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Skin Disease and Medications

Adverse Drug Reaction Probability Scale

Question

Yes

No

Do not know

1.  Are there previous conclusive reports of this reaction?

+1

0

0

2.  Did the adverse event appear after the suspected drug was administered?

+2

-1

0

3.  Did the adverse reaction improve when the drug was discontinued or a specific antagonist was administered?

+1

0

0

4.  Did the adverse reaction reappear when the drug was readministered?

+2

-1

0

5.  Are there alternative causes (other than the drug) that could on their own have caused the reaction?

-1

+2

0

6.  Did the reaction reappear when a placebo was given?

-1

+1

0

7.  Was the drug detected in the blood (or other fluids) in concentrations known to be toxic?

+1

0

0

8.  Was the reaction more severe when the dose was increased, or less severe when the dose was decreased?

+1

0

0

9.  Did the patient have a similar reaction to the same or similar drugs in any previous exposure?

+1

0

0

10.  Was the adverse event confirmed by any objective evidence?

+1

0

0

  

Definite association; score = or > 9

 

 

 

Probable association; score 5 to 8

 

 

 

Possible association; score 1 to 4

 

 

 

Doubtful association; score = or < 0

 

 

 

Naranjo CA, Busto U, Sellers EM, et al. A method for estimating the probability of adverse drug reactions.  Clin Pharmacol Ther 1981; 30 (2): 239-45.

Drug Reaction Classification

Classification of drug reactions

Type I: immediate-type immunologic reaction: IgE mediated urticaria/angioedema, anaphylactic shock ex: penicillin

Type II: cytotoxic reaction:  1) drug plus cytotoxic antibodies cause cell lysis (platelets and leukocytes) ex: cephalosporins, penicillin, rifampin, sulfonamides   2) drug plus antibodies form immune complexes and cause lysis or phagocytosis ex: chlorpromazine, isoniazid, quinidine, quinine, salicylamide, sulfonamides, sulfonylureas

Type III: serum sickness, vasculitis: IgG or IgM antibodies form to drug resulting in deposition of immune complexes in small vessels, activated by complement and recruitment of granulocytes; onset 5-7 days after drug introduction.  Agranulocytosis, alveolitis, arthritis, hemolytic anemia, nephritis, thrombocytopenia, urticaria-like lesions, vasculitis

Type IV: morbilliform exanthematous reactions: cell-mediated immune reaction by sensitized lymphocytes reacting with drug, releasing cytokines

Type I reactions

angioedema, urticaria

Type III reactions

angioedema, exanthematous(?),fixed drug(?),Stevens-Johnson s., TEN, urticaria, vasculitis

Type IV reactions

bullous, exanthematous, fixed drug(?), lichenoid(?), photoallergic, Stevens-Johnson s.(?), TEN(?)

Life threatening reaction signs & symptoms

general: arthralgias/arthritis, dyspnea, fever  > 40° C, hypotension, lymphadenopathy, wheezing

laboratory: abnormal LFTs, atypical lymphocytes, eosinophilia >1000/ul, lymphocytosis

skin: angioedema, confluent erythema, laryngeal/glossal edema, mucous membrane erosions, necrosis, Nikolsky’s sign, painful skin, palpable purpura, urticaria

Skin Disease and Medications

acanthosis nigricans

corticosteroids, diethylstilbestrol, estrogen, fusidic acid, hydantoin, INH, insulin, methyl testosterone, niacinamide, nicotinic acid, OCPs, pituitary extract, triazinate

acneiform eruption

ACTH, actinomycin D, amoxapine, androgens, azathioprine, corticosteroids, cyclosporine, dactinomycin, dilantin, ethambutol, ethionamide, fluoxymesterone, halogens, haloperidol, isoniazid, lithium, medroxyprogesterone, OCPs, phenobarbital, phenytoin, psoralen, quinine, tar, trimethadione, vinblastine, vitamin B12 (cyanocobalamin)

acral erythema

chemotherapeutics, cytosine arabinoside, doxorubicin, etoposide, fluorouracil, hydroxyurea, mercaptopurine, methotrexate, mitoxantrone

acrodynia

mercury

actinic keratoses (inflammation)

docetaxel, doxorubicin, fluorouracil, pentostatin, dactinomycin/vincristine/dacarbazine, doxorubicin/cytarabine/6-thioguanine, doxorubicin/vincristine, fluorouracil/cisplatin

allergic contact dermatitis

cisplatin, daunorubicin, doxorubicin, 5-fluorouracil (topical and IV), mechlorethamine, mitomycin

alopecia

allopurinol, anticoagulants, antithyroid drugs, b-blockers, bismuth, boric acid, bromocriptine, carbimazole, chemotherapeutics, chloramphenicol, cimetidine, clomiphene, colchicine, diazoxide, dilantin, ethionamide, fluorobutyrphenone, gentamicin, heavy metals, hydantoin, hypocholesterolemics, indomethacin, interferon-a, levodopa, methyldopa, metoprolol, NSAIDs, OCPs, piroxicam, potassium thiocyanates, propranolol, quinacrine, retinoids, Rozaxane, testosterone, thallium, thyroid drugs, trimethadione, thiouracil, triparanol, valproate, vitamin A

alopecia, chemotherapeutic agents

aminocamptothecin, amsacrine, bleomycin, carmustine, chlorambucil, cyclophosphamide, cytarabine, dacarbazine, dactinomycin, daunorubicin, doxorubicin, epirubicin, etoposide, fluorouracil, hydroxyurea, idarubicin, ifosfamide, irinotecan, mechlorethamine, melphalan, methotrexate, mitomycin, mitoxantrone, paclitaxel, teniposide, thiotepa, topotecan, vinblastine, vincristine, vindesine, vinorelbine

alopecia, permanent

busulfan (high dose)

anagen effluvium (inducers)

alkylating agents, antimetabolites, bleomycin, boron cyclophosphamide, mitotic inhibitors, thallium, thiouracil

anetoderma

penicillamine

basal cell carcinoma

arsenic

black hairy tongue

methyldopa, penicillin, tetracycline

Bowen’s disease

arsenic

bullous eruptions

arsenic, barbiturates, bromides, halides, iodides, mercury, penicillin, phenolphthalein, salicylates

bullous pemphigoid

amoxicillin, dactinomycin/methotrexate, fluorouracil, furosemide, penicillin, PUVA, sulfasalazine

candidiasis

tetracyclines

capillaritis (purpura simplex)

aminoglutethimide

carcinogens, chemical

arsenic, 4,4’-bipyridyl, coal tar, immunosuppressants, nitrogen mustard, petroleum oils, PCB, pitch, psoralen, soot

cellulitis

antineoplastic agents, doxorubicin, 5-FU, mithramycin

ceruloderma

blue pigmentation; amiodarone, atabrine, bismuth, chloroquine, gold, iron lead, minocycline, mercury, silver

chilblains-like erythema

coumadin, phenindione, sulindac

color changes of skin due to chemical (also see pigmentation)

