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5 Types of Medications That Can Harm Your Lungs

Some common drugs carry potential risks to the respiratory system

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It’s one thing to contend with a drug’s side effects in the name of treating whatever it is that’s ailing you. It’s quite another to know that the very drug that’s helping treat one health condition may set you up for another one.

Case in point: the medications that can cause respiratory issues.

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“There are obviously many drugs that we use to treat breathing problems, but similarly, there are many drugs that are not used to treat lung problems that will cause lung dysfunction,” says Neil Schachter, M.D., a pulmonologist and Professor of Medicine at the Icahn School of Medicine at Mount Sinai.

In fact, a review of research published in the Journal of Clinical Medicine found that although a number of drugs used to treat a range of conditions — including arthritis, cancer and an irregular heartbeat — are successful for most patients, they carry potential risks to the respiratory system. 

Those risks include difficulty catching your breath at one end of the spectrum, to the more serious drug-induced interstitial lung disease (DIILD) at the other end. More than 350 drugs are believed to cause DIILD, a type of inflammation that scars the lungs’ delicate tissue.

All of which begs the question: What makes the lungs so vulnerable?

Why the lungs?

Part of it has to do with the role they play, working to bring oxygen into the body and send carbon dioxide out. Over time, that constant exposure to the environment can take a toll.

“Because the lungs are connected to both the outside environment and blood circulation, they’re exposed to more elements than other organs,” says Tianshi David Wu, M.D., assistant professor of pulmonary medicine at Baylor College of Medicine.  

Some people are at greater risk of drug-induced respiratory problems than others. For example, people with underlying lung disease and a history of smoking, as well as people with kidney disease or liver disease because the offending drug is disposed of more slowly by both of these organs.

Age is also a risk factor.

“Like all organs, lung function slowly decreases with age, and the lungs become less able to tolerate disruptions to the environment that occur with any new exposure, such as a drug,” Wu explains.

The most common lung-irritating drugs are well-known, so if you’re prescribed one of these medications and a respiratory issue arises, your doctor will have a high level of suspicion that it’s the drug that’s causing the problem.

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].”


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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.

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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.

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