723 records found Click here to return to the search form. |
|||||
Class | Type | Generic name | Brand name | Conclusion | References |
---|---|---|---|---|---|
n/a | n/a | Levobunolol | Betagan, others | OK! | |
n/a | n/a | Proparacaine | Alcaine, Ophthetic, Ophthaine, others | OK! | |
n/a | n/a | Timolol | Combigan, Timolide, Cosopt | OK! | |
Anesthetics | GENERAL | Desflurane | Suprane | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic |
ANESTHETICS | GENERAL | Etomidate | Amidate | BAD! | www.porphyria-europe.com: Unsafe web.uct.ac.za/depts/porphyria/: Avoid www.uq.edu.au/porphyria/: Unsafe in animals Br J Anaesth 1985;57:420. Unsafe in animals |
ANESTHETICS | GENERAL | Isoflurane | Forane | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use with Caution www.uq.edu.au/porphyria/: Unsafe in animals |
ANESTHETICS | GENERAL | Ketamine | Ketalar | BAD! | www.drugs-porphyria.org: Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Caution www.uq.edu.au/porphyria/: Probably safe Br J Anaesth 1985;57:420. Safe in animals |
Anesthetics | GENERAL | Midazolam | Versed | OK? | www.drugs-porphyria.org: Possibly Porphyrinogenic www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use with Caution www.uq.edu.au/porphyria/: Cell culture - Safe Substrate of CYP3A4. Transactivates pregnane X receptor, but low probability of CYP3A4 induction (Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007; Curr Drug Metab 7:375,2006; Curr Drug Metab 9:827,2008) |
ANESTHETICS | GENERAL | Propofol | Diprivan | OK! | www.porphyria-europe.com: safe web.uct.ac.za/depts/porphyria/: Use www.uq.edu.au/porphyria/: Safe in patients Anaesthesia 1992;47:355 Safe Anaesthesia 1988;43:1022. Safe in patients |
ANESTHETICS | GENERAL | Sevoflurane | Ultane | OK! | www.drugs-porphyria.org: Possibly Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Caution Pediat Anesthes 2005;15:426. Safe USP DI? Drug Info. for the Health Care Pro. - 26th Ed. (2006): Only 5% is metabolized, primarily by CYP2E1 (not CYP3A or 2C9) |
Anesthetics | General | Thiamylal | Surital | BAD! | Barbiturate drug |
Anesthetics | GENERAL | Thiopental | Pentothal | BAD! | www.drugs-porphyria.org: Porphyrinogenic www.porphyria-europe.com: Unsafe web.uct.ac.za/depts/porphyria/: Avoid See Phenobarbital |
ANESTHETICS | LOCAL | Benzocaine | Many | NO INFO | |
ANESTHETICS | LOCAL | Bupivacaine | Many | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use www.uq.edu.au/porphyria/: Safe in animals Medicine (Balt) 1992;71:1. Safe |
ANESTHETICS | LOCAL | Chloroprocaine | Nesacaine | NO INFO | |
ANESTHETICS | LOCAL | Dibucaine | Nupercainal | NO INFO | |
ANESTHETICS | LOCAL | Ethyl chloride | Ethyl Chloride | OK! | |
ANESTHETICS | LOCAL | Prilocaine | Citanest | OK! | www.drugs-porphyria.org: Possibly Porphyrinogenic www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use www.uq.edu.au/porphyria/: Unsafe in patients Medicine (Balt) 1992;71:1. Safe |
ANESTHETICS | LOCAL | Procaine | Many | OK! | www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use www.uq.edu.au/porphyria/: Safe in patients |
ANESTHETICS | LOCAL | Ropivacaine | Naropin | OK? | www.drugs-porphyria.org: Possibly Porphyrinogenic. Substrate of CYP 1A. Use with care in doses >2 mL (of 10 mg/mL solution) Clin Pharmacol Ther 1998;64:484. Mostly metabolized by CYP1A2 |