black: mercury, osmium trioxide

blue: cobalt, indigo, oxalic acid (radiator cleaners), silver nitrate, silvadene

brown: chrysarobin, anthralin, paraphenylenediamine, permanganates, phenothiazines

green: copper dust

orange: chlorine gas, phenothiazine, trinitrophenylmehtylnitramine

red: soda ash, TNT

yellow: dichromate, dinobuton, fluorescein dye, glutaraldehyde,

cutaneous reactions, most common

in order: amoxicillin, trimethoprim-sulfamethoxazole, ampicillin, blood products, penicillin (semi-synthetic), penicillin G, acetylcysteine, allopurinol, gentamicin, barbiturates, metoclopramide, atropine, heparin, furosemide, diazepam, potassium chloride

cutaneous reactions, none or very rare

acetaminophen, aminophylline, aspirin, codeine, digoxin, diphenhydramine, docusate sodium, ferrous sulfate, flurazepam, insulin, isosorbide dinitrate, magnesium sulfate, methyldopa, milk of magnesia, nitroglycerin, potassium iodide, prednisone, promethazine, prochlorperazine, propranolol, spironolactone

cutis laxa

isoniazid, penicillamine, penicillin, tryptophan

Darier’s d.

ethyl chloride, lithium, phenol

delusion of parasitosis

atropine, methylphenidate, phenelzine

dermatitis herpetiformis (flare)

cyclophosphamide/doxorubicin/vincristine, iodides (exacerbate)

dermatomyositis-like

aspirin, diclofenac, hydroxyurea (long term), niflumic acid, penicillamine, practolol, tamoxifen, tegafur, tryptophan

discoid lupus erythematosus

penicillamine

drug reactions, common types

acanthosis nigricans, alopecia, annular erythema, bullous, dermatomyositis, eczematous, elastosis perforans serpiginosa, EM, erythema nodosum, erythrodermic/exfoliative, erythromelalgia, exanthematous (maculopapular), fixed, hidradenitis, hypertrichosis, ichthyosiform, lichenoid, lupus, lymphomatoid, panniculitis, pemphigoid, pemphigus, photosensitivity, pigmented, pityriasiform, porphyria, pseudoporphyria, psoriasiform, purpuric, pustular, sclerodermoid, Stevens-Johnson s., TEN, urticarial, vasculitic

eczema

aminophylline, antibiotics, antihistamines, arsenic, b-blockers, carbamazepine, chloral hydrate, disulfiram, diuretics, fluorouracil, gold, HMG-CoA reductase inhibitors, hypoglycemics, meprobamate, mercurials, minoxidil, neomycin, nystatin, penicillin, phenothiazines, procainamide, quinacrine, quinidine, resorcinol, streptomycin, sulfonamides, thiazide diuretics

elastosis perforans serpiginosa

penicillamine, thiopronine

eosinophilic fasciitis

L-tryptophan (contaminated)

eruption, exanthematous (chemotherapeutic agents)

bleomycin, carboplatin, cis-dichloro-trans-dihydroxy-bis-isopropylamine platinum (CHIP), chlorambucil, cytarabine, docetaxel, diethylstilbestrol, doxorubicin etoposide, 5-fluorouracil, hydroxyurea, methotrexate, mitomycin C, mitotane, mitoxantrone, paclitaxel, pentostatin, procarbazine, suramin, thiotepa

erythema annulare centrifugum

chloroquine, cimetidine, estrogens, penicillin, plaquenil, progesterone, salicylates

erythema multiforme

allopurinol, aminopenicillins, anticonvulsants (carbamazepine, diphenylhydantoin, phenobarbital, trimethadione), barbiturates, busulfan, bleomycin/cisplatin, bleomycin/cisplatin/vinblastine, carbamazepine, cephalosporin, chlorambucil, cimetidine, ciprofloxacin, codeine, cyclophosphamide, danazol, diethylstilbestrol, etoposide, furosemide, glutethimide, griseofulvin, hydantoins, hydroxyurea, lithium, mechlorethamine (IV), methotrexate, minoxidil, mitomycin C, mitotane, NSAIDs, oxyphenbutazone, paclitaxel, penicillamine, penicillin, phenobarbital, phenolphthalein, phenothiazines, phenylbutazone, prazosin, pyritinol, rifampin, salazopyrin, salicylates, streptomycin, sulfonamides, sulfonylureas, suramin, tetracycline, trimethoprim

erythema multiforme-like

antihistamines, DNCB, DPCP, IPPD, rosewood, Rhus, sulfonamides

erythema multiforme, contactants

chemicals: brominated compounds, N-hydroxyphthalamide, phenyl sulfone derivatives, dinitrochlorobenzene

medications, topical: econazole, ethylenediamine, idoxuridine, iodochlorhydroxyquin, mafenide acetate, mephenesin, neomycin, povidone iodine, proflavine, promethazine, pyrrolnitrin, scopolamine, sulfonamide, vitamin E

metals: cobalt, nickel sulfate

plants: poison ivy, primula, terpenes, St. John’s wort

other: epoxy resin, formaldehyde, isopropyl-p-phenylenediamine, soap, spray cologne, trichlorethylene, tropical wood (rio rosewood, pao ferro)

erythema nodosum

amidopyrine, bromides, busulfan, 13-cis-retinoic acid, diethylstilbestrol, estrogen, gold, halogens, isotretinoin, OCPs, penicillin, phenacetin, salicylates, sulfonamides, sulfones, sulfonylureas, tetracycline, thiazides, vaccines

erythema, acral

cisplatin, cyclophosphamide, cytarabine, daunorubicin, docetaxel, doxifluridine, doxorubicin, etoposide, floxuridine, fluorouracil, hydroxyurea, idarubicin, lomustine, melphalan, mercaptopurine, methotrexate, mitomycin, mitotane, paclitaxel, suramin, tegafur, vincristine

erythermalgia

bromocriptine, nicardipine, nifedipine, verapamil

erythroderma

acetylsalicylic acid, captopril, clofazimine, co-trimoxazole, etretinate, fenbufen, gentamicin, GM-CSF, ketoconazole, methotrexate, minoxidil, nystatin, oxytetracycline, phenobarbital, quinidine, sulfasalazine, sulfonamides, timolol

erythromelalgia

bromocriptine, nifedipine, pergolide

exanthematous eruption

allopurinol, amphotericin B, atropine, barbiturates, benzodiazepines, calcium channel blockers, captopril, carbamazepine, chloramphenicol, cisplatin, diltiazem, erythromycin, gentamicin, GM-CSF, gold, hydantoin, hypoglycemics, isoniazid, lithium, methazolamide, nitrofurantoin, NSAIDs, penicillins, phenothiazines, phenylbutazone, phenytoin, quinidine, streptomycin, sulfonamides, tetracyclines, thiazides, trazodone

exfoliative dermatitis (exfoliative erythroderma)

