Substances With Toxic Pulmonary Effects

Substances With Toxic Pulmonary Effects

Condition

Medication or Substance*

Asthma

Aspirin, beta-blockers (eg, timolol), Aspirin, beta-blockers (eg, timolol),cocaine, dipyridamole, IV hydrocortisone (rarely in patients with sensitivity to , dipyridamole, IV hydrocortisone (rarely in patients with sensitivity toaspirin and asthma), interleukin-2, methylphenidate, nitrofurantoin, protamine, sulfasalazine, vinca alkaloids (with mitomycin)and asthma), interleukin-2, methylphenidate, nitrofurantoin, protamine, sulfasalazine, vinca alkaloids (with mitomycin)

Organizing pneumonia

Amiodarone, bleomycin, checkpoint inhibitors, Amiodarone, bleomycin, checkpoint inhibitors,cocaine, cyclophosphamide, methotrexate, minocycline, mitomycin, penicillamine, sulfasalazine, tetracycline, cyclophosphamide, methotrexate, minocycline, mitomycin, penicillamine, sulfasalazine, tetracycline

Hypersensitivity pneumonitis

Azathioprine plus mercaptopurine, busulfan, fluoxetine, methotrexate, radiationAzathioprine plus mercaptopurine, busulfan, fluoxetine, methotrexate, radiation

Interstitial pneumonia or fibrosis

Amphotericin B, bleomycin, busulfan, carbamazepine, checkpoint inhibitors, chlorambucil, Amphotericin B, bleomycin, busulfan, carbamazepine, checkpoint inhibitors, chlorambucil,cocaine, cyclophosphamide, phenytoin, flecainide, , cyclophosphamide, phenytoin, flecainide,heroin, melphalan, methotrexate, methylphenidate, , melphalan, methotrexate, methylphenidate,mineral oil (via chronic microaspiration), nitrofurantoin, nitrosoureas, procarbazine, silicone (subcutaneous injection), tocainide, vinca alkaloids (with mitomycin)(via chronic microaspiration), nitrofurantoin, nitrosoureas, procarbazine, silicone (subcutaneous injection), tocainide, vinca alkaloids (with mitomycin)

Noncardiac pulmonary edema

Beta-adrenergic agonists (eg, ritodrine, terbutaline), chlordiazepoxide, Beta-adrenergic agonists (eg, ritodrine, terbutaline), chlordiazepoxide,cocaine, cytarabine, ethiodized oil (IV, and via chronic microaspiration), gemcitabine, , cytarabine, ethiodized oil (IV, and via chronic microaspiration), gemcitabine,heroin, hydrochlorothiazide, methadone, mitomycin, phenothiazines, protamine, sulfasalazine, tocolytic drugs (eg, terbutaline), tricyclic antidepressants, tumor necrosis factor, vinca alkaloids (with mitomycin), hydrochlorothiazide, methadone, mitomycin, phenothiazines, protamine, sulfasalazine, tocolytic drugs (eg, terbutaline), tricyclic antidepressants, tumor necrosis factor, vinca alkaloids (with mitomycin)

Parenchymal hemorrhage

Anticoagulants, azathioprine plus mercaptopurine, Anticoagulants, azathioprine plus mercaptopurine,cocaine, mineral oil (via chronic microaspiration), nitrofurantoin, radiation(via chronic microaspiration), nitrofurantoin, radiation

Pleural effusion

Amiodarone, anticoagulants, bleomycin, bromocriptine, busulfan, check-point inhibitors, granulocyte-macrophage colony-stimulating factor, interleukin-2, methotrexate, mitomycin, nitrofurantoin, para-aminosalicylic acid, procarbazine, radiation, tocolytic drugs (eg, terbutaline)Amiodarone, anticoagulants, bleomycin, bromocriptine, busulfan, check-point inhibitors, granulocyte-macrophage colony-stimulating factor, interleukin-2, methotrexate, mitomycin, nitrofurantoin, para-aminosalicylic acid, procarbazine, radiation, tocolytic drugs (eg, terbutaline)

Pulmonary infiltrate with eosinophilia

Amiodarone, amphotericin B, bleomycin, carbamazepine, checkpoint inhibitors, Amiodarone, amphotericin B, bleomycin, carbamazepine, checkpoint inhibitors,cocaine, phenytoin, ethambutol, etoposide, granulocyte-macrophage colony-stimulating factor, isoniazid, methotrexate, minocycline, mitomycin, nitrofurantoin, para-aminosalicylic acid, procarbazine, radiation, sulfasalazine, sulfonamides, tetracycline, trazodone, phenytoin, ethambutol, etoposide, granulocyte-macrophage colony-stimulating factor, isoniazid, methotrexate, minocycline, mitomycin, nitrofurantoin, para-aminosalicylic acid, procarbazine, radiation, sulfasalazine, sulfonamides, tetracycline, trazodone

Pulmonary vascular disease

Appetite suppressants (eg, fenfluramine, phentermine), busulfan, Appetite suppressants (eg, fenfluramine, phentermine), busulfan,cocaine, heroin, methylphenidate, nitrosoureas, methylphenidate, nitrosoureas

Yavordios S, Beltramo G, Freppel R, et al. Diffuse lung diseases ascribed to drugs: a nationwide observational study over 37 years using the French Pharmacovigilance Database. Eur Respir J 2025;65(2):2400756. doi:10.1183/13993003.00756-2024

* For a comprehensive list of drugs with pulmonary toxicity, see The Drug-Induced Respiratory Disease Website.

Yavordios S, Beltramo G, Freppel R, et al. Diffuse lung diseases ascribed to drugs: a nationwide observational study over 37 years using the French Pharmacovigilance Database. Eur Respir J 2025;65(2):2400756. doi:10.1183/13993003.00756-2024

* For a comprehensive list of drugs with pulmonary toxicity, see The Drug-Induced Respiratory Disease Website.