Table 3: Drugs that could be related to the development of an atrophic condition of the tongue.

Drug name Application Side effect potentially producing an atrophic tongue Ref
Metformin Type 2 diabetes treatment Vitamin B12 and folic acid deficiency (in association with proton-pump inhibitor) [60]
Proton-pump inhibitor (omeoprazole, lansoprazole) Acid-lowering agent Vitamin B12 deficiency (in association with metformin) [53]
Histamine antagonist Acid-lowering agents Vitamin B12 deficiency [61]
Isoniazid Anti-tuberculosis agent Vitamin B3 and vitamin B6 deficiency [49]
Chloramphenicol Antibiotic Vitamin B3 deficiency [58]
Fluorouracil Cancer treatment (antimetabolite) Vitamin B3 deficiency [69]
Oral contraceptives Contraceptive Vitamin B6 and folic acid deficiency [54]
Anticonvulsants (carbamazepine, valproic acid, gabapentin, phenobarbital, phenytoin and primidone) Treatment of epilepsy and neuropathic pain Vitamin B6 and folic acid deficiency [59]
Cycloserine Anti-tuberculosis agent Vitamin B6 deficiency [62]
Penicillamine Immunosuppression to treat rheumatoid arthritis Vitamin B6 deficiency [63]
Hydrocortisone Immune system suppression Vitamin B6 deficiency [48]
Mercaptopurine Immunesuppressive agent Vitamin deficiency [64]
Methotrexate Treatment of cancer and autoimmune diseases Folic acid deficiency [65]
Sulfasalazine Rheumatoid arthritis treatment Folic acid deficiency [66]
Triamterene Treatment of hypertension and edema Folic acid deficiency [67]
Chemotherapy Cancer treatment Changes of oral microcirculation [69, 70]
Bleomycin Cancer treatment Tissutal hypoxia [69, 70]
Bisphosphonates (alendronate, etidronate and risedronate) Metastatic prevention, treatment of osteoporosis and arthritis rheumatoid Xerostomia, alteration of cellular turnover [72]
Antidepressants (clomipramine, doxepin) Tricyclic antidepressants Xerostomia, anemia (rare) [73]
Fluoxetine Antidepressant Xerostomia, gastrointestinal disorders [68]
Venlafaxine Antidepressant Xerostomia, gastrointestinal disorders [68]
Fluvoxamine Treatment of obsessive-compulsive disorder and major depressive disorder Xerostomia, gastrointestinal disorders [68]
Serteraline Antidepressant Gastrointestinal disorders determining malabsorption [68, 73]
Antibiotics Antibacterial activity Candidiasis, gastrointestinal disorders [48]
Rivastigmine Treatment of dementia of the Alzheimer’s type and dementia due to Parkinson's disease. Gastrointestinal disorders [74]
Sulfonamides Various Hemolytic anemia [48]
Trihexyphenidyl Antiparkinsonian agent Xerostomia [48]

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