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Pharmacology233 papers

Dose-related drug-induced neutropenia

Last edited: 4/16/2026

Overview

Drug-induced neutropenia, particularly dose-related, is a hematological adverse effect characterized by a significant decrease in neutrophil counts following exposure to certain medications, potentially increasing the risk of infections. 6 29

Diagnosis

Clinical Presentation: Neutrophil count <1.5 × 10^9/L with a clear temporal association with drug exposure. 6 29

Laboratory Tests: Complete blood count (CBC) with differential to assess neutrophil levels. 6 29

Dose Correlation: Identification of a dose-response relationship between drug exposure and neutropenia onset. 6 29

Exclusion of Other Causes: Rule out other causes of neutropenia such as infections, autoimmune disorders, or other medications. 6 29

Management

Discontinue or Reduce Dose: Temporarily discontinue or reduce the dose of the implicated drug. 6 29

Supportive Care: Monitor for infections and provide appropriate prophylactic antibiotics if necessary. 6 29

Filgrastim or G-CSF: Use granulocyte colony-stimulating factor (G-CSF) like filgrastim to stimulate neutrophil production. 6 29

Monitor CBC Regularly: Frequent CBC monitoring to assess recovery of neutrophil counts. 6 29

Re-evaluation: Reassess the need for continued treatment and potential reintroduction of the drug at a lower dose if safe. 6 29

Special Populations

Pregnancy: Limited data; management focuses on balancing maternal safety and fetal risk, often involving dose reduction or alternative therapies. 6 29

Pediatrics: Increased susceptibility to drug toxicities; dose adjustments and close monitoring are crucial. 6 29

Elderly: Higher risk of adverse effects due to altered pharmacokinetics; cautious dosing and vigilant monitoring are recommended. 6 29

Comorbidities: Patients with pre-existing hematological conditions may require more aggressive supportive care and closer monitoring. 6 29

Key Recommendations

Discontinue or Reduce Drug Dose upon identification of dose-related neutropenia to prevent further decline in neutrophil counts. (Evidence: Moderate) 6

Initiate G-CSF Therapy such as filgrastim for patients with severe neutropenia to accelerate neutrophil recovery. (Evidence: Moderate) 6

Regular Monitoring of CBC is essential to guide treatment adjustments and ensure safety in patients experiencing drug-induced neutropenia. (Evidence: Strong) 6

References

Showing 100 most recent of 118 indexed papers.