allopurinol, aminoglycosides, amiodarone, antimalarials, arsenic, aspirin, aztreonam, BAL, barbiturates, calcium channel blockers, captopril, carbamazepine, cefoxitin, cephalosporins, chlorambucil/busulfan, chloroquine, chlorpromazine, chlorpropamide, cimetidine, cisplatin, codeine, co-trimoxazole, dapsone, diltiazem, desipramine, diphenylhydantoin, ethylenediamine, fluorouracil, gold, griseofulvin, hydantoins, imipramine, indinavir, iodine, isoniazid, isotretinoin, lithium, mefloquine, mephenytoin, mercury, methotrexate, mexiletine, minocycline, neomycin, nifedipine, nitrofurantoin, penicillin, phenindione, phenobarbital, phenothiazines, phenylbutazone, phenytoin, pyrazolone derivatives, quinacrine, quinidine, ranitidine, rifampin, streptomycin, sulfonamides, sulfonylureas, terbutaline, thalidomide, thiazides, trimethadione, trimethoprim, trazodone, vancomycin

fixed drug eruption

acetaminophen, acetylsalicylic acid, aminosalicylic acid, ampicillin, anticonvulsants, antifungals, antimalarials, arsenicals, aspirin, barbiturates, benzodiazepines, butazolidin-alka, chlordiazepoxide, ciprofloxacin, dacarbazine, dapsone, dextromethorphan, diflunisal, diphenhydramine, erythromycin, fiorinol, fluoroquinolones, gold, heroin, hydroxyurea, ibuprofen, meprobamate, metronidazole, minocycline, naproxen, norfloxacin, NSAIDs, nystatin, OCPs, opiates, oxyphenylbutazone, paclitaxel (bullous), paracetamol, penicillins, phenacetin, phenolphthalein, phenylbutazone, piroxicam, procarbazine, Quaalude, quinidine, quinine, salicylates, sulfonamides, sulindac, tetracycline, tolmetin, trimethoprim-sulfamethoxazole

flushing

alizapride, amyl nitrite, asparaginase, bleomycin, bromocriptine, butyl nitrite, capsaicin, carboplatin, carmustine, cholinergic drugs, cisplatin, cyclophosphamide, cyclosporine, cyproterone acetate, dacarbazine, didemnin B, diethylstilbestrol, diltiazem, docetaxel, doxorubicin, etoposide, fluorouracil (IV/topical), flutamide, interferons, leuprolide, lomustine, metoclopramide, mithramycin, morphine, niacin, nicotinic acid, nifedipine, opiates, paclitaxel, plicamycin, procarbazine, rifampin, suramin, tamoxifen, teniposide, thyrotropin-releasing hormone, trimetrexate, vancomycin, verapamil

EtOH following; b-lactams, calcium carbamide, cefamandole, cefoperazone, chloramphenicol, chlorpropamide, disulfiram, griseofulvin, industrial chemicals (trichloroetylene, N-dimethylformamide, N-butyraldoxime), ketoconazole, metronidazole, moxalactam, phentolamine, quinacrine, sulfonylureas

flushing (pharmacologic menopause)

4-hydroxyandrostenedione, danazol, tamoxifen, clomiphene citrate, decapeptyl, leuprolide

folliculitis

dactinomycin, daunorubicin, fluorouracil, methotrexate, tar

furuncle

fluoxymesterone, methotrexate

gingival hyperplasia

cyclosporine, diltiazem, nifedipine, phenytoin (hydantoin derivatives), verapamil

hair color change

bleomycin (and combinations), cisplatin, cyclophosphamide (and combinations), methotrexate, tamoxifen

hair hyperpigmentation

actinomycin, bleomycin, cyclophosphamide, daunorubicin, doxorubicin, melphalan

hair pigment loss

bleomycin, chloroquine, haloperidol, mephenesin, nafoxidine

Henoch-Schönlein purpura

ampicillin, erythromycin, penicillin, quinidine, quinine

hirsutism

ACTH, astezolamide, corticosteroids, cyclosporin, diazoxide, diethylstilbestrol, dilantin, fluoxymesterone, hexachlorobenzene, minoxidil, penicillamine, phenytoin, tamoxifen

histamine-releasing

aspirin, bacteria toxins, chlortetracycline, codeine, compound 48/80, decamethonium, dextran, D-tubocurare, estrogen, EtOH, gallimine, gastrin, meperidine, morphine, NSAIDs, polymyxin antibiotics, quinine, radiocontrast media, scopolamine, snake venom, substance P, thiamin, vancomycin

hyperpigmentation, Addisonian

ACTH, busulfan (sun-exposed), 5-FU

hyperpigmentation, chemotherapeutic agents

bleomycin, brequinar sodium, busulfan, carmustine, cisplatin, cyclophosphamide, dactinomycin, daunorubicin, docetaxel, doxorubicin, fluorouracil, fotemustine, hydroxyurea, ifosfamide, mechlorethamine, methotrexate, mitoxantrone, plicamycin, procarbazine, tegafur, thiotepa, vinorelbine

hyperpigmentation, dermal

melanotic: fixed drug eruption

non-melanotic: amiodarone, antimalarials, arsenic, bismuth, gold, iron, lead, mercury, minocycline, OCPs, PCB poisoning, phenothiazine, silver

hyperpigmentation, linear

bleomycin, zidovudine

hyperpigmentation, melasma-like

estrogen, mephenytoin, phenytoin

hyperpigmentation, mucosal

busulfan, cisplatin, cyclophosphamide, doxorubicin, fluorouracil, hydroxyurea, tegafur

hyperpigmentation, palms & soles

cyclophosphamide, dibromomannitol, doxorubicin, procarbazine

hypertrichosis

acetazolamide, anabolic steroids, bromocriptine, corticosteroids, cyclosporine, danazol, diazoxide, digoxin, diphenylhydantoin, dyazide, erythropoietin, estrogen, fenoterol, hydantoin, metyrapone, minoxidil, oxadiazolopyrimidine, penicillamine, phenothiazines, phenytoin, progesterone, psoralen, spironolactone, streptomycin, tacrolimus, testosterone, thyroid hormones

ichthyosiform, ichthyosis (acquired)

allopurinol, butyrophenone, cimetidine, clofazimine, dyrazine, ergocalciferol, hydrochlorothiazide, nafoxidine, nicotinic acid, retinoids, triparanol

hypocholesterolemics; butyrophenones, diazacholesterol, dixyrazine, nicotinic acid, triparanol

intertrigo

amoxicillin, cefazolin, clindamycin, metronidazole

keloid

insulin

keratoderma

gold salts

lens opacities

chloroquine, chlorpromazine

lichenoid

ACE inhibitors, aminosalicylic acid, antimalarials, antimony, antipsychotics, anti-tuberculous agents, arsenic, b-blockers, bismuth, calcium channel blockers, captopril, carbamazepine, chloroquine, dapsone, demeclocycline, color film processors, furosemide, gold, hydroxyurea, hypoglycemics, iodide (contrast), isoniazid, ketoconazole, levamisole, lithium, mercury, methyldopa, NSAIDs, paraphenylenediamine, penicillamine, phenothiazines, phenytoin, propranolol, pyrimethamine, quinidine, quinine, spironolactone, streptomycin, sulfasalazine, sulfonylureas, tegafur, tetracycline, thiazides

lichenoid contact dermatitis

aminoglycosides, color film developer, dental restoration materials, gold, mercury, silver

lichenoid-oral

ACE inhibitors, allopurinol, cyanamide, dental restoration materials, gold salts, ketoconazole, methyldopa, NSAIDs, penicillamine, sulfonylureas

lichenoid-photodistributed

5-FU, carbamazepine, chlorpromazine, diazoxide, ethambutol, furosemide, pyritinol, quinidine, quinine, tetracyclines, thiazides

linear IgA d.

amiodarone, ampicillin, captopril, cefamandole, cyclosporine, diclofenac, glibenclamid, glucophage (?), IFN-g, IL-2, iodine, lithium, penicillin G, phenytoin, somatostatin, trimethoprim/sulfamethoxasole, vancomycin, vigabatrin

lipoatrophy

insulin

livedo reticularis

amantadine, quinidine, quinine

lupus erythematosus

allopurinol, aminoglutethimide, b-blockers, captopril, carbamazepine, chlorthalidone, chlordiazepoxide, chlorpromazine, cimetidine, clofibrate, diethylstilbestrol, dilantin, ethosuximide, gold, griseofulvin, hydantoin, hydralazine, hydroxyurea, isoniazid, leuprolide, levodopa, lithium, lovastatin, methyldopa, methysergide, nitrofurantoin, OCPs, penicillamine, penicillin, phenothiazines, phenylbutazone, phenytoin, procainamide (25%), quinidine, reserpine, streptomycin, sulfonamides, tegafur, tetracycline, thiouracil, trimethadione

lupus erythematosus, subacute cutaneous

gold, photosensitizing medications, thiazides

mastocytosis, cutaneous

provoke; anticholinergic medications, EtOH, narcotics, polymyxin B sulfate, salicylates

medications; most common reactions

amoxicillin 5%, trimethoprim-sulfamethoxazole 3%, ampicillin 3%, blood products 2%, semi-synthetic penicillins 2%, penicillin G 2%, acetylcysteine 0.9%, allopurinol 0.8%, gentamicin 0.5%, barbiturates 0.4%, metoclopramide 0.3%, atropine 0.2%, heparin 0.1%, furosemide 0.05%, diazepam 0.04%, potassium chloride 0.03%

medications; rare (or no) reaction

acetaminophen, aminophylline, antacids, aspirin, codeine, digoxin, diphenhydramine, docusate sodium, ferrous sulfate, flurazepam, insulin, isosorbide dinitrate, magnesium, methyldopa, milk of Magnesia, nitroglycerin, potassium iodide, prednisone, prochlorperazine, promethazine, propranolol, spironolactone

melanonychia

AZT, bleomycin, cyclophosphamide, ketoconazole, minocycline, psoralen

melasma

OCPs

morbilliform eruption

see exanthematous eruption

morphea

penicillamine

mucositis

retinoids

nail color change

blue: antimalarials, argyria, arsenic, chlorpromazine, ketoconazole, mercury, sulfa

yellow: amphotericin B, beta-carotene, chromium salts, dinitrophenol, DNCB, fluorescein, penicillamine, tars, tetracycline

neutrophilic eccrine hidradenitis

bleomycin, chlorambucil, cyclophosphamide, cytarabine, doxorubicin, lomustine, mitoxantrone

ochronosis, exogenous

inhibition of sulfhydryl group of homogentisic acid oxidase; hydroquinone, mepacrine, phenol, quinacrine, resorcinol

onycholysis

doxycycline, 8-methoxypsoralen, minocycline, tetracycline, thiazides

panniculitis

bromine, iodine, penicillin, phenacetin, pyritinol, sulfathiazole

papules, keratotic

suramin

pellagra-like

anticonvulsants, antidepressants, chloramphenicol, 5-fluorouracil, isoniazid, 6-mercaptopurine, sulfapyridine

pemphigoid

ampicillin, captopril, furosemide, penicillamine, penicillin, phenacetin, psoralens, PUVA, sulfa drugs, thiol derivatives

pemphigus, drug-induced

aminophenazone, ampicillin, aminopyrine, aspirin (with ampicillin,indomethacin, penicillin, rifampin), aurothioglucose, azapropazone, captopril, cephalexin, ceftraxone sodium, digoxin, enalapril, ethambutol HCL, 5-FU (topical), furosemide, gold sodium thiomalate, heroin, hydantoin, ibuprofen, indomethacin, interleukin 2, interferon b, isoniazid, levodopa, lysine acetylsalicylate, meprobamate, mercaptopropionylglycine, methimazole, nalidixic acid, nifedipine, optalidon, oxyphenylbutazone, pentachlorophenol, penicillamine, penicillin, phenacetin, phenylbutazone, phosphamide, phenobarbital, piroxicam, practolol, progesterone, propranolol, pyritinol, rifampin, sulfasalazine, thiopronine, thiopyridoxine, tincture of benzoin

pemphigus erythematosus

penicillamine

pemphigus vegetans

captopril

pemphigus vulgaris

penicillamine, penicillin, rifampin, thiopronine

persistent light reaction

musk ambrette, salicylanilides

petechiae, non-palpable

aspirin, heparin, quinine, quinidine,

photoallergic drug reaction

amiodarone, antidepressants, antifungals, antimalarials, benzodiazepines, griseofulvin, hypoglycemics, musk ambrette, 6-methylcoumarin, NSAIDs, OCPs, PABA esters, phenothiazines, sulfonamides, sulfonylureas, thiazides, vinblastine

photosensitizing

amiodarone, antidepressants, chloroquine, fluoroquinolones, fluorouracil, griseofulvin, methotrexate, nalidixic acid, NSAIDs, phenothiazines, sulfonamides, sulfonylureas, tetracyclines, thiazides, vinblastine (also see following section)

phototoxic drug eruption

medications; amiodarone, anthracene, benoxaprofen, brequinar sodium, chloroquine, chlorpromazine, dacarbazine, dactinomycin, demeclocycline, doxorubicin, doxycycline, 5-fluorouracil, furosemide, griseofulvin, HCTZ, hydroxyurea, methotrexate, mitomycin C, nalidixic acid, naproxen, NSAIDs, PABA, phenothiazines, piroxicam, porphyrins, procarbazine, psoralen, quinidine, sulfanilamide, sulfonamides, sulfonylureas, tegafur, tetracycline, thiazides, tolbutamide, vinblastine

other; dye (eosin, methylene blue), fumocoumarins (fragrance, lime, celery, parsnip, fig), hemotroporphyrin, tar

phytophotodermatitis

bergamot, carrot (wild), cow parsnip, dill, fennel, gas plant, Persian lines, rue (common)

pigmentation-blue

amiodarone-slate blue, argyria-slate blue, bismuth-blue black on gingival margin, bleomycin-flagellate pigmentation, chloroquine-blue gray, minocycline-brown, gray, blue black in acne scar, plaquenil-blue black, tetracycline-blue cutaneous osteomas

