What medications cause neuropathy in feet
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Medications That Cause Neuropathy in Feet
Introduction to Neuropathy in Feet
Neuropathy in the feet, often characterized by pain, numbness, and burning sensations, can be caused by various medications. This condition is particularly prevalent among individuals with diabetes but can also result from other pharmacological treatments.
Diabetic Neuropathy and Medications
Metformin and Vitamin B12 Deficiency
Metformin, a common oral antidiabetic drug, has been associated with iatrogenic vitamin B12 deficiency, which can lead to neuropathy in the feet. This deficiency disrupts nerve function, contributing to the development of neuropathic symptoms1.
Antiretroviral Drugs and Peripheral Neuropathy
Nucleoside analogue reverse transcriptase inhibitors, used in the treatment of HIV, are significant contributors to peripheral neuropathy. Drugs such as stavudine, zalcitabine, and didanosine have been reported to cause neuropathy in a notable percentage of patients. The neuropathy manifests as pain, numbness, and burning sensations in the feet, often necessitating the discontinuation of these medications7.
Pain Management Medications and Neuropathy
Antidepressants and Antiepileptics
Several medications used to manage neuropathic pain can also contribute to neuropathy. Tricyclic antidepressants (e.g., amitriptyline) and serotonin-norepinephrine reuptake inhibitors (e.g., duloxetine) are commonly prescribed for diabetic neuropathy but can have adverse effects, including exacerbating neuropathic symptoms1 3 4 9.
Gabapentin and Pregabalin
Gabapentin and pregabalin, both antiepileptic drugs, are frequently used to treat neuropathic pain. While effective, these medications can sometimes lead to side effects that include worsening neuropathy in some patients3 4 7.
Other Medications and Neuropathy
Chemotherapy Agents
Certain chemotherapy agents are known to cause peripheral neuropathy. These drugs can damage peripheral nerves, leading to symptoms such as pain, tingling, and numbness in the feet. The exact mechanism often involves direct neurotoxicity4.
Statins
Statins, used to manage cholesterol levels, have been implicated in causing neuropathy in some patients. The mechanism is not entirely understood but may involve muscle and nerve damage5.
Conclusion
Neuropathy in the feet can be a debilitating side effect of various medications, including those used to manage diabetes, HIV, neuropathic pain, and cholesterol levels. Understanding the potential for these adverse effects is crucial for healthcare providers to manage and mitigate the risk of neuropathy in patients undergoing these treatments.
Sources and full results
Most relevant research papers on this topic
[Causes, spectrum, and treatment of the diabetic neuropathy].
Diabetic neuropathy is common and causes severe complications, with intensive insulin therapy and individualized oral antidiabetic drugs being effective in reducing the risk of neuropathy.
Systematic ReviewTreatment of symptomatic diabetic peripheral neuropathy with the anti-oxidant alpha-lipoic acid. A 3-week multicentre randomized controlled trial (ALADIN Study).
Intravenous alpha-lipoic acid treatment at 600 mg/day for 3 weeks effectively reduces diabetic peripheral neuropathy symptoms without significant adverse reactions.
RCT
Large Human Trial
Highly CitedTreating Painful Diabetic Peripheral Neuropathy: An Update.
Pregabalin and duloxetine are the FDA-approved medications for treating painful diabetic peripheral neuropathy, with other options including opioids and selective serotonin reuptake inhibitors.
Highly CitedPharmacological Treatment of Diabetic Neuropathic Pain
Pharmacological treatments for diabetic neuropathic pain include antidepressants, 2 ligands, and topical lidocaine patches, with potential for future advancements in targeting individual patient aberrant mechanisms.
Drugs for neuropathic pain
Neurological conditions like diabetes and peripheral neuropathy can cause neuropathic pain, which can be effectively treated with antiepileptics and antidepressants.
Case Report
Rigorous JournalHighly CitedAn Insight into Potential Pharmacotherapeutic Agents for Painful Diabetic Neuropathy
Additional clinical trials are needed to develop more effective and minimally side effects treatments for painful diabetic neuropathy.
Literature Review
Very Rigorous JournalPeripheral Neuropathy with Nucleoside Antiretrovirals
Nucleoside analogue antiretrovirals can cause peripheral neuropathy, and prompt withdrawal and management can help resolve symptoms.
Highly CitedGabapentin in the treatment of painful diabetic neuropathy: a placebo controlled, double blind, crossover trial
Low dose gabapentin (300 mg capsules) effectively relieves pain in patients with painful diabetic neuropathy, potentially benefiting those with other neurological conditions.
RCTHighly CitedDiabetic Neuropathy
Pharmacologic remedies, such as tricyclic antidepressants, can improve diabetic neuropathy and quality of life.
Highly CitedTREATMENT OF SEVERELY PAINFUL DIABETIC NEUROPATHY WITH AN ALDOSE REDUCTASE INHIBITOR: RELIEF OF PAIN AND IMPROVED SOMATIC AND AUTONOMIC NERVE FUNCTION
Aldose reductase inhibitors can effectively relieve severe diabetic neuropathy symptoms and improve somatic and autonomic nerve function, with minimal toxicity observed.
RCTHighly Cited