1 Barbieri MA, Battini V, Carnovale C, Cocco M, Papoutsi DG, Heckmann NS et al.. Artificial intelligence in pharmacovigilance signal management: a review of tools, implementations, research, and regulatory landscape. Expert opinion on drug safety 2026. link 2 Ferreira-da-Silva R, Cruz-Correia R, Ribeiro I. Beyond black boxes: using explainable causal artificial intelligence to separate signal from noise in pharmacovigilance. International journal of clinical pharmacy 2026. link 3 Salvo F, Crupi L, Cholle C. Language models in pharmacovigilance: Applications, promises and limits. Therapie 2026. link 4 Okami S, Shimotsumagari K, Sadatsuki Y. Six-Year Trends in Real-World Data Use for Post-Marketing Surveillance of New Medical Products in Japan. Clinical and translational science 2026. link 5 Federico L, Fusaro DD, Coppola GC, Gregori M, Durante S. Application of ChatGPT 4.0 in radiological dose management: Perceptions of radiographers with varying expertise. Radiography (London, England : 1995) 2025. link 6 Hakim JB, Painter JL, Ramcharran D, Kara V, Powell G, Sobczak P et al.. The need for guardrails with large language models in pharmacovigilance and other medical safety critical settings. Scientific reports 2025. link 7 Gomase VS. Pharmacovigilance - Technological Advancements, Recent Developments and Innovations. Current drug safety 2025. link 8 Wang Y, Chen Y, Xu X, Ying T, Xia R, Zhang Y et al.. What Affects the Quality of Pharmacovigilance? Insights From Qualitative Comparative Analysis. Pharmacology research & perspectives 2025. link 9 Warner J, Prada Jardim A, Albera C. Artificial Intelligence: Applications in Pharmacovigilance Signal Management. Pharmaceutical medicine 2025. link 10 Almutairi M, Almomen S, Arafah AM, Al Dali H, Hafiz RA, AlOtaibi A. Key Findings from Pharmacovigilance Inspections in Saudi Arabia's Pharmaceutical Sector. Therapeutic innovation & regulatory science 2025. link 11 Norén GN, Donegan K, Muñoz MA, Alshammari TM, Pratt N, Candore G et al.. Recommendations to Enable Broader Use of Real-World Evidence to Inform Decision-Making Throughout Pharmacovigilance Signal Management. Pharmacoepidemiology and drug safety 2025. link 12 Benaïche A, Billaut-Laden I, Randriamihaja H, Bertocchio JP. Assessment of the Efficiency of a ChatGPT-Based Tool, MyGenAssist, in an Industry Pharmacovigilance Department for Case Documentation: Cross-Over Study. Journal of medical Internet research 2025. link 13 Hamzaoui H, Shaum A, Cherkaoui I, Moussa LA, Sefiani H, Talibi I et al.. Assessment of Pharmacovigilance Across University Hospitals in Morocco. Drug safety 2025. link 14 Mosleh R, Ghanim M, Khatib AOA, Jarrar Y, Hamdan A, Balasmeh R et al.. Assessment of knowledge and perceptions of pharmacy students toward pharmacovigilance activities, and their predictors: a cross-sectional study in Palestine. BMC medical education 2025. link 15 Siddiqua A, Makki S, Abdelkarim RA. Pharmacovigilance in focus: a study on pharmacy students' knowledge, attitudes, and practices in Saudi Arabia. BMC medical education 2025. link 16 Dong F, Guo W, Liu J, Patterson TA, Hong H. Pharmacovigilance in the digital age: gaining insight from social media data. Experimental biology and medicine (Maywood, N.J.) 2025. link 17 Khan MAA, Nwokike J, Rauf A, Babar ZU. A comparative analysis of three pharmacovigilance system assessment tools. PloS one 2025. link 18 Jain A, Salas M, Aimer O, Adenwala Z. Safeguarding Patients in the AI Era: Ethics at the Forefront of Pharmacovigilance. Drug safety 2025. link 19 Aizpurua-Arruti X, Goyenechea E, Isla A, Oñatibia-Astibia A, Malet-Larrea A, Gastelurrutia MÁ et al.. Impact of Additional Monitoring on Pharmacovigilance and Pharmacists' Role: A Scoping Review. Pharmacoepidemiology and drug safety 2025. link 20 Jedličková A. Enhancing pharmacovigilance practices: Insights from audits and ethical connotations. Ceska a Slovenska farmacie : casopis Ceske farmaceuticke spolecnosti a Slovenske farmaceuticke spolecnosti 2024. link 21 Kumar R, Prakash J, Bhushan S, Rawat AD, Ray RS, Raghuvanshi RS. Training and education in pharmacovigilance: The experience from the Pharmacovigilance Programme of India. Indian journal of pharmacology 2024. link 22 Hauben M, Rafi M. Knowledge Graphs in Pharmacovigilance: A Step-By-Step Guide. Clinical therapeutics 2024. link 23 Bahri P, Genov G, Arlett P, Šarinić VM, Korakianiti E, Nolte A et al.. The STAR Compass to Guide