What is drug-induced interstitial lung disease (ILD)?
Drug-induced interstitial lung disease (ILD) is caused by medicines or treatments.
Very rarely, certain medicines or treatments can cause your lungs to become inflamed and scarred. Around 3 to 5% of ILDs are caused by medicines or treatments.
Non-urgent advice: What is an interstitial lung disease (ILD)?
An interstitial lung disease is a lung condition that affects the tissues that support the tiny air sacs (alveoli) in your lungs. This group of tissue is called the interstitium.
Find out more about how an ILD like drug-induced ILDs affect your lungs and airways.
What medicines cause a drug-induced ILD?
Drug-induced ILD is very rare, but a small number of medicines or treatments have been linked to inflammation and scarring of the lungs. Scarring of the lungs is called pulmonary fibrosis.
Before starting any new medicine or treatments, talk to your GP about the risks and benefits, and any side effects you’re worried about.
Some medicines or treatments that may increase your risk of a drug-induced ILD are:
- the antibiotic nitrofurantoin
- drugs for heart conditions such as amiodarone
- chemotherapy drugs used to treat cancer such as cyclophosphamide and bleomycin
- biologic therapies used to treat cancer and autoimmune conditions.
If you have scarring of the lungs (pulmonary fibrosis), some medicines or treatments may not be suitable for you. Your healthcare team can help you understand the risks and benefits of starting any medicines or treatments.
What are the symptoms of drug-induced ILD?
Drug-induced ILDs affect everyone differently. Some people have few or no symptoms.
Symptoms of drug-induced ILD can appear within a few weeks to months of starting treatment. They are:
- breathlessness
- a cough that does not go away
- fever
- rash
- a sharp pain that happens when breathing, coughing or sneezing.
Tell your GP about any new or worsening symptoms, especially if you’ve started taking a new medicine.
How is drug-induced ILD diagnosed?
Your GP will ask about your symptoms, when you get them and anything you think that might trigger them. They’ll also ask about your medical and family history.
Your GP will check any medicines that you’re currently taking or have taken in the past.
They may also refer you for tests, including:
If your GP thinks you may have an ILD, they will refer you to a respiratory specialist for more support.
Your diagnosis will be confirmed by a team of experts, called a multi-disciplinary team. It can take time to diagnose a drug-induced ILD because the symptoms are often the same as other lung conditions.
Find out more about the tests used to diagnose ILDs.
How is drug-induced ILD treated?
Your GP and specialist team can help you find out the cause of your condition. Once they know the drug that caused the reaction, they may advise you to stop taking it and change the medicine as soon as possible.
Most drug-induced ILDs do not get worse once you stop taking the medicine or treatment
Always speak to your GP, respiratory specialist or other healthcare professional before stopping any medicine you’ve been prescribed.
If your symptoms are not improving, you may be prescribed medicines such as:
- corticosteroids to reduce lung inflammation
- immunosuppressants, if corticosteroids are not reducing your lung inflammation.
How is drug-induced ILD managed?
Your respiratory specialist will review your symptoms and do some lung function tests to see how well your treatments are working.
Most people will have a review at least once a year. If you’re having treatment at a specialist hospital, you may be seen every 3 to 4 months until your condition is stable.
If you’re breathless, your specialist may refer you for pulmonary rehabilitation (PR).
You may also be prescribed home oxygen therapy if you have low oxygen levels in your blood.
Read more about how to manage ILDs like drug-induced ILD.
What is the outlook for drug-induced ILD?
Most people can make a good recovery when they stop the medicines or treatments that are causing their reaction. An early diagnosis is important help to prevent your condition from getting worse.
The outlook of your drug-induced ILD can depend on:
- the medicine or treatment that caused the reaction
- how much lung scarring you have, if you have any
- your general health.
Your specialist team can advise you about what to expect and how to manage your condition. Get more support to help you manage and live well with an ILD.
If your drug-induced ILD has caused pulmonary fibrosis, you may be prescribed an antifibrotic (anti-scarring), like nintedanib. Making lifestyle changes can also help you manage your symptoms.
Help and support for drug-induced ILD
Meeting other people who are living with lung conditions, who relate with your experiences, can help you build a supportive network.
- Join one of our online communities on Health Unlocked forum to connect with other people with similar experiences to you.
- Find support in your area, including online and face to face support groups, mobility and wellbeing sessions, and singing for lung health sessions.
- Get in touch with our friendly helpline to talk about any aspects of your lung condition. We’ll give you as much time as you need to talk about what’s important to you.
Action for Pulmonary Fibrosis has information about support groups for anyone living with and affected by pulmonary fibrosis, including friends, family and carers.
How we develop our health information
About our health information
All our information is reviewed and updated by Asthma + Lung UK’s experienced Health Advice Team. People living with lung conditions, qualified healthcare professionals and specialists also review our content.
This information has been clinically reviewed and approved by Asthma + Lung UK’s Clinical Leads, Dr Matthew Swallow, a practising GP, and Nazir Hussain, a specialist pharmacist, who share a passion for improving respiratory care.
Our information is based on the latest, trustworthy evidence and guidelines. Below is a sample list of the sources referenced in our drug-induced ILD information.
- Spagnolo P, Bonniaud P, Rossi G et al. Drug-induced interstitial lung disease. European Respiratory Journal. 2022
- Wells, AU & Hirani N. Interstitial lung disease guideline. Drug-induced ILD: classification with examples. Thorax. 2008
If you'd like a full list of the sources we've used to produce our health information, you can email us at healthadvicequeries@asthmaandlung.org.uk.
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