61 - Drugs potentially harmful in Porphyria

1. BARBITURATES : The effect of barbiturates on ALA synthetase can cause dangerous disease exacerbations in persons with intermittent porphyria.Because barbiturates enhance porphyrin synthesis, they are absolutely contraindicated in patients with acute intermittent porphyria or porphyria variegata.
2. ETHCHLORVYNOL: Ethchlorvynol may enhance the hepatic metabolism of other drugs such as oral anticoagulants, and it is contraindicated in patients with intermittent porphyria.
3. CHLOROQUINE : It should not be used for malaria in patients with porphyria cutanea tarda but is used in smaller doses for treatment of the underlying disease.

Documented Porphyrinogenic  Carbamazepine Carisoprodol Chloramphenicol Clindamycin Dextropropoxyphene Dihydralazine Dihydroergotamine Drospirenone + estrogen Dydrogesterone Etonogestrel Fosphenytoin sodium Hydralazine Hydroxyzine Indinavir Ketamine Ketoconazole Lidocaine Lynestrenol Lynestrenol + estrogen Mecillinam Medroxyprogesterone Megestrol Methylergometrine Methyldopa Mifepristone Nicotinic acid/meclozine/hydroxyzine Nitrofurantoin Norethisterone Norgestimate + estrogen Orphenadrine Phenobarbital Phenytoin Pivampicillin Pivmecillinam Primidone Rifampicin Ritonavir Spironolactone Sulfadiazine + trimethoprim Tamoxifen Testosterone, inj. Thiopental Trimethoprim Valproic acid

Probably Porphyrinogenic  Altretamine Lidocaine Aminophylline Lopinavir Amiodarone Lutropin alfa Amitriptyline Lymecycline Amlodipine Meclozine Amprenavir Medroxyprogesterone + estrogen Aprepitant Atorvastatin Metoclopramide Azathioprine Metronidazole Bosentan Metyrapone Bromocriptine Moxonidine Buspirone Nandrolone Busulfan Nefazodone Butylscopolamine Nelfinavir Cabergoline Nevirapine Ceftriaxone + lidocaine Nifedipine Cerivastatin Nimodipine Cetirizine Nitrazepam Cholinetheophyllinate Norethisterone Clarithromycin Nortriptyline Clemastine Oxcarbazepine Clonidine Oxytetracycline Cyclizine Paclitaxel Cyproterone Paroxetine Danazol Phenazone + caffeine Delavirdine Pioglitazone Desogestrel + estrogen Probenecid Diazepam Progesterone, vaginal gel Dienogest + estrogen Quinidine Diclofenac Rabeprazole Diltiazem Raloxiphene Diphenhydramine Rifabutin Disopyramide Riluzole Disulfiram Risperidone Drospirenone + estrogen Rosiglitazone Dydrogesterone Saquinavir Ergoloid mesylate Selegiline Erythromycin Simvastatin Estramustine Sulfasalazine Ethosuximide Telithromycin Etoposide Terbinafine Exemestane Terfenadine Felbamate Testosterone, transdermal patch Felodipine Tetracycline Fluconazole Theophylline Flunitrazepam Thiamazole Fluvastatin Tibolone Glibenclamide Ticlopidine Halothane Tinidazole Hyoscyamine Thiotepa Imipramine Topiramate Irinotecan Topotecan Isoniazid Toremifene Isradipine Tramadol Itraconazole Trimegestone + estrogen Lamivudine +zidovudine Verapamil Lansoprazole Voriconazole Lercanidipine Zidovudine/AZT Levonorgestrel

Possibly Porphyrinogenic  Aceclofenac Gramicidin Phenylpropanolamine + cinnarizine Acitretin Guaifenesin Pizotifen Acrivastine Hydrocortisone Polidocanol Alfuzosin Hydroxycarbamide Polyestradiol phosphate Anastrozole Hydroxychloroquine Potassium canrenoate Auranofin Ibutilide Pravastatin Azelastine Imatinib Prednisolone Benzatropine Indomethacin Prilocaine Benzydamine Ketobemidone + DDBA Proguanil Betaxolol Ketorolac Propafenone Bicalutamide Lamotrigine Pseudoephedrine + dexbrompheniramine Biperiden Letrozole Quillaia extract Bupropion Levodopa + benserazide Quinagolide Carvedilol Levonorgestrel intrauterine Quinine Chlorambucil Levosimendan Quinupristin + dalfopristin Chlorcyclizine + guaifenesin Linezolid ReBoxetine Chloroquine Lofepramine Repaglinide Chlorprothixene Lomustine Rizatriptan Chlorzoxazone Malathion Rofecoxib Chorionic gonadotrophin Maprotiline Ropinirole Ciclosporin Mebendazole Ropivacaine Cisapride Mefloquine Roxithromycin Citalopram Melperone Sertraline Clomethiazole Melphalan Sevoflurane Clomiphene Mepenzolate Sibutramine Clomipramine Mepivacaine Sildenafil Clopidogrel Mercaptopurine Sirolimus Clotrimazole Methadone Sodium aurothiomalate Cortisone Methylprednisolone Sodium oleate + chlorocymol Cyclandelate Metixene Stavudine Metolazone Cyclophosphamide Sulindac Cyproheptadine Metronidazole Sumatriptan Dacarbazine Mexiletine Tacrolimus Daunorubicin Mianserin Tadalafil Desogestrel Midazolam Tegafur + uracil Dichlorobenzyl alcohol Minoxidil Telmisartan Dithranol Mirtazapine Thioridazine Docetaxel Mitomycin Thioguanine Donepezil Mitoxantrone Tolphenamic acid Doxycycline Moclobemide Tolterodine Ebastine Montelukast Torsemide Econazole Morphine + scopolamine Triamcinolone Efavirenz Multivitamins Trihexyphenidyl Escitalopram Mupirocin Trimipramine Esomeprazole Nabumetone Valerian Estradiol/tablets Nafarelin Venlafaxine Estriol/tablets Naltrexone Vinblastine Estrio/vainal crème, tablet Nateglinide Vincristine Ifosfamide Nilutamide Vindesine Estrogen, conjug. Noscapine Vinorelbine Finasteride Omeprazole Xylometazoline Flecainide Oxybutynin Zaleplon Flucloxacillin Oxycodone Ziprasidone Fluoxetine Pantoprazole Zolmitriptan Flupentixol Papaverine Zolpidem Flutamide Parecoxib Zuclopenthixol Fluvoxamine Pentifylline Follitropin alfa and beta Pentoxyverine Galantamine Glimepiride Glipizide Gonadorelin