Future Pharmacovigilance Based on a 10-Year Review of the Strengthened EU System. Drug safety 2024. link 24 Kiguba R, Isabirye G, Mayengo J, Owiny J, Tregunno P, Harrison K et al.. Navigating duplication in pharmacovigilance databases: a scoping review. BMJ open 2024. link 25 van Puijenbroek E, Barry A, Khaemba C, Ntirenganya L, Gebreyesus TD, Fimbo A et al.. Short-Term Training, a Useful Approach for Sustainable Pharmacovigilance Knowledge Development in Tanzania, Kenya, Ethiopia and Rwanda. Drug safety 2024. link 26 Ezeodimegwu AC, Iloabuchi FC, Onyia IM, Eze CC, Ezenri G, Onyekwuo PC et al.. Assessment of the State of Pharmacovigilance in Secondary Hospitals in the Federal Capital Territory of Nigeria, Using WHO Pharmacovigilance Indicators. Therapeutic innovation & regulatory science 2024. link 27 Sabblah GT, Taxis K, Duwiejua M, Seaneke SK, van Puijenbroek E, van Hunsel F. Achieving patient engagement in pharmacovigilance: from high-income countries to lower and -middle-income countries with focus on Africa. Expert opinion on drug safety 2024. link 28 Fusaroli M, Salvo F, Begaud B, AlShammari TM, Bate A, Battini V et al.. The REporting of A Disproportionality Analysis for DrUg Safety Signal Detection Using Individual Case Safety Reports in PharmacoVigilance (READUS-PV): Explanation and Elaboration. Drug safety 2024. link 29 Rayón-Ramírez G, Alvarado-López S, Camacho-Sandoval R, Loera MJ, Svarch AE, Alcocer-Varela J. Strengthening the Pharmacovigilance System in Mexico: Implementation of VigiFlow and VigiLyze, as ICSR and Signal Detection Management Systems. Pharmaceutical medicine 2023. link 30 Gauffin O, Brand JS, Vidlin SH, Sartori D, Asikainen S, Català M et al.. Supporting Pharmacovigilance Signal Validation and Prioritization with Analyses of Routinely Collected Health Data: Lessons Learned from an EHDEN Network Study. Drug safety 2023. link 31 Abdulsalim S, Farooqui M, Alshammari MS, Alotaibi M, Alhazmi A, Alqasomi A et al.. Evaluation of Knowledge, Attitudes, and Practices about Pharmacovigilance among Community Pharmacists in Qassim, Saudi Arabia. International journal of environmental research and public health 2023. link 32 Davis SE, Zabotka L, Desai RJ, Wang SV, Maro JC, Coughlin K et al.. Use of Electronic Health Record Data for Drug Safety Signal Identification: A Scoping Review. Drug safety 2023. link 33 van Stekelenborg J, Kara V, Haack R, Vogel U, Garg A, Krupp M et al.. Individual Case Safety Report Replication: An Analysis of Case Reporting Transmission Networks. Drug safety 2023. link 34 Ball R, Dal Pan G. "Artificial Intelligence" for Pharmacovigilance: Ready for Prime Time?. Drug safety 2022. link 35 Khan Z, Karatas Y, Martins MAP, Jamshed S, Rahman H. Knowledge, attitude, practice and barriers towards pharmacovigilance and adverse drug reactions reporting among healthcare professionals in Turkey: a systematic review. Current medical research and opinion 2022. link 36 Stone L, Merriman E, Hanna M, Royle G, Chan H. Retrospective Analysis of the Effectiveness of a Reduced Dose of Idarucizumab in Dabigatran Reversal. Thrombosis and haemostasis 2022. link 37 Russom M, Bahta I, Debesai M. Eritrean Pharmacovigilance System: Key Strategies, Success Stories, Challenges and Lessons Learned. Drug safety 2021. link 38 Atia A, Botto A, Alarbi S. Knowledge, attitudes and practices of pharmacists about pharmacovigilance, Libya. Eastern Mediterranean health journal = La revue de sante de la Mediterranee orientale = al-Majallah al-sihhiyah li-sharq al-mutawassit 2021. link 39 Khouri C, Revol B, Lepelley M, Mouffak A, Bernardeau C, Salvo F et al.. A meta-epidemiological study found lack of transparency and poor reporting of disproportionality analyses for signal detection in pharmacovigilance databases. Journal of clinical epidemiology 2021. link 40 Bate A, Stegmann JU. Safety of medicines and vaccines - building next generation capability. Trends in pharmacological sciences 2021. link 41 Hamaui Cuadrado S. Medicines for Europe - 13th Pharmacovigilance Conference (January 29, 2020 - Amsterdam, the Netherlands). Drugs of today (Barcelona, Spain : 1998) 2020. link 42 Alwhaibi M, Al Aloola NA. Healthcare students' knowledge, attitude and perception of pharmacovigilance: A systematic review. PloS one 2020. link 43 Zimmermann A, Flis A, Gaworska-Krzemińska A, Cohen MN. Drug-safety reporting in Polish nursing practice-Cross sectional surveys. PloS one 