ANESTHETICS | LOCAL | Tetracaine | Many | OK! | www.drugs-porphyria.org: Not Porphyrinogenic www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use www.uq.edu.au/porphyria/: Safe in animals |
Anesthetics | MUSCLE RELAXANTS | Baclofen | Many | OK? | www.drugs-porphyria.org: Probably Not Porphyrinogenic http://www.bio.net/bionet/hypermail/neur-sci/2005-July/060879.html: Ca. 85% is excreted unchanged, and ca. 15% of the dose is metabolized primarily by deamination |
Anesthetics | MUSCLE RELAXANTS | Cyclobenzaprine | Flexeril | BAD? | www.drugs.com: Metabolized by CYP3A4; forms ligand with PXR Williams DA. Drug metabolism. In: Foye?s Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007. Substrate of CYP3A4 |
ANESTHETICS | MUSCLE RELAXANTS | Doxacurium | Nuromax | NO INFO | |
ANESTHETICS | MUSCLE RELAXANTS | Pancuronium | Pavulon | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use www.uq.edu.au/porphyria/: Probably safe |
ANESTHETICS | MUSCLE RELAXANTS | Succinylcholine | Anectine | OK? | Patient report: Safe |
ANESTHETICS | MUSCLE RELAXANTS | Vecuronium | Norcuron | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Caution |
ANTI-INFECTIVES | AMINOGLYCOSIDES | Amikacin | Amikin | OK! | www.drugs-porphyria.org: Not Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use PV Tishler MD clinical data: Safe |
ANTI-INFECTIVES | AMINOGLYCOSIDES | Gentamicin | Many | OK! | www.drugs-porphyria.org: Not Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use www.uq.edu.au/porphyria/: Safe in patients and animals |
ANTI-INFECTIVES | AMINOGLYCOSIDES | Neomycin | Many | OK? | |
ANTI-INFECTIVES | AMINOGLYCOSIDES | Streptomycin | Many | OK! | www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use www.uq.edu.au/porphyria/: Safe www.porphyriafoundation.com: Safe |
ANTI-INFECTIVES | AMINOGLYCOSIDES | Tobramycin | Many | OK! | www.drugs-porphyria.org: Not Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use S Afr Med J 1984;65:924. Safe in patients |
Anti-infectives | Animycobacterial agents | Rifapentine | Priftin | BAD! | Induces CyP3A, 2C9, ALA synthase (analogous to rifampicin) |
Anti-infectives | anthelmintics | albendazole | multiple | BAD? | poorly absorbed from GI tract; but signif metabolsim by CyP3A4. Poor data.(Eur. J. Clin Pharm 71:528, 2011) |
Anti-infectives | anthelmintics | mebendazole | multiple | No info | Poorly absorbed from GI tract. Probably metabolised by P450. |
ANTI-INFECTIVES | ANTIFUNGALS | Amphotericin B | Amphotec | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic/Not Porphyrinogenic www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use with Caution www.uq.edu.au/porphyria/: Safe in cell culture |
ANTI-INFECTIVES | ANTIFUNGALS | Carbamide Peroxide | Debrox | OK? | www.drugs-porphyria.org: Not Porphyrinogenic |
ANTI-INFECTIVES | ANTIFUNGALS | Caspofungin | Cancidas | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic www.rxlist.com: Metabolized by hydrolysis and N-acetylation |
Anti-infectives | ANTIFUNGALS | Clotrimazole | none | OK? | www.drugs-porphyria.org: Probably Not /Possibly Porphyrinogenic Comp Biochem Physiol C Toxicol Pharmacol 2005;140:403. Induces CYP3A. Did not affect expression of PXR and MDR1 in zebrafish. Inhibits constituitive androstene receptor. |
Anti-infectives | ANTIFUNGALS | Fluconazole | Diflucan | BAD! | www.drugs-porphyria.org: Probably Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Extreme Caution Inhibits Cyt3A,2C9, and pregnane X receptor. 3 Patient reports: Unsafe. |
