LHON and Drugs to avoid

Drugs to Avoid

As well as avoiding smoke and alcohol, people carrying a LHON gene should avoid the following drugs, as they have been quoted as possible LHON triggers in research.

These cases are usually where a prolonged course and/or a particularly strong antibiotic has been used.  In many cases the eyesight has recovered if the medication is stopped as soon as the effect on vision is reported by the patient.

At the 2015 LHON day the scientific panel’s opinion was that a standard two-week course of antibiotic is very unlikely to cause any problems for anyone with a LHON gene mutation.

CYANOCOBALAMIN ( a common form of Vitamin B12).

Many drug manufacturers warn that people with LHON or carrying a LHON gene mutation should not take Cyanocobalamin.  This seems to be based on a very old  (1960’s) theory that optic nerve damage in many diseases, including LHON, is due to a build up of cyanide in the body.  This theory was discredited in the 1980’s (3479705)

Biochemistry of Brain  by Sudhir Kumar published in 1980  refers to this theory in the section on Vitamin B12, effects of alcohol, tobacco and LHON.  This might explain the source of this idea.

In the 1970’s someone produced a list of “foods containing cyanide to avoid” based on the same out-of-date theory.  Even in the 21st century   some people ask about foods they should avoid.

Don’t be worried by the term CYANIDE.  Crime writers have made it notorious as a deadly poison, but in fact our bodies handle tiny amounts of cyanide all the time in the natural processes of digestion and metabolism.

Pure cyanide in the form of HCN (Prussic Acid) is the deadly poison with the “smell of bitter almonds” that crime writers used to love.

In the human body, there is a constant balance between two forms of Vitamin B12, Hydroxycobalamin and Cyanocobalamin.

If your doctor wants to treat you with injections of Vitamin B12 and you want to avoid Cyanocobalamin, then look for medications containing Hydroxycobalamin or trade names Cobalin-H® , Neo-Cytamen®

Hydroxycobalamin medicine entry on Drugs.com

Another form of Vitamin B12 often sold in tablets by health food and diet supplement stores is METHYLCOBALAMIN.

A cell culture study has shown that Methylcobalamin is more easily absorbed than Cyanacobalamin, and is as effective as Hydroxycobalamin in forming the “active” Cobalamin form needed by the body. (8487649)



CHLORAMPHENICOL antibiotic used against major infectioins such as typhoid fever (8091248)(23681241)

COCAINE (17334960#)


ERYTHROMYCIN antibiotic (16120371) (23681241)

ETHAMBUTOL antibiotic for Tuberculosis (16767386)(8091248) (23681241)(20491810)(12527998) (16921234) Although the exact effect of Ethambutol on mitochondria in LHON is unclear. (19130740)

ISONIAZID antibiotic  (8091248)

LINEZOLID antibiotic  (23681241)

PROPOFOL anesthetic often used in children.  An adult patient died when sedated for five days with Propofol after a head injury.  The LHON mutation and Complex I dysfunction it causes   seems to have triggered Propofol Infusion Syndrome (PRIS). (22260353)


RAPAMYCIN antibiotic (16921234)

RISPIRIDONE antipsychotic drug for schizophrenia (23059157)

STREPTOMYCIN antibiotic  (23681241)

TADALAFIL  for erectile dysfunction (21275598)

TELITHROMYCIN antibiotic (17334960#)

Protective effect of Tetracycline

Although one or two web sites say Tetracycline should be avoided, the scientific evidence does not support this.

Tetracyclines such as Doxycycline are known to inhibit gene expression in mitochondria and are used in researh labs to artificially stress mitochondria.  (25772356)

Howver the effect is described as reversible and there are other effects, such as suppression of Reactive Oxygen Species and reduced Apoptosis (Programmed Cell Death).  These factors give Tetracyclines a protective effect for neurodegenerative disorders including LHON (25772356)

There is some lab evidence based on testing cell cultures that Minocycline might protect cells against the effects of a LHON mutation. (17822909)

This page was last updated September 14 2015


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