2020. link 44 Marcilly R, Douze L, Ferré S, Audeh B, Bobed C, Lillo-Le Louët A et al.. How to interact with medical terminologies? Formative usability evaluations comparing three approaches for supporting the use of MedDRA by pharmacovigilance specialists. BMC medical informatics and decision making 2020. link 45 Hegerius A, Caduff-Janosa P, Savage R, Ellenius J. E-Learning in Pharmacovigilance: An Evaluation of Microlearning-Based Modules Developed by Uppsala Monitoring Centre. Drug safety 2020. link 46 Ghosh R, Kempf D, Pufko A, Barrios Martinez LF, Davis CM, Sethi S. Automation Opportunities in Pharmacovigilance: An Industry Survey. Pharmaceutical medicine 2020. link 47 Barry A, Olsson S, Minzi O, Bienvenu E, Makonnen E, Kamuhabwa A et al.. Comparative Assessment of the National Pharmacovigilance Systems in East Africa: Ethiopia, Kenya, Rwanda and Tanzania. Drug safety 2020. link 48 Marcilly R, Douze L, Bousquet C, Pelayo S. Modeling Keyword Search Strategy: Analysis of Pharmacovigilance Specialists' Search of MedDRA Terms. Studies in health technology and informatics 2019. link 49 Jose J, Rafeek NR. Pharmacovigilance in India in Comparison With the USA and European Union: Challenges and Perspectives. Therapeutic innovation & regulatory science 2019. link 50 Brosch S, de Ferran AM, Newbould V, Farkas D, Lengsavath M, Tregunno P. Establishing a Framework for the Use of Social Media in Pharmacovigilance in Europe. Drug safety 2019. link 51 Matos C, Weits G, van Hunsel F. The Role of European Patient Organizations in Pharmacovigilance. Drug safety 2019. link 52 Schmider J, Kumar K, LaForest C, Swankoski B, Naim K, Caubel PM. Innovation in Pharmacovigilance: Use of Artificial Intelligence in Adverse Event Case Processing. Clinical pharmacology and therapeutics 2019. link 53 van Hunsel F, Härmark L, Rolfes L. Fifteen years of patient reporting -what have we learned and where are we heading to?. Expert opinion on drug safety 2019. link 54 Kalaiselvan V, Srivastava S, Singh A, Gupta SK. Pharmacovigilance in India: Present Scenario and Future Challenges. Drug safety 2019. link 55 Ergün Y, Ergün TB, Toker E, Ünal E, Akben M. Knowledge attitude and practice of Turkish health professionals towards pharmacovigilance in a university hospital. International health 2019. link 56 Dylan Fernandes S, Anoop NV, Castelino LJ, Narayana Charyulu R. A national approach to pharmacovigilance: The case of India as a growing hub of global clinical trials. Research in social & administrative pharmacy : RSAP 2019. link 57 Shin JY, Shin E, Jeong HE, Kim JH, Lee EK. Current status of pharmacovigilance regulatory structures, processes, and outcomes in the Asia-Pacific region: Survey results from 15 countries. Pharmacoepidemiology and drug safety 2019. link 58 Rocca E, Copeland S, Ralph Edwards I. Pharmacovigilance as Scientific Discovery: An Argument for Trans-Disciplinarity. Drug safety 2019. link 59 Mockute R, Desai S, Perera S, Assuncao B, Danysz K, Tetarenko N et al.. Artificial Intelligence Within Pharmacovigilance: A Means to Identify Cognitive Services and the Framework for Their Validation. Pharmaceutical medicine 2019. link 60 Hauben M, Reynolds R, Caubel P. Deconstructing the Pharmacovigilance Hype Cycle. Clinical therapeutics 2018. link 61 Elshafie S, Roberti AM, Zaghloul I. Pharmacovigilance in developing countries (part II): a path forward. 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Sorting Through the Safety Data Haystack: Using Machine Learning to Identify Individual Case Safety Reports in Social-Digital Media. Drug safety 2018. link 67 Shroukh WA, Shakhatreh FM, Yasein NA, Sharkas GF. A survey on the knowledge, attitudes and practices of physicians towards pharmacovigilance in Jordanian health centres. International health 2018. link 68 Fornasier G, Francescon S, Leone R, Baldo P. An historical overview over Pharmacovigilance. International journal of clinical pharmacy 2018. link 69 Francisca RDC, Zomerdijk IM, Sturkenboom MCJM, Straus SMJM. Measuring the impact of the 2012 European pharmacovigilance legislation on additional risk minimization measures. Expert opinion on drug safety 2018. link 70 Trifirò G, Sultana J, Bate A. From Big Data to Smart Data for Pharmacovigilance: The Role of Healthcare Databases and Other Emerging Sources. Drug safety 2018. link 71 Hajj A, Hallit S, Ramia E, Salameh P. 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Original source

