Drugs associated with autoimmune hemolytic anemia and/or a positive direct antiglobulin test (DAT; Coombs test)

Antibiotics	NSAIDs and analgesic/antipyretics	Anti-cancer drugs	Other
Amoxicillin Amphotericin B Ampicillin Cefazolin Cefotaxime Cefotetan Cefoxitin Ceftazidime Ceftizoxime Ceftriaxone Cefuroxime Cephalexin Cephalothin Chloramphenicol Ciprofloxacin Erythromycin Isoniazid Levofloxacin Mefloquine Nafcillin P-aminosalicylic acid Penicillin Piperacillin Pyrimethamine Quinidine Quinine Rifampin Stibophen Streptomycin Teicoplanin Temafloxacin Tetracycline Ticarcillin Trimethoprim/sulfamethoxazole	Acetaminophen Aspirin Azapropazone Diclofenac Dipyrone Ibuprofen Methadone (positive DAT only) Naproxen Phenacetin Sulfasalazine Sulindac Tolmetin	Alemtuzumab Atezolizumab Bendamustine Carboplatin Cisplatin Cladribine Fluorouracil Fludarabine Imatinib Ipilimumab Methotrexate Nivolumab Oxaliplatin Pembrolizumab Pemetrexed Pentostatin	Alemtuzumab Antazoline Buthiazide Carbimazole Catechin Chlorinated hydrocarbon insecticides Chlorpromazine Chlorpropamide Cyclofenil Cyclosporin Diethylstilbestrol Furosemide (positive DAT only) Hydrochlorothiazide Insulin Methadone (positive DAT only) Methotrexate Nomifensine Probenecid Puerarin (Chinese herb) Quinidine Quinine Radiocontrast medium Tolbutamide Triamterene Trimellitic anhydride (used in dyes, resins)

Only drugs with more than one case report of drug-induced AIHA are listed. Drugs that belong in two classes are listed under both. Refer to UpToDate for further information about patient evaluation and management.

DAT: direct antiglobulin (Coombs) test; NSAIDs: nonsteroidal antiinflammatory drugs; AIHA: autoimmune hemolytic anemia.

References:

Garratty G, Arndt PA. Drugs that have been shown to cause drug-induced immune hemolytic anemia or positive direct antiglobulin tests: Some interesting findings since 2007. Immunohematology 2014; 30:66.
Maurin C, Vassal O, Darien M, et al. Immune hemolysis secondary to injection of contrast medium. Transfusion 2018; 58:2113.
Sharma P, Saksena A, Diaz A, et al. Severe autoimmune intravascular hemolytic anemia in patients receiving alemtuzumab for multiple sclerosis. Blood Adv 2023; 7:2534.

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Drugs associated with autoimmune hemolytic anemia and/or a positive direct antiglobulin test (DAT; Coombs test)