Update on medication-induced peripheral neuropathy

Curr Neurol Neurosci Rep. 2009 Jan;9(1):69-75. doi: 10.1007/s11910-009-0011-z.


Despite improvements in the identification of causes of peripheral neuropathy, idiopathic polyneuropathy remains common. Medication and toxic neuropathy account for a small but important percentage of potentially preventable or reversible causes of neuropathy. New drugs that can induce neuropathy have been approved over the past several years, including the anticancer agents bortezomib, ixabepilone, and oxaliplatin. We review the neurotoxic effects of tumor necrosis factor-alpha blockers infliximab and etanercept, the inflammatory arthritis agent leflunomide, and the antibiotic linezolid. The controversy of statin-induced neuropathy continues to unfold; the large Fremantle Diabetes Study has suggested that statins may have neuroprotective effects. Dichloroacetate is a promising agent for lactic acidosis-associated disorders, but toxic neuropathy is a treatment-limiting factor. We also describe a progressive inflammatory neuropathy in swine slaughterhouse workers that appears to be a toxin-induced immune response.

Publication types

  • Review

MeSH terms

  • Acetamides / adverse effects
  • Anti-Infective Agents / adverse effects
  • Antibodies, Monoclonal / adverse effects
  • Antirheumatic Agents / adverse effects
  • Clinical Trials as Topic
  • Etanercept
  • Humans
  • Immunoglobulin G / adverse effects
  • Immunosuppressive Agents / adverse effects
  • Infliximab
  • Isoxazoles / adverse effects
  • Leflunomide
  • Linezolid
  • Oxazolidinones / adverse effects
  • Peripheral Nervous System Diseases / chemically induced*
  • Peripheral Nervous System Diseases / pathology
  • Peripheral Nervous System Diseases / physiopathology
  • Peripheral Nervous System Diseases / therapy
  • Receptors, Tumor Necrosis Factor
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors


  • Acetamides
  • Anti-Infective Agents
  • Antibodies, Monoclonal
  • Antirheumatic Agents
  • Immunoglobulin G
  • Immunosuppressive Agents
  • Isoxazoles
  • Oxazolidinones
  • Receptors, Tumor Necrosis Factor
  • Tumor Necrosis Factor-alpha
  • Infliximab
  • Leflunomide
  • Linezolid
  • Etanercept