ANTI-INFECTIVES | ANTIFUNGALS | Flucytosine | Ancobon | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use www.uq.edu.au/porphyria/: Safe in cell culture www.porphyriafoundation.com: Safe |
Anti-infectives | ANTIFUNGALS | Griseofulvin | Many | BAD! | www.porphyria-europe.com: Unsafe web.uct.ac.za/depts/porphyria/: Avoid www.uq.edu.au/porphyria/: Unsafe in patients www.porphyriafoundation.com: Unsafe. Induces CYP3A |
Anti-infectives | ANTIFUNGALS | Itraconazole | Sporanox | BAD! | www.drugs-porphyria.org: Probably Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Extreme Caution Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007. substrate & inhibitor of CYP3A4 |
Anti-infectives | ANTIFUNGALS | Ketoconazole | Many | BAD! | www.drugs-porphyria.org: Porphyrinogenic www.porphyria-europe.com: Unsafe web.uct.ac.za/depts/porphyria/: Avoid www.uq.edu.au/porphyria/: Unsafe in cell culture Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007. Substrate & inhibitor of CYP3A4. Inhibitor of pregnane X receptor & constit. androstene receptor. |
Anti-infectives | ANTIFUNGALS | Metronidazole | Flagyl | BAD? | www.drugs-porphyria.org: Probably Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Extreme Caution www.uq.edu.au/porphyria/: probably safe J Neurol Neurosurg Psychiat 1997;62:421. Sinz: Cur Drug Metab 2006; 7:375: no human pregnane X receptor activation. Unsafe in patients. 1 patient: safe |
Anti-infectives | ANTIFUNGALS | Micafungin | Mycamine | OK? | Metab by and weakely inhibits CYP3A. 3A is not major path. |
Anti-infectives | ANTIFUNGALS | Miconazole | Monistat, others | BAD? | www.drugs-porphyria.org: Probably Not Porphyrinogenic/Not Porphyrinogenic web.uct.ac.za/depts/porphyria/: Avoid www.uq.edu.au/porphyria/: Unsafe in cell culture |
Anti-infectives | ANTIFUNGALS | Nystatin | Many | OK! | www.drugs-porphyria.org: Not Porphyrinogenic USP DI? Drug Info. for the Health Care Pro. - 26th Ed. (2006): No P450 metabolism |
ANTI-INFECTIVES | ANTIFUNGALS | Posaconazole | Noxafil | NO INFO | |
Anti-infectives | ANTIFUNGALS | Terbinafine | Lamisil | BAD? | www.drugs-porphyria.org: Oral -Probably Porphyrinogenic. Topical - ok. web.uct.ac.za/depts/porphyria/: Use with Extreme Caution. Vickers, Drug Metab Disp 1999; 27:1029: Main metab via CYP2C9, 1A2, 3A4. Sinz M. Cur Drug Metab 2006; 7:375: High activation of pregnane X receptor but low prediction of clinical induction. (This is given over a ca. 3 month period, so acute experimental data may not be relevant.) |
Anti-infectives | ANTIFUNGALS | Terconazole | Terazol | No info | Induces pregnane X receptor. |
Anti-infectives | ANTIFUNGALS | Voriconazole | Vfend | BAD! | www.drugs-porphyria.org: Probably Porphyrinogenic Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007. Substrate of & inhibits CYP3A4 & 2C9. |
ANTI-INFECTIVES | ANTIMALARIALS | Atovaquone | Mepron | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic www.porphyria-europe.com: Safe http://www.pharmgkb.org/: Not much is metabolized |
Anti-infectives | ANTIMALARIALS | Chloroquine | Many | OK? | www.drugs-porphyria.org: Possibly Porphyrinogenic, Compare the 8-aminoquioline primaquine: Inducer of CYPs 1A1, 1A2 and 1B1. No data pointing to clinically significant CYP-inducing properties. Conflicting references. One report of possible porphyrinogenicity. www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use www.uq.edu.au/porphyria/: Probably safe Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007. Substrate of CYP3A4 |