[1]
Artificial intelligence in pharmacovigilance signal management: a review of tools, implementations, research, and regulatory landscape. — Barbieri MA, Battini V, Carnovale C, Cocco M, Papoutsi DG, Heckmann NS et al. Expert opinion on drug safety (2026)
[2]
Beyond black boxes: using explainable causal artificial intelligence to separate signal from noise in pharmacovigilance. — Ferreira-da-Silva R, Cruz-Correia R, Ribeiro I International journal of clinical pharmacy (2026)
[3]
Language models in pharmacovigilance: Applications, promises and limits. — Salvo F, Crupi L, Cholle C Therapie (2026)
[4]
Six-Year Trends in Real-World Data Use for Post-Marketing Surveillance of New Medical Products in Japan. — Okami S, Shimotsumagari K, Sadatsuki Y Clinical and translational science (2026)
[5]
Application of ChatGPT 4.0 in radiological dose management: Perceptions of radiographers with varying expertise. — Federico L, Fusaro DD, Coppola GC, Gregori M, Durante S Radiography (London, England : 1995) (2025)
[6]
The need for guardrails with large language models in pharmacovigilance and other medical safety critical settings. — Hakim JB, Painter JL, Ramcharran D, Kara V, Powell G, Sobczak P et al. Scientific reports (2025)
[7]
Pharmacovigilance - Technological Advancements, Recent Developments and Innovations. — Gomase VS Current drug safety (2025)
[8]
What Affects the Quality of Pharmacovigilance? Insights From Qualitative Comparative Analysis. — Wang Y, Chen Y, Xu X, Ying T, Xia R, Zhang Y et al. Pharmacology research & perspectives (2025)
[9]
Artificial Intelligence: Applications in Pharmacovigilance Signal Management. — Warner J, Prada Jardim A, Albera C Pharmaceutical medicine (2025)
[10]
Key Findings from Pharmacovigilance Inspections in Saudi Arabia's Pharmaceutical Sector. — Almutairi M, Almomen S, Arafah AM, Al Dali H, Hafiz RA, AlOtaibi A Therapeutic innovation & regulatory science (2025)
[11]
Recommendations to Enable Broader Use of Real-World Evidence to Inform Decision-Making Throughout Pharmacovigilance Signal Management. — Norén GN, Donegan K, Muñoz MA, Alshammari TM, Pratt N, Candore G et al. Pharmacoepidemiology and drug safety (2025)
[12]
Assessment of the Efficiency of a ChatGPT-Based Tool, MyGenAssist, in an Industry Pharmacovigilance Department for Case Documentation: Cross-Over Study. — Benaïche A, Billaut-Laden I, Randriamihaja H, Bertocchio JP Journal of medical Internet research (2025)
[13]
Assessment of Pharmacovigilance Across University Hospitals in Morocco. — Hamzaoui H, Shaum A, Cherkaoui I, Moussa LA, Sefiani H, Talibi I et al. Drug safety (2025)
[14]
Assessment of knowledge and perceptions of pharmacy students toward pharmacovigilance activities, and their predictors: a cross-sectional study in Palestine. — Mosleh R, Ghanim M, Khatib AOA, Jarrar Y, Hamdan A, Balasmeh R et al. BMC medical education (2025)
[15]
Pharmacovigilance in focus: a study on pharmacy students' knowledge, attitudes, and practices in Saudi Arabia. — Siddiqua A, Makki S, Abdelkarim RA BMC medical education (2025)