pigmentation-brown

ACTH, arsenic, minocycline, OCPs, phenytoin

pigmentation-gray

chlorpromazine, minocycline

pigmentation-red

methysergide, rifampin-red man syndrome

pigmentation-yellow

cathaxanthin, phenazopyridine, quinacrine

pityriasiform, pityriasis rosea-like

acetylsalicylic acid, arsenic, barbiturates, b-blockers, bismuth, captopril, clonidine, gold, griseofulvin, isoniazid, isotretinoin, ketotifen, mercurials, methoxypromazine, metronidazole, NSAIDs, omeprazole, penicillamine, penicillin, pyribenzamine, salvarsan, tripelennamine

porphyria

cisplatin (also see following section)

porphyria cutanea tarda)

androgens, busulfan, chloroquine, cyclophosphamide, dapsone, diethylstilbestrol, estrogen, EtOH, furosemide, griseofulvin, hexachlorobenzene, hydroxychloroquine, methotrexate, nalidixic acid, naproxen, OCPs, pyridoxine, quinidine, quinine, rifampin, sulfonylureas, tetracycline, 2,4,5-trichlorophenol (also see following section

porphyria, acute intermittent

chlorambucil, cyclophosphamide(also see following section)

pruritus

antimicrobials: acyclovir, ampicillin, antimalarials, cephalosporins, chloroquine, colistin, erythromycin, halofantrine, ketoconazole, lomefloxacin, metronidazole, miconazole, polymyxin B, sulfonamides, suramin

cardiovascular: amiodarone, beta-blockers, captopril, clonidine, diazoxide, diphenoxylate, dobutamine, enalapril, naftazone, quinidine

diuretics: furosemide, HCTZ

hormones: anabolic steroids, dexamethasone, estrogen, OCPs, progesterone, testosterone

miscellaneous: allopurinol, aspirin, bleomycin, chlorpropamide, colchicine, coumarin, heparin, imipramine, NSAIDs, phenothiazines, probenecid, tolbutamide

opiates: butorphanol, cocaine, fentanyl, heroin, morphine

vitamins: etretinate, isotretinoin, niacin, vitamin B complex

pseudolymphoma

ACE inhibitors, anticonvulsants, antidepressants, benzodiazepines, beta blockers, calcium channel blockers, dilantin, H1 & H2 antagonists, lipid-lowering agents, lithium, NSAIDs, phenothiazines, steroids

pseudoporphyria (also see following section)

furosemide, nalidixic acid, tetracycline

psoriasiform, induce or exacerbate

ACE inhibitors, acetylsalicylic acid, ampicillin, antimalarials, arsenic, chloroquine, codeine, cyclosporine, etretinate, gold, ibuprofen, interferons, interleukins, iodine, lithium, methoxsalen, morphine, penicillamine, pindolol, practolol, propranolol, quinidine

psoriasis, erythrodermic

antimalarials, b-blockers, captopril, chlorthalidone, clonidine, corticosteroids (withdrawal), digoxin, indomethacin, lithium, NSAIDs

psoriasis, exacerbation

antimalarials, b-blockers, lithium, steroid withdrawal

psoriasis, pustular

aminoglutethimide, lithium, OCPs, steroid withdrawal

purpura

anticonvulsants, aspirin, barbiturates, benzoate, carbamides, chloroquine, chlorothiazide, chlorpromazine, coumadin, gold, griseofulvin, heparin, iodides, methotrexate, NSAIDs, phenothiazines, phenylbutazone, quinidine, quinine, sedatives, sulfonamides, tartrazine, thiazides

purpura pigmentosa chronica

sedatives

pustular eruption

acetaminophen, amoxicillin, ampicillin, bromides, carbamazepine, cefaclor, erythromycin, imipenam, iodides, nifedipine, penicillin, quinidine

pustulosis, acute generalized exanthematous

antibiotics; azithromycin, cephalosporin, chloramphenicol, ciprofloxacin, doxycycline, erythromycin, isoniazid, itraconazole, norfloxacin, penicillin, streptomycin, sulfasalazine, terbinafine, trimethoprim, vancomycin,

others; acetaminophen, allopurinol, carbamazepine, chromium picolinate, diclofenac, diltiazem, disulfiram, enalapril, furosemide, hydroxychloroquine, mercury, nifedipine, phenytoin, quinidine

pyoderma gangrenosum

bromides, GM-CSF, iodides, isotretinoin

pyogenic granuloma

isotretinoin

radiation enhancement

bleomycin, chlorambucil, cyclophosphamide (+dactinomycin, vincristine, doxorubicin, cisplatin, bleomycin, triazinate), dactinomycin, dactinomycin and amethopterin, doxorubicin, doxorubicin and cyclophosphamide, fluorouracil, fluorouracil and cisplatin, hydroxyurea, 6-mercaptopurine, methotrexate

radiation recall

bleomycin, cyclophosphamide, cytarabine, dactinomycin, daunorubicin, doxorubicin, docetaxel, edatrexate, etoposide (VP-16), 5-fluorouracil, hydroxyurea, idarubicin, lomustine, melphalan, methotrexate, paclitaxel, tamoxifen, trimetrexate, vinblastine

rash, macular & papular

allopurinol, ampicillin, barbiturates, chloroquine, diflunisal, dilantin, gentamicin, gold salts, isoniazid, meclofenamate, penicillin, phenothiazines, phenylbutazone, piroxicam, quinidine, streptomycin, sulfonamides, thiazides, thiouracil, trimethoprim/sulfamethoxasole,

rash, morbilliform

ampicillin, aspirin, barbiturates, benzodiazepines, chlorpromazine, dapsone, erythromycin, gentamicin, gold salts, griseofulvin, isoniazid, phenothiazines, thiazides

Raynaud’s d.

amphetamines, arsenic, b-adrenergic blockers, bleomycin (and combinations), clonidine, cyanamide, ergotamine, EtOH, heavy metals, methysergide, OCPs, tobacco, vincristine, vinyl chloride

“red man” s.

see exfoliate erythroderma

rosacea

aminophylline, amyl nitrite, cyclosporine, diazoxide, dipyridamole, EtOH, glutamate, hydralazine, iodides, isoprel, isordil, nicotinic acid, nitrate, papaverine, reserpine, theophylline, vasodilators

SCC, inflammation

fludarabine

SCLE

aldactone, chrysotherapy, griseofulvin, penicillamine, piroxicam, procainamide, sulfonylureas, thiazides

scleroderma-like

aliphatic hydrocarbons, aromatic hydrocarbons, bleomycin, carbidopa, cyclohexylamines, docetaxel, penicillamine, silica, trichlorethylene, valproic acid, vinyl chloride

sclerosis

bleomycin, polyvinylchloride, tryptophan, vitamin K (IM)

seborrheic dermatitis

arsenic, cimetidine, gold, methyldopa, neuroleptics, phenothiazines

seborrheic keratoses (inflammation)

cytarabine

serum sickness vasculitis

cephalosporins, penicillin, sulfa, thiazides

serum sickness-like

b-lactam antibiotics, cefaclor, dilantin, penicillin, sulfonamides

splinter hemorrhage

tetracycline

squamous cell carcinoma

arsenic

Stevens-Johnson s.