ANTI-INFECTIVES | ANTIMALARIALS | Hydroxychloroquine | Plaquenil | OK? | www.drugs-porphyria.org: Possibly Porphyrinogenic. Partly CYP-metabolized. Compare the 8-aminoquinoline primaquine: Inducer of CYPs 1A1, 1A2 and 1B1 |
ANTI-INFECTIVES | ANTIMALARIALS | Mefloquine | Lariam | OK! | www.drugs-porphyria.org: Possibly Porphyrinogenic. Substrate for CYP 3A4. No clinical observations pointing to CYP-induction. Compare the other methanolquinoline quinine: Inducer of CYPs 1A1, 1A2 and 2C9. Activator/stimulator of CYP 3A4. Inhibitor of CYPs e.g. 1A1 (potent). |
ANTI-INFECTIVES | ANTIMALARIALS | Primaquine | Primaquine | OK! | www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use www.uq.edu.au/porphyria/: Safe in patients |
Anti-infectives | ANTIMALARIALS | Proguanil | Malarone (also contains atovaquone) | OK! | www.drugs-porphyria.org: Possibly Porphyrinogenic, substrate of CYP2C19, 1A2, 3A4; no clinical observations pointing to CYP induction web.uct.ac.za/depts/porphyria/: Use |
ANTI-INFECTIVES | ANTIMALARIALS | Pyrimethamine | Daraprim | OK! | www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use |
Anti-infectives | ANTIMALARIALS | Quinine Sulfate | Many | OK? | www.drugs-porphyria.org: Possibly Porphyrinogenic. Metab. by CYP3A. Inducer of 2C9. Possible activator/stimulator of CYP 3A4. 1Aweb.uct.ac.za/depts/porphyria/: Use www.uq.edu.au/porphyria/: Safe in patients S Afr Med J 1988;74:321. Safe in patients Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007. Substrate of CYP3A4 |
Anti-infectives | antimycobacterial | rifampicin | none | ||
ANTI-INFECTIVES | ANTIMYCOBACTERIAL AGENTS | Ethambutol | Myambutol | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use |
ANTI-INFECTIVES | ANTIMYCOBACTERIAL AGENTS | Isoniazid | Many | BAD! | www.drugs-porphyria.org: Probably Porphyrinogenic. Inhibitor of CYP 1A2, 2A6, 2C19, 3A4. Several references warn against its use web.uct.ac.za/depts/porphyria/: Use with Extreme Caution www.uq.edu.au/porphyria/: Probably unsafe |
ANTI-INFECTIVES | ANTIMYCOBACTERIAL AGENTS | Pyrazinamide | Many | BAD! | www.porphyria-europe.com: Unsafe web.uct.ac.za/depts/porphyria/: Avoid www.uq.edu.au/porphyria/: unsafe in patients www.porphyriafoundation.com: Unsafe |
Anti-infectives | ANTIMYCOBACTERIAL AGENTS | Rifabutin | Mycobutin | BAD! | www.drugs-porphyria.org: Probably Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Extreme Caution Substrate of CYP3A4. Induces CYP3A4 via pregnane X receptor transactivation (Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007; Arch Toxicol 82:667,2008; Cur Drug Metab 7:375,2006) |
Anti-infectives | ANTIMYCOBACTERIAL AGENTS | Rifampin | Rifadin | BAD! | Substrate of CYP3A4. Induces CYP3A4 via transactivation of pregnane X receptor (Cur Drug Metab 7:375,2006; Arch Toxicol 82:667,2008) |
Anti-infectives | ANTIPARASITICS | Albendazole | Many | OK? | web.uct.ac.za/depts/porphyria/: Use with Caution Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007. Substrate of CYP3A4 |
ANTI-INFECTIVES | ANTIPARASITICS | Iodoquinol | Yodoxin | NO INFO | |
ANTI-INFECTIVES | ANTIPARASITICS | Ivermectin | Stromectol | BAD? | Xenabiotica 1998; 28: 313. Metabolized extensively by CYP3A4 |
