Hematologic Effects of Topiramate and Fluconazole

Introduction to Hematologic Effects

• The Centers for Disease Control and Prevention (CDC) reports that thrombocytopenia and leucopenia have been documented with itraconazol, but does not specifically mention these effects with fluconazol in the context of opportunistic infections 1, 2

Antifungal-Associated Hematologic Effects

• The CDC guidelines indicate that amphotericin B can cause anemia, thrombophlebitis, and hematologic toxicity 4, 5, 6, 2, 7
• Flucytosine has considerable potential for bone marrow toxicity, causing anemia, leucopenia, and thrombocytopenia 5, 1, 2, 7

Drug-Specific Hematologic Effects

• Fluconazol may cause leucopenia and thrombocytopenia, although these effects are rare, with a documented case of agranulocitosis and thrombocytopenia associated with fluconazol 1, 2
• The most common adverse effects of fluconazol are gastrointestinal (nausea and vomiting), not hematologic, according to the CDC 3