From the FDA Drug Label
Intracranial Hypertension Intracranial hypertension (IH, pseudotumor cerebri) has been associated with the use of tetracyclines including Minocin. Clinical manifestations of IH include headache, blurred vision, diplopia, and vision loss; papilledema can be found on fundoscopy Pseudotumor Cerebri Isotretinoinuse has been associated with a number of cases of pseudotumor cerebri (benign intracranial hypertension), some of which involved concomitant use of tetracyclines. increased intracranial pressure with papilledema (pseudotumor cerebri) usually following discontinuation of treatment
The medications that may cause papilledema are:
These medications can cause intracranial hypertension or pseudotumor cerebri, which may lead to papilledema.
From the Research
Medications that can cause papilledema include tetracyclines, vitamin A derivatives, corticosteroids, growth hormone, oral contraceptives, lithium, nalidixic acid, and certain antibiotics like fluoroquinolones, with the most recent evidence suggesting that cyclosporine is also a potential cause 4. These medications can lead to papilledema by increasing intracranial pressure through various mechanisms.
- Tetracyclines and vitamin A derivatives are particularly well-documented causes, potentially altering cerebrospinal fluid dynamics or affecting cerebral blood flow.
- Corticosteroids may cause papilledema during withdrawal as the body readjusts to normal hormone levels.
- Cyclosporine has been associated with papilledema, and switching to tacrolimus may be a suitable alternative in patients requiring immunosuppression 4. If papilledema is suspected while taking these medications, prompt ophthalmologic evaluation is essential, as continued use could lead to permanent vision loss.
- Management typically involves discontinuation of the offending medication when possible, though this should be done under medical supervision.
- The development of papilledema is dose-dependent in many cases, with higher doses and longer durations of therapy increasing the risk, although a recent study found no statistically significant association between cycline antibiotic use and the development of pseudotumor cerebri syndrome after adjusting for confounders 5.