Anti-infectives | ANTIPARASITICS | Mebendazole | Vermox | OK? | www.drugs-porphyria.org: Possibly Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Caution |
Anti-infectives | ANTIPARASITICS | Praziquantel | Many | BAD! | web.uct.ac.za/depts/porphyria/: Use with Extreme Caution Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007. Substrate of CYP3A4 |
Anti-infectives | ANTIPARASITICS | Tinidazole | Tindamax | BAD? | ~75% metab by CYP3A4. Porphyrinogenic in vitro (Eur J Clin Pharmacol 59:429,2003) |
Anti-infectives | antiretroviral | Telbivudine | Tyzeka | OK? | Not metabolized; no P450 interaction (Medical Letter 49:11, 2007; Micromedex |
ANTI-INFECTIVES | ANTIRETROVIRALS | Abacavir | Ziagen | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic USP DI? Drug Info. for the Health Care Pro. - 26th Ed. (2006): No P450 metabolism |
Anti-infectives | ANTIRETROVIRALS | Amprenavir | Agenerase | BAD! | www.drugs-porphyria.org: Probably Porphyrinogenic. Substrate of CYP3A4. Induces CYP3A4 via transactivation of pregnane X receptor (Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007; Arch Toxicol 82:667,2008) |
Anti-infectives | ANTIRETROVIRALS | Atazanavir | Reyataz | BAD? | USP DI? Drug Info. for the Health Care Pro. - 26th Ed: Extensively metabolized by CYP3A4 Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007. Substrate of CYP3A4 |
Anti-infectives | ANTIRETROVIRALS | Delavirdine | Rescriptor | BAD! | www.drugs-porphyria.org: Probably Porphyrinogenic Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007. Substrate of CYP3A4 |
ANTI-INFECTIVES | ANTIRETROVIRALS | Didanosine | Videx | OK? | www.drugs-porphyria.org: Probably Not Porphyrinogenic |
Anti-infectives | ANTIRETROVIRALS | Efavirenz | Sustiva | BAD? | www.drugs-porphyria.org: Probably Porphyrinogenic Metab mainly by CYP2B6, with minor role for CYP3A4. Induces CYP2B6,3A4 via transactivation of constitutive androstane rerceptor & pregnane X receptor (Pharmacogenet Genomics 19:300, 2009; Arch Toxicol 82:667,2008; J Pharmacol Exp Therap 320:72,2007; Clin. Pharmacol. Ther. 91: 475, 2012). |
Anti-infectives | ANTIRETROVIRALS | Emtricitabine | Emtriva, Truvada | OK? | Blum MR: C Clin Pharm 2007; 47:751 - Primarily eliminated via renal excretion; 60-70% recovered unchanged. |
ANTI-INFECTIVES | ANTIRETROVIRALS | Enfuvirtide | Fuzeon | OK? | |
Anti-infectives | ANTIRETROVIRALS | Indinavir | Crixivan | BAD! | www.drugs-porphyria.org: Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Extreme Caution Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007. Substrate,inducer and inhibitor of CYP3A4; pregnane X receptor inducer |
ANTI-INFECTIVES | ANTIRETROVIRALS | Lamivudine | Epivir | OK? | www.drugs-porphyria.org: Probably Not Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Extreme Caution www.drugs.com: 70% excreted as unchanged drug in urine |
Anti-infectives | ANTIRETROVIRALS | Lopinavir/Ritonavir | Kaletra | BAD! | Lopinavir www.drugs-porphyria.org: Probably Porphyrinogenic USP DI? Drug Info. for the Health Care Pro. - 26th Ed. (2006): Metabolized mainly by CYP3A, but metabolized by CYP2D6 if used with ritonavir. Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007. Substrate of CYP3A4 Ritonavir www.drugs-porphyria.org: Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Extreme Caution. Substrate of & inhibits CYP3A via human pregnane X receptor transactivation (Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T CYP2C9, pregnane X receptor Combