Neurotoxic Drugs for CMT
This is a list of the most common neurotoxic drugs for CMT, however, it may not include every drug with neurotoxic effects. Please talk with your doctor before starting or changing a medication.
Definite High Rick (Including Asyptomatic CMT)
- Vinca sulfate (Vincristine)
- Taxane (paclitaxel, docetaxel, cabazitaxel)
Moderate To Significant Risk
- Amiodarone (Cordarone)
- Arsenic Trioxide (Trisenox)
- Auranofin (Ridaura)
- Aurothioglucose (Solganal)
- Bortezomib (Velcade)
- Brentuximab Vedotin (Adcetris)
- Cetuximab (Erbitux)
- Ciprofloxacin
- Cisplatin
- Colchicine (extended-use risk)
- Dapsone
- Didanosine (ddI, Videx)
- Dichloroacetate (in clinical trials)
- Disulfiram (Antabuse)
- Enoxacin (Penetrex)
- Eribulin (Halaven)
- Fluoroquinolones
- Gatifloxacin
- Gold salts
- Gold Sodium (Aurolate/Taylor)
- Ipilimumab (Yervoy)
- Ixabepilone (Ixempra)
- Leflunomide (Arava)
- Lenalidomide (Revlimid)
- Levofloxacin (Levaquin)
- Metronidazole (Flagyl) (extended-use risk)
- Misonidazole (extended-use risk)
- Moxifloxacin (Avelox)
- Nitrofurantoin (Macrodantin, Furadantin, Macrobid)
- Nitrous oxide (inhalation abuse or Vitamin B12 deficiency)
- Nivolumab (Opdivo)
- Norfloxacin (Noroxin)
- Oxaliplatin (Eloxatin)
- Ofloxacin (Floxin)
- Pembrolizumab (Keytruda)
- Perhexiline (Pexsig) (not used in the U.S.)
- Pomalidomide (Pomalyst)
- Pyridoxine (Vitelle Nestrex) (risk with mega-dose)
- Sparfloxacin (Zagam)
- Stavudine (d4T, Zerit)
- Suramin
- Thalidomide (Celegene)
- Trovafloxacin/Alatrofloxacin (Trovan)
- Zalcitabine (ddC, Hivid)
Uncertain or Minor Risk
- 5-Fluoracil
- Adriamycin
- Almitrine (not in the U.S.)
- Atorvastatin (Lipitor)
- Chloroquine
- Cytarabine (high dose)
- Ethambutol
- Etoposide (VP-16)
- Fluvastatin (Lescol)
- Gemcitabine (Gemzar)
- Griseofulvin
- Hexamethylmelamine (Altretamine/Hexalen)
- Hydralazine
- Ifosphamide (Ifex)
- Infliximab (Remicade)
- Isoniazid (INH)
- Lansoprazole (Prevacid)
- Lovastatin
- Mefloquine (Lariam)
- Omeprazole
- Phenytoin
- Podophyllin resin (Prodocon-25) (high exposure or unintended route)
- Pravastatin
- Rosuvastatin (Crestor)
- Sertraline (Zoloft)
- Simvastatin (Zocor)
- Statins
- Tacrolimus (FK506, ProGraf)
- Zimeldine (withdrawn from the market and not in the U.S.)
- a-Interferon
Negligible or Doubtful Risk
- Allopurinol
- Amitriptyline (Elavil)
- Chloramphenicol
- Chlorprothixene (Taractan)
- Cimetidine
- Clioquinol
- Clofibrate (Atromid)
- Cyclosporin A (Sandimmune)
- Enalapril
- Gluthethimide
- Lithium
- Phenelzine (Nardil)
- Propafenone
- Sulfonamide (sulfacetamide, sulfabenzamide, sulfadiazine, sulfasalazine, sulfathiazole, sulfamethoxazole, sulfisoxazole)
Citations: Cavaletti G, Forsey K, Alberti P. Toxic medications in Charcot-Marie-Tooth patients: A systematic review. J Peripher Nerv Syst. 2023 Sep;28(3):295-307. doi: 10.1111/jns.12566. Epub 2023 Jun 5. PMID: 37249082.