side effect with an incidence of less than 1%. Clinical details A 44‐year‐old man presented to his GP with fever, cough, lymphadenopathy, mouth ulcers, night sweats and lack of energy. His neutrophil count was 0.07times10 9 /L. He had taken 6 to 8 ibuprofen 400 mg tablets in the previous 24 hours to alleviate his symptoms. He had also used ibuprofen on an ‘as required’ basis for body aches during the 2 weeks prior to presentation. Outcomes The patient was given filgrastim 300 micrograms daily. Piperacillin+tazobactam and gentamicin were also commenced. Bone marrow biopsy showed active normocellular marrow with ‘maturation arrest‘, consistent with a drug‐induced reaction. The patient was discharged 48 hours after presentation with 2 further doses of filgrastim. The patient was advised to avoid nonsteroidal anti‐inflammatory drug use in the future. Conclusion While ibuprofen is thought by many to be a safe over‐the‐counter medicine, it is not without life‐threatening side effects. The possibility of ibuprofen‐induced neutropenia should be considered in all cases of unexpected isolated neutropenia in patients taking this drug, with prompt referral to specialist care in cases of severe neutropenia or sepsis.