20th February 2025

Overview of drug-induced ILD

Drug-induced interstitial lung disease can be caused by a wide variety of medications including antibiotics, antiarrhythmics, chemotherapy agents and immunosuppressive drugs. Radiation can also result in lung damage.

Specific drugs associated with drug-induced ILD include nitrofurantoin, sulfasalazine, bleomycin, busulfan, cyclophosphamide, methotrexate, amiodarone and gold (Table 1).

Symptoms may include breathlessness, cough, fever, rash, wheeze and reduced exercise tolerance. Signs may include crackles on respiratory examination and clubbing. In later stages, signs of pulmonary hypertension may develop.

Clinical, radiological and histological findings are non-specific, and therefore a history suggestive of exposure to a medication known to cause ILD is paramount for diagnosis.

Table 1 Drug and radiation-induced ILD patterns of disease, causative agents and typical HRCT findings