Drug-induced anemia and other red cell disorders: a guide in the age of polypharmacy

Several medications have been linked to red blood cell (RBC) disorders. The frequency of these side effects varies, depending on the condition, but they can be associated with significant morbidity and mortality. The problem is likely to exacerbate in aging populations with frequent comorbidities, proportional to the growing number of medications used. Notable drug-related RBC disorders include hemolytic anemia, megaloblastic anemia, sideroblastic anemia, polycythemia, methemoglobinemia, anemia of irritation/inflammation, and anemia caused by suppression of RBC production. The list of medications that are associated with these disorders is long and includes many commonly-used drugs. This could pose a challenge in timely diagnosis and management of these disorders. Prior knowledge of the potential for drug-related RBC disorders and monitoring the patients who are being treated with medications known to cause RBC disorders are critical to ensure timely and effective response, should such adverse reactions occur.