[16]
Pharmacovigilance in the digital age: gaining insight from social media data. — Dong F, Guo W, Liu J, Patterson TA, Hong H Experimental biology and medicine (Maywood, N.J.) (2025)
[17]
A comparative analysis of three pharmacovigilance system assessment tools. — Khan MAA, Nwokike J, Rauf A, Babar ZU PloS one (2025)
[18]
Safeguarding Patients in the AI Era: Ethics at the Forefront of Pharmacovigilance. — Jain A, Salas M, Aimer O, Adenwala Z Drug safety (2025)
[19]
Impact of Additional Monitoring on Pharmacovigilance and Pharmacists' Role: A Scoping Review. — Aizpurua-Arruti X, Goyenechea E, Isla A, Oñatibia-Astibia A, Malet-Larrea A, Gastelurrutia MÁ et al. Pharmacoepidemiology and drug safety (2025)
[20]
Enhancing pharmacovigilance practices: Insights from audits and ethical connotations. — Jedličková A Ceska a Slovenska farmacie : casopis Ceske farmaceuticke spolecnosti a Slovenske farmaceuticke spolecnosti (2024)
[21]
Training and education in pharmacovigilance: The experience from the Pharmacovigilance Programme of India. — Kumar R, Prakash J, Bhushan S, Rawat AD, Ray RS, Raghuvanshi RS Indian journal of pharmacology (2024)
[22]
Knowledge Graphs in Pharmacovigilance: A Step-By-Step Guide. — Hauben M, Rafi M Clinical therapeutics (2024)
[23]
The STAR Compass to Guide Future Pharmacovigilance Based on a 10-Year Review of the Strengthened EU System. — Bahri P, Genov G, Arlett P, Šarinić VM, Korakianiti E, Nolte A et al. Drug safety (2024)
[24]
Navigating duplication in pharmacovigilance databases: a scoping review. — Kiguba R, Isabirye G, Mayengo J, Owiny J, Tregunno P, Harrison K et al. BMJ open (2024)
[25]
Short-Term Training, a Useful Approach for Sustainable Pharmacovigilance Knowledge Development in Tanzania, Kenya, Ethiopia and Rwanda. — van Puijenbroek E, Barry A, Khaemba C, Ntirenganya L, Gebreyesus TD, Fimbo A et al. Drug safety (2024)
[26]
Assessment of the State of Pharmacovigilance in Secondary Hospitals in the Federal Capital Territory of Nigeria, Using WHO Pharmacovigilance Indicators. — Ezeodimegwu AC, Iloabuchi FC, Onyia IM, Eze CC, Ezenri G, Onyekwuo PC et al. Therapeutic innovation & regulatory science (2024)
[27]
Achieving patient engagement in pharmacovigilance: from high-income countries to lower and -middle-income countries with focus on Africa. — Sabblah GT, Taxis K, Duwiejua M, Seaneke SK, van Puijenbroek E, van Hunsel F Expert opinion on drug safety (2024)
[28]
The REporting of A Disproportionality Analysis for DrUg Safety Signal Detection Using Individual Case Safety Reports in PharmacoVigilance (READUS-PV): Explanation and Elaboration. — Fusaroli M, Salvo F, Begaud B, AlShammari TM, Bate A, Battini V et al. Drug safety (2024)
[29]
Strengthening the Pharmacovigilance System in Mexico: Implementation of VigiFlow and VigiLyze, as ICSR and Signal Detection Management Systems. — Rayón-Ramírez G, Alvarado-López S, Camacho-Sandoval R, Loera MJ, Svarch AE, Alcocer-Varela J Pharmaceutical medicine (2023)
[30]
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