Medications associated with shortness of breath
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Medications Commonly Associated with Shortness of Breath
Shortness of breath, or dyspnea, can be a side effect or complication of various medications. Understanding which drugs are most often linked to this symptom is important for both clinicians and patients.
Opioids and Breathlessness
Short-acting opioids are frequently used to manage breathlessness, especially in patients with advanced diseases. Evidence shows that these medications can actually reduce shortness of breath when given before exertion or as needed for episodes of breathlessness. However, their use as a scheduled, ongoing treatment for overall relief of breathlessness is less well supported by current research. While opioids can help relieve breathlessness, their use must be carefully managed to avoid potential side effects and optimize quality of life 13.
Methotrexate Toxicity
Methotrexate, a medication used for autoimmune diseases, can cause shortness of breath if taken incorrectly. For example, taking methotrexate daily instead of the prescribed weekly dose can lead to toxicity, which may present as increasing shortness of breath. This highlights the importance of correct dosing and regular medication reviews to prevent such adverse effects .
Ticagrelor-Induced Dyspnea
Ticagrelor, an antiplatelet medication, is known to cause shortness of breath in 6–9% of patients. This side effect often appears soon after starting the medication and is not linked to structural heart or lung problems. The symptoms are usually reversible and improve after discontinuing ticagrelor. The mechanism may involve inhibition of adenosine reuptake or sensory neuron effects .
Idelalisib and Drug-Induced Pneumonitis
Idelalisib, a medication used in certain cancers, has been associated with drug-induced pneumonitis, which can present as shortness of breath and cough. This is a serious side effect that requires prompt recognition and management .
Inhaled Medications for Obstructive Airway Disorders
Many patients with shortness of breath are treated with inhaled medications, such as beta2 agonists and corticosteroids, especially for conditions like asthma and chronic obstructive pulmonary disease (COPD). However, not all patients receiving these treatments have confirmed obstructive airway disorders, and some may have other causes for their symptoms, such as heart failure or pulmonary hypertension. This underscores the need for proper diagnostic testing before starting inhaled therapies 510.
Corticosteroids in Advanced Illness
Corticosteroids are often used as adjuvant therapy for shortness of breath in patients with advanced cancer and other terminal illnesses. While they are commonly prescribed, there is limited evidence regarding their effectiveness for this symptom, and more research is needed to guide their use .
Conclusion
Shortness of breath can be caused or worsened by several medications, including methotrexate (when misused), ticagrelor, idelalisib, and sometimes inhaled therapies if used without proper diagnosis. Opioids and corticosteroids are often used to manage breathlessness, but their benefits and risks must be carefully weighed. Accurate diagnosis and careful medication management are essential to minimize drug-induced shortness of breath and ensure optimal patient care 123567810.
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