Drug-induced lung disease

Abstract Drug-induced lung disease is common and needs to be considered in the differential diagnosis of many respiratory conditions. The nature and timing of events often provide important clues and are sometimes sufficiently characteristic for drug-induced lung disease to be diagnosed with confidence, with resolution of symptoms on drug cessation providing further supportive evidence. Direct drug effects may arise through toxic, pharmacological, allergic, or idiosyncratic mechanisms (there may also be indirect effects). From a clinical perspective, adverse effects may be classified according to the induced disorder and the site of involvement. Asthma is the most common airway disorder to be induced or exacerbated by drugs. Cough is a well-recognized side effect of treatment with angiotensin-converting enzyme inhibitors. Pulmonary vascular involvement includes venous thromboembolism (e.g. oral contraceptive pill), and pulmonary hypertension (e.g. aminorex, now withdrawn), dasatinib, and interferons. Pleural effusions and thickening may result from drugs (e.g. dantrolene, bromocriptine, methysergide, and dasatinib).