see erythema multiforme

stomatitis (chemotherapeutic agents)

amsacrine, bleomycin, cyclophosphamide, cytarabine, dactinomycin, daunorubicin, docetaxel, doxorubicin, edatrexate, epirubicin, floxuridine, fluorouracil, hydroxyurea (high-dose), idarubicin, mechlorethamine, 6-mercaptopurine, methotrexate, mithramycin, mitomycin, paclitaxel, procarbazine, tegafur, 6-thioguanine, tomudex, topotecan, vinblastine, vincristine

striae

corticosteroids, isoniazid

Sweet’s s.

all-trans-retinoic acid, GM-CSF, minocycline, OCPs

telangiectasia

carmustine, hydroxyurea, nifedipine, OCPs

thrombocytopenic purpura

NSAIDs, phenothiazines, quinidine, thiazides

toxic epidermal necrolysis

allopurinol, amoxapine, ampicillin, anti-tuberculosis drugs, asparaginase, aspirin, barbiturates, bleomycin, carbamazepine, cephalosporins, chlorambucil, chloramphenicol, chlorpropamide, ciprofloxacin, cladribine, cytarabine, dapsone, dicloxacillin, dilantin, disulfiram, doxorubicin, doxycycline, erythromycin, fansidar, 5-fluorouracil, gold, griseofulvin, hydantoin, hypoglycemics, imipramine, methotrexate, minipress, mithramycin, nitrofurantoin, NSAIDs, oxicam derivatives, penicillamine, penicillin, phenobarbital, phenolphthalein, phenybutazone, phenytoin, plicamycin, procarbazine, quinine, rifampin, streptomycin, sulfonamides, suramin, tetracycline, thiobendazole, trimethoprim/sulfadoxine, trimethoprim/sulfamethoxasole, valproic acid, vancomycin

With HIV infection; clindamycin, erythromycin, fluconazole, phenobarbital, valproic acid, vancomycin

ulcer

barbiturates, ergotamine, halogens, methotrexate

ulcers, leg

hydroxyurea, methotrexate

ultraviolet recall

etoposide/cyclophosphamide, methotrexate, methotrexate/cyclophosphamide/fluorouracil, suramin

urticaria

ACE inhibitors, acetylsalicylic acid, ACTH, animal sera, azo dyes, barbiturates, benzoates, benzocaine, calcium channel blockers, cephalosporin, chloramphenicol, chlorpromazine, cimetidine, corticotropin, curare, dextran, enzymes, fluoxetine, griseofulvin, hormones, hydantoin, hydralazine, imipramine, indomethacin, insulin, mechlorethamine (nitrogen mustard), mesna, NSAIDs, opiates, penicillin, phenolphthalein, phenothiazines, phenylbutazone, pollen vaccines, polymyxin B, polypeptide procainamide, promethazine quinidine, radiocontrast dye, salicylates, streptomycin, sulfonamides, tetracycline, trazodone, trimethoprim

urticaria, non-allergic contact

acetic acid, alcohol, balsam of Peru, benzoic acid, caterpillar hair, cinnamic acid, cinnamic aldehyde, cobalt chloride, dimethyl sulfoxide, insect sting, methyl nicotinate, moth, sodium benzoate, sorbic acid, trafuril

urticaria, chemotherapeutic agents

amsacrine, L-asparaginase, bleomycin, busulfan, carboplatin, chlorambucil, cisplatin, cyclophosphamide, cytarabine, daunorubicin, diaziquone, didemnin B, diethylstilbestrol, docetaxel, doxorubicin, epirubicin, etoposide, 5-fluorouracil, mechlorethamine, melphalan, methotrexate, mitomycin C, mitotane, mitoxantrone, paclitaxel, pentostatin procarbazine, teniposide, thiotepa, trimetrexate, vincristine, zinostatin

urticaria (localized)

doxorubicin, epirubicin, idarubicin

vasculitis

ampicillin, chlorothiazide, phenytoin, thiouracil

vasculitis, leukocytoclastic

allopurinol, aminosalicylic acid, busulfan, cimetidine, clindamycin, corticosteroids, cyclophosphamide, cytarabine, diltiazem, gold, griseofulvin, heparin, hexamethylene bisacetamide, hydantoins, hydralazine, hydroxyurea, indomethacin, insulin, iodides, ketoconazole, levamisole, 6-mercaptopurine, methotrexate, mitoxantrone, nifedipine, NSAIDs, OCPs, penicillin, phenothiazines, phenylbutazone, procainamide, propylthiouracil, quinidine, quinine, serum, sotalol, streptokinase, streptomycin, sulfonamides, tamoxifen, tetracycline, thiazides, vaccine (influenza), vancomycin, vitamins

vesiculobullous eruption

amoxapine, arsenic, barbiturates, bromides, captopril, chemotherapeutic agents, dipyridamole, furosemide, griseofulvin, iodides, mercury, nalidixic acid, NSAIDs, penicillamine, penicillin, phenolphthalein, phenytoin, PUVA, salicylates, sulfonamides, thiazides, thioridazine

xanthoma (eruptive)

isotretinoin

xerostomia

anticholinergics, antihistamines, hypnotics, sedatives


Photosensitizing medications, categorical

anti-acne

isotretinoin, tretinoin

antibiotics

(see sulfonamides and tetracyclines) ciprofloxacin, clofazimine, erythromycin ethylsuccinate + sulfisoxazole, ethionamide, gentamicin, hexachlorophene, interferon a-2B, nalidixic acid, norfloxacin, pyrazinamide, trimethoprim, trimethoprim +sulfamethoxasole

anticonvulsants

acetazolamide, carbamazepine, phenytoin

antidepressants (tricyclic and other)

amitripyline, amoxapine, chlordiazepoxide, +amitripyline, desipramine, doxepin, imipramine, isocarboxazid, maprotiline, nortriptyline, perphenazine +amitripyline, protriptyline, trimipramine

antiemetics

see antipsychotics

antifungals

fentichlor, flucytosine, griseofulvin, jadit, multifungin

antihistamines

astemizole, azatadine, bromodipheyhydramine +codeine, brompheniramine, buclizine, carbinoxamine, chlorpheniramine, chlorpheniramine +D-pseudoephedrine, chlorpheniramine +phenylpropanolamine, clemastine, cyclizine, cyclobenzaprine, cyproheptadine, dexchlorpheniramine, dimenhydrinate, diphenhydramine, diphenylpyraline, doxylamine, hydroxyzine, meclizine, methapyrilene, methdilazine, orphenadrine, pheniramine, phenylpropanolamine +chlorpheniramine, phenylpropanolamine +pheniramine +pyrilamine, promethazine, pyrilamine, terfenadine, trimeprazine, tripelennamine, triprolidine

