title: Severe reversible thrombocytopenia resulting from butoconazole cream.
abstract: A 54-year-old woman with a 19-year history of rheumatoid arthritis developed life-threatening thrombocytopenia one week after beginning butoconazole therapy for a vaginal yeast infection. This was complicated by upper gastrointestinal hemorrhage that probably resulted from ibuprofen and methotrexate therapy. Sepsis, myelophthisic anemias, and other potential etiologies were ruled out. Once stabilized, the patient was rechallenged with other medications without incident. These findings indicate that a potentially serious thrombocytopenia may result from the administration of butoconazole vaginal cream or in combination with methotrexate and/or ibuprofen.
authors.affiliation: Department of Pharmacy Practice, College of Pharmacy, University of Nebraska Medical Center, Omaha 68105.
authors.forename: P A
authors.initials: PA
authors.lastname: Maloley
authors.forename: E
authors.initials: E
authors.lastname: Nelson
authors.forename: H A
authors.initials: HA
authors.lastname: Montgomery
authors.forename: J R
authors.initials: JR
authors.lastname: Campbell
mesh_terms: D000282:Administration, Intravaginal; D000935:Antifungal Agents / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007052:Ibuprofen / Q000009:adverse effects; D007093:Imidazoles / Q000008:administration & dosage / Q000009:adverse effects*; D008727:Methotrexate / Q000009:adverse effects; D008875:Middle Aged; D009824:Ointments; D013921:Thrombocytopenia / Q000139:chemically induced*
chemical_list: D000935:Antifungal Agents; D007093:Imidazoles; D009824:Ointments; C017125:butoconazole; D007052:Ibuprofen; D008727:Methotrexate