title: Does famotidine induce thrombocytopenia in neurosurgical patients?
abstract: The incidence of thrombocytopenia in neurosurgical patients prescribed famotidine is unknown. Using hospital records of neurosurgery patients treated between July 2001 and July 2002, a retrospective cohort study was performed comparing platelet counts in patients treated with famotidine with a similar group of patients who were not prescribed an H2 antagonist. Patients were excluded if: 1) platelets were less than 150,000 prior to famotidine administration; 2) pre-drug and post-drug platelets were not drawn; 3) they were concurrently taking a potential thrombocytopenic inducing drug; or 4) disseminated intravascular coagulation, thrombocytopenic purpura, or any other confounding hematologic disorder developed. Seventeen of 50 (34%) patients on famotidine developed thrombocytopenia compared with 11 of 98 (11.2%) of those untreated (P = 0.002). In this retrospective study, neurosurgical patients on famotidine developed thrombocytopenia statistically significantly more often than those untreated. Although no clinically significant sequelae developed as a result of the thrombocytopenia, if these findings are confirmed by a prospective study, proton pump inhibitors and sucralfate, with their similar efficacy, may be a better choice for gastrointestinal prophylaxis in neurosurgical patients.
authors.affiliation: Department of Neurosurgery, Division of Critical Care Neurology, Mayo Clinic College of Medicine and Foundation, Rochester, Minnesota 55905, USA.
authors.forename: Robert D
authors.initials: RD
authors.lastname: Ecker
authors.forename: Eelco F M
authors.initials: EF
authors.lastname: Wijdicks
authors.forename: Kelly
authors.initials: K
authors.lastname: Wix
authors.forename: Robyn
authors.initials: R
authors.lastname: McClelland
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000897:Anti-Ulcer Agents / Q000009:adverse effects*; D015738:Famotidine / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D010976:Platelet Count; D012189:Retrospective Studies; D013921:Thrombocytopenia / Q000139:chemically induced* / Q000453:epidemiology
chemical_list: D000897:Anti-Ulcer Agents; D015738:Famotidine