5 Types of Medications That Can Harm Your Lungs

What are the symptoms to look out for?

“The lungs have a few ways of expressing their displeasure with a situation,” Schachter says. “Coughing is one symptom that a drug is irritating the airways. And I don’t mean just a few coughs. I’m talking about coughing that wakes you up at night, coughing that’s [uncontrollable].”

See your doctor if you have a cough that persists or shortness of breath that interferes with your ability to do things.

“Some patients respond to just going off the drug, some require additional treatment with anti-inflammatory drugs,” Schachter says. In extreme instances, “some have to be admitted to the hospital, put on ventilators and receive oxygen.”

Here are five of the most common types of drugs that can harm your lungs — plus, the questions you should be asking your doctor.

5 Common drugs that can harm the lungs

1. Over-the-counter pain medications

What they are: Over-the-counter pain meds — aka analgesics — relieve mild to moderate pain, and fever.

Examples: Acetaminophen (Tylenol) and nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen (Advil, Motrin) and naproxen (Aleve)

What you need to know: Pain meds can lead to shortness of breath in a couple of different ways. With acetaminophen, research suggests that chronic use of the pain reliever reduces the lungs’ capacity for antioxidants, the molecules that ward off cell damage and play a key role in fighting oxidative stress. Oxidative stress is believed to increase the risk of asthma, hasten the progression of existing asthma, and decrease lung function.  

With NSAIDs, a condition called NSAID-exacerbated respiratory disease (or NERD) is characterized by moderate-to-severe asthma and a higher prevalence of chronic sinusitis. “For these folks, aspirin and (other) NSAIDs can make the airway more constricted and provoke an asthma attack,” Wu says.

2. Some antibiotics

What they are: Medicines used to fight and treat bacterial infections

Example: Nitrofurantoin (Macrobid)

What you need to know: Nitrofurantoin is an antibiotic often prescribed to treat and prevent urinary tract infections. The drug can cause interstitial lung disease, but that reaction is rare, occurring in about 1 percent of patients, according to research published in Respirology Case Reports.

3. Heart medicines

What they are: Medications used to prevent and treat various forms of heart disease

Examples: Beta blockers, Amiodarone

What you need to know: Beta blockers, which are prescribed to treat high blood pressure, atrial fibrillation (AFib), and heart failure can cause the airways to tighten in people with underlying asthma or COPD. Amiodarone, commonly used to treat irregular heartbeat such as AFib, is the drug most commonly associated with lung problems. Research suggests DIILD affects as many as 2 percent of those on lower doses of amiodarone; it’s more frequent in men and those with preexisting lung disease may be more susceptible.

4. Cancer treatments

What they are: Chemotherapy medications

Examples: Any chemotherapy drug can harm the lungs, but the ones most commonly implicated are Bleomycin, Carmustine, Busulfan, and Cyclophosphamide.

What you need to know: Research suggests that cancer drugs are the most common cause of DIILD. Experts concede it’s challenging to pinpoint specific culprits in oncology since drugs are given in combination regimens or along with radiation, which is itself associated with lung damage and scarring.

5. Antirheumatic drugs

What they are: Drugs for rheumatoid arthritis and psoriasis drugs

Example: Methotrexate

What you need to know: Methotrexate can cause lung problems — including acute inflammation of the lungs and DIILD, Wu says — but the same can also be said of some of the conditions it treats, such as rheumatoid arthritis.

“In many cases, it’s hard to know if you’re dealing with the natural course of the disease or if it’s the drug that’s causing the problem,” Schachter says. “There’s no single test that we can do in most cases that says OK this is a toxic reaction to a specific drug.” 

What can patients do?

All medications come with side effects, which is why any time you begin a new drug it’s important that you ask your health care provider what those effects could be, so that together you can discuss the risks and benefits.  

It’s not always the case, but your doctor may be able to prescribe an alternative medication that doesn’t carry the same side effects.

“In particular, if you’re susceptible to lung injury, you should ask about lung toxicity and about potential symptoms you should look for,” Schachter says. And if you experience any of those symptoms, reach out to your doctor.