What medications can cause paresthesia (tingling sensation) in the fingers?

From the Guidelines

Medications that can cause tingling in fingers include chemotherapy drugs like paclitaxel and oxaliplatin, as well as other agents such as duloxetine, venlafaxine, and certain antidepressants and anticonvulsants. According to the most recent and highest quality study available, specifically the 2020 ASCO guideline update on prevention and management of chemotherapy-induced peripheral neuropathy in survivors of adult cancers 1, chemotherapy-induced peripheral neuropathy can be caused by various medications. The study highlights that paclitaxel and oxaliplatin are two of the most prominent neurotoxic chemotherapy agents, and their neuropathy symptoms can be similar, with numbness, tingling, and pain being the most common descriptors.

Some key points to consider:

• Chemotherapy-induced peripheral neuropathy can markedly affect the quality of life (QOL) of patients and may be detrimental to their cancer outcomes 1.
• The diagnosis of chemotherapy-induced peripheral neuropathy can generally be made by clinical history, and neurologic physical examination can be abnormal in a patient with this condition 1.
• Duloxetine has been shown to be effective in reducing neuropathic pain in patients with chemotherapy-induced peripheral neuropathy, particularly those treated with platinum-based therapies 1.
• Other medications, such as venlafaxine, gabapentin, and pregabalin, may also be considered for the treatment of neuropathic pain, although the evidence is less strong 1.

It is essential to note that if you experience persistent tingling in your fingers after starting a new medication, you should consult your healthcare provider rather than discontinuing the medication on your own. They may adjust your dosage, switch to an alternative medication, or recommend supportive treatments to manage this side effect while maintaining necessary treatment.

From the FDA Drug Label

Hypersensitivity Reactions: Serious and occasionally fatal hypersensitivity (anaphylactic) reactions, some following the first dose, have been reported in patients receiving quinolone therapy. Some reactions were accompanied by cardiovascular collapse, loss of consciousness, tingling, pharyngeal or facial edema, dyspnea, urticaria, and itching Peripheral neuropathy: Rare cases of sensory or sensorimotor axonal polyneuropathy affecting small and/or large axons resulting in paresthesias, hypoesthesias, dysesthesias and weakness have been reported in patients receiving quinolones, including ciprofloxacin Cases of sensory or sensorimotor axonal polyneuropathy affecting small and/or large axons resulting in paresthesias, hypoesthesias, dysesthesias and weakness have been reported in patients receiving fluoroquinolones, including levofloxacin. Symptoms may occur soon after initiation of levofloxacin and may be irreversible Peripheral neuropathy was observed in 60% of all patients (3% severe) and in 52% (2% severe) of the patients without pre-existing neuropathy. The frequency of peripheral neuropathy increased with cumulative dose Paresthesia commonly occurs in the form of hyperesthesia.

Medications that can cause tingling in fingers:

• Ciprofloxacin (PO) 2
• Levofloxacin (PO) 3
• Paclitaxel (IV) 4 These medications can cause peripheral neuropathy, which may result in tingling sensations in the fingers. It is essential to monitor patients for symptoms of neuropathy and discontinue the medication if necessary to prevent irreversible damage.

From the Research

Medications Causing Tingling in Fingers

• Fluoroquinolones, a class of antibiotics, have been associated with peripheral neuropathy, which can cause tingling in fingers 5
• Specifically, ciprofloxacin has been linked to peripheral neuropathy, including axonal polyneuropathy, which can result in tingling sensations in the fingers 5
• Other fluoroquinolones, such as levofloxacin, may also have similar adverse effects, although the difference in efficacy and safety between levofloxacin and ciprofloxacin is not statistically significant 6, 7
• The exact mechanism of fluoroquinolone-induced peripheral neuropathy is not fully understood, but it is thought to be related to the drug's effect on nerve cells 5
• Treatment for fluoroquinolone-induced peripheral neuropathy may include intravenous immunoglobulin, steroids, and physical therapy, which have shown promising results in some cases 5