antimalarial

quinine

antineoplastic

dacarbazine, floxuridine, fluorouracil, flutamide, methotrexate, vinblastine

antiparkinsonian

selegiline

antipsychotics, tranquilizers, phenothiazines, and antiemetics

acetophenazine, butaperazine, carphenazine, chlorpromazine, chlorprothixene, ethopropazine, fluphenazine, haloperidol, mesoridazine, methdilazine, methotrimeprazine, nabilone, perphenazine, piperacetazine, prochlorperazine, promazine, promethazine, propiomazine, thiethylperazine, thioridazine, thiothixene, trifluoperazine, triflupromazine, trimeprazine

cardiac agents

see hypertensive and cardiac agents

cholesterol-lowering

lovastatin

estrogens

see oral contraceptives

glaucoma medication

methazolamide

gonadotropin inhibitor

danazol

hypertensive and cardiac agents

amiodarone, atenolol +chlorthalidone, captopril, clorthalidone +reserpine, diltiazem, enalapril, enalapril +hydrochlorothiazide, furosemide, guanethidine +hydrochlorothiazide, indapamide, labetalol, labetalol +hydrochlorothiazide, metoalazone, metoprolol, minoxidil, nadolol +bendrofumethiazide, nifedipine, propranolol +hydrochlorothiazide, quinethazone, quinidine gluconate, quinidine sulfate, timolol +hydrochlorothiazide, triamterene

hypoglycemics

see sulfonylureas

NSAIDs, antiarthritics, anti-inflammatory

auranofin, diclofenac, diflunisal, fenoprofen, flurbiprofen, gold compounds, ibuprofen, indomethacin, ketoprofen, meclofenamate, naproxen, phenylbutazone, piroxicam, sulindac, suprofen, tolmetin

oral contraceptives & estrogens

estrogens; chlorotrianisene, diethylstilbestrol, estradiol, estrogens (conjugated and esterified), estropipate   

progesterones; ethinyl estradiol, medroxyprogesterone, megestrol, norethindrone, norgestrel, quinestrol

phenothiazines

see antipsychotics

psoralens

methoxsalen, trioxsalen

sulfonamides

sulfacytine, sulfadiazine, sulfadoxine, sulfadoxine +pyrimethamine, sulfamethizole, sulfamethoxazole, sulfapyridine, sulfasalazine, sulfinpyrazone, sulfisoxazole, sulfone

sulfonylureas, oral hypoglycemics

acetohexamide, chlorpropamide, glipizide, glyburide, tolazamide, tolbutamide

sunscreen ingredients

6-Acetoxy-2,4,-dimethyl-m dioxane, benzophenones, cinnamates, oxybenzone, paba esters, PABA (para-aminobenzoic acid)

tetracyclines

chloretracycline, demeclocycline, docycycline, methacycline, minocycline, oxytetracycline, tetracycline

thiazide diuretics

bendroflumethiazide, benzthiazide, chlorothiazide, chlorthalidone, cyclothiazide, hydrochlorothiazide, hydroflumethiazide, poythiazide, rauwolfia serpentina +bendroflumenthiazide, reserpine +chlorothiazide, reserpine +hydralazine +hydrochlorothiazide, reserpine +hydrochlorothiazide, trichlormethiazide

tranquilizers

see antipsychotics

 

Photosensitizing medications, alphabetical

a

acetazolamide, acetohexamide, acetophenazine, amiodarone, amitripyline, amoxapine, astemizole, atenolol +chlorthalidone, auranofin, azatadine,

b

bendroflumethiazide, benzophenones, benzthiazide, bromodiphenhydramine +codeine, brompheniramine, buclizine, butaperazine,

c

captopril, carbamazepine, carbinoxamine, carphenazine, chlordiazepoxide + amitriptyline, chloretracycline, chlorothiazide, chlorotrianisene, chlorpheniramine, chlorpheniramine + phenylpropanolamine, chlorpheniramine + pseudoephedrine, chlorpromazine, chlorpropamide, chlorprothixene, chlorthalidone, cinnamates, ciprofloxacin, clemastine, clofazime, clorthalidone + reserpine, cyclobenzaprine, cyclizine, cyclothiazide, cyproheptadine

d

dacarbazine, danazol, demeclocycline, dexchlorpheniramine, diclofenac, diflunisal, diltiazem, dimenhydrinate, 6-Acetoxy-2,4,-dimethyl-m dioxane, diphenhydramine, diphenylpyraline, doxylamine, diethylstilbestrol, desipramine, doxepin, doxycycline

e

enalapril, enalapril +hydrochlorothiazide, erythromycin ethylsuccinate + sulfisoxazole, ethionamide, ethoproopazine, estradiol, estrogens (conjugated and esterified), estropipate   

ethinyl estradiol

f

fentichlor, fenoprofen, floxuridine, flurbiprofen, flucytosine, fluorouracil, fluphenazine, flutamide, furosemide

g

gentamicin, glipizide, glyburide, gold compounds, griseofulvin, guanethidine +hydrochlorothiazide

h

haloperidol, hexachlorophene, hydrochlorothiazide, hydroflumethiazide, hydroxyzine

i

ibuprofen, imipramine, indapamide, indomethacin, interferon a-2B, isocarboxazid, isotretinoin,

j

jadit

k

ketoprofen

l

labetalol, labetalol +hydrochlorothiazide, lovastatin

m

maprotiline, meclizine, meclofenamate, medroxyprogesterone, megestrol, mesoridazine, methacycline, methapyrilene, methazolamide, methdilazine, methotrexate, methotrimeprazine, methoxsalen, metoalazone, metoprolol, minocycline, minoxidil, multifungin

n

nabilone, nadolol +bendrofumethiazide, nalidixic acid, naproxen, nifedipine, norethindrone, norfloxacin, norgestrel, nortroptyline

o

orphenadrine, oxybenzone, oxytetracycline

p

PABA (para-aminobenzoic acid), perphenazine, perphenazine + amitriptyline, pheniramine, phenylbutazone, phenylpropanolamine + chlorpheniramine, phenylpropanolamine + pheniramine + pyrilamine, phenytoin, piperacetazine, piroxicam, polythiazide, prochlorperazine, promazine, promethazine, propiomazine, propranolol + hydrochlorothiazide, protriptyline, pyrazinamide, pyrilamine

q

quinestrol, quinethazone, quinidine gluconate, quinidine sulfate, quinine,

r

rauwolfia serpentina + bendroflumenthiazide, reserpine +chlorothiazide, reserpine +hydralazine +hydrochlorothiazide, reserpine +hydrochlorothiazide,

s

selegiline, sulfacytine, sulfadiazine, sulfadoxine, sulfadoxine +pyrimethamine, sulfamethizole, sulfamethoxazole, sulfapyridine, sulfasalazine, sulfinpyrazone, sulfisoxazole, sulfone, sulindac, suprofen

t

terfenadine, tetracycline, thiethylperazine, thioridazine, thiothixene, timolol +hydrochlorothiazide, tolazamide, tolbutamide, tolmetin, tretinoin, triamterene, trichlormethiazide, trifluoperazine, triflupromazine, trimeprazine, trimethoprim, trimethoprim +sulfamethoxasole, trimipramine, trioxsalen, tripelennamine, triprolidine

v

vinblastine

*Modified from Levine JI. Medications that increase sensitivity to light; a 1990 listing. Rockville, Md; US Dept. of Health and Human Services

