Riluzole-induced neutropenia

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Abstract
The glutamatergic antagonist riluzole was approved in 1995 for the management of ALS and has become its standard therapy.1 Common side effects of the drug are nausea, asthenia, and reversible liver enzyme elevation.2,3⇓ Neutropenia is an extremely rare, not well-described, life-threatening adverse reaction of the drug. Only one case of reversible neutropenia associated with an inadvertent dose increase of riluzole to 200 mg/d has been reported previously.4 A review of the pharmacodynamic and pharmacokinetic properties of riluzole in ALS reported only 3 cases of neutropenia among 4,000 patients who received the drug without any additional details.5 We report a patient who developed severe neutropenia in association with a standard dose (100 mg/d) of riluzole. A woman aged 71 years with ALS was admitted to the hospital because of fever. She had a medical history of arterial hypertension and hypercholesterolemia and had undergone left mastectomy and breast reconstruction because of breast cancer 22 years earlier. She did not receive chemotherapy or radiotherapy. Three months before her admission, a diagnosis of ALS was …