 

Porphyria; drugs that may precipitate acute porphyria 

a

alcuronium, alphaxalone, alphadolone, alprazolam, aluminum preparations, amidopyrine, aminoglutethimide, aminophylline, amitripyline, amylobarbitone, amphetamines, antipyrine, apronalide, auranofin, aurothiomalate, azapropazone

b

baclofen, barbiturates, bemegride, bendrofluazide, benoxaprofen, benzbromarone, benzylthiouracil, bepridil, bromocriptine, busulphan, butylscopolamine

c

captopril, carbamazepine, carbromal, carisoprodol, cefuroxime, cephalexin, cephalosporins, cephradine, chlorambucil, chloramphenicol, chlordiazepoxide, chlormezanone, chloroform, chlorpropamide, cimetidine, cinnarizine, clemastine, clobazam, clomipramine HCL, clonazepam, clorazepate, cocaine, colistrin, co-trimoxazole, cyclophosphamide, cycloserine, cyclosporine

d

danazol, dapsone, dexfenfluramine, dextropropoxyphene, diazepam, dichloralphenazone, diclofenac NA, diethylpropion, dihydralazine, dihydroergotamine, dimenhydrinate, diphenhydramine, dothiepin HCL, doxycycline, dydrogesterone

e

econazole NO3, enalapril, enflurane, ergometrine maleate, ergot compounds, ergotamine tartrate, erythromycin, estramustine, ethamsylate, ethanol, ethionamide, ethosuximide, ethotoin, etidocaine, etomidate

f

flufenamic acid, flunitrazepam, fluroxine, furosemide

g

glutethimide, gold preparations, griseofulvin

h

halothane, hydantoins (phenytoin, ethotoin, mephenytoin), hydralazine, hydrochlorothiazide, hyoscine N-butyl bromide

i

imipramine, isoniazid, isopropylmeprobamate

k

ketamine, ketoprofen

l

lead, lidocaine, lignocaine

m

mephenezine, meprobamate, mercury compounds, methoxyflurane, methsuximide, methyldopa, methyprylone, metoclopramide, metyrapone, metronidazole

n

nalidixic acid, nikethamide, novobiocin, nitrazepam, nitrofurantoin

o

oral contraceptives, oxazolidinediones (paramethadione and trimethadione), oxazepam

p

pancuronium, paraldehyde, pargyline, pentazocine, pentylenetetrazol, pethidine, phenoxybenzamine, phenylbutazone, phenylhydrazine, primidone, probenecid, progesterone, propanidid, pyrazinamide, pyrazolones (amidopyrine, antipyrine, isopropylantipyrine, dipyrone, sodium phenyl dimethyl pyrazolone), pyrimethamine

s

spironolactone, steroids, succinimides (ethosuximide, methsuximide, phensuximide), sulphonal, sulfonamides, sulfonylureas, sulthiame

t

tetracyclines, theophylline, tolazamide, tolbutamide, tranylcypromine, trional, troxidone

v

valproic acid, sodium valproate

x

Xylocaine

 

 

Porphyria; drugs thought to be safe in acute porphyria

 

a

acetazolamide, adrenaline, amethocaine, amytriptyline, aspirin, atropine

b

biguanides (phenformin, metformin), bromides, bumetanide, bupivicaine, buprenorphine

c

cephalexin, cephalosporins, chloral hydrate, chloramphenicol, chlormethiazole, chlorpheniramine, chloroquine, chlorpromazine, chlorothiazide, clofibrate, clonazepam, codeine, colchicine, corticosteroids, cyclizine

d

dexamethasone, diamorphine, diazepam, diazoxide, digitalis, diphenhydramine, dicoumarol anticoagulant, droperidol, digoxin

e

EDTA, ether (diethyl)

f

fentanyl, flurbiprofen,

g

gentamicin, glipizide, guanethidine

h

heparin, hydrallizine, hyoscine

i

ibuprofen, imipramine, indomethacin, insulin

k

ketamine

l

labetalol, lithium

m

mecamylamine, meclizine, mefenamic acid, mersalyl, methadone, methylphenidate, morphine

n

naproxen, neostigmine, nitrofurantoin, nitrous oxide, nortriptyline

o

oxazepam

p

parpcetamol, paraldehyde, penicillins, penicillamine, petinidine, phenoperidine, phenylbutazone, prednisolone, procaine, prisocaine, promethazine, propantheline bromide, propanidid, primaquine, prochlorperazine, promazine, propoxyphene, propanolol, prostigmine, pyrimethamine

q

quinine

r

rauwolfia alkaloids, reserpine, resorcinol, rifampicin

s

salicylates, streptomycin, succinylcholine

t

tetracycline, tetraethylammonium bromide, thiouracil, trifluoperazine, thiazides, trifluoperazine, tripelennamine, tubocurarine

v

sodium valproate, vitamin B, vitamin C

Michael R. Moore, Tschudy DP, Ann Intern Med 1975; 83: 851-64.

 

 

 

Pseudoporphyria; associated drugs; categories

antiarrhythmics

amiodarone, quinidine

antibiotics

nalidixic acid, tetracycline, oxytetracycline

chemotherapy

5-fluorouracil, busulfan

diuretics

furosemide, chlorthalidone, butemide, triamterene/hydrochlorothiazide

foods

cola

hormones

estrogens/progesterones

immunosuppressants

cyclosporine, methotrexate

muscle relaxants

carisoprodol/aspirin

NSAIDs

naproxen, diflunisal, ketoprofen, nabumetone, oxaprozin

other

barbiturates, colchicine, chronic renal failure, hemodialysis, ultraviolet A radiation/sunbeds

sulfones

dapsone

sulfonylureas

tolbutamide

vitamin A derivatives

etretinate, isotretinoin

vitamins

brewer’s yeast, pyridoxine, iron preparations

 

 Psuedoporphyria; associate drugs; alphabetical

a

amiodarone

b

barbiturates, brewer’s yeast, busulfan, butemide

c

carisoprodol/aspirin, chlorthalidone, chronic renal failure, cola, colchicine, cyclosporine

d

dapsone, diflunisal

e

estrogens, etretinate

f

5-fluorouracil, furosemide

h

hemodialysis

i

iron preparations, isotretinoin

k

ketoprofen

m

methotrexate

n

nabumetone, nalidixic acid, naproxen

o

oxaprozin, oxytetracycline

p

progesterones, pyridoxine

q

quinidine

t

tetracycline, tolbutamide, triamterene/hydrochlorothiazide

u

ultraviolet A radiation/sunbeds,

 

 Pseudoporphyria; drugs thought to be safe

NSAIDs

diclofenac, indomethacin, sulindac

Checketts SR, et al. Cutis 1999;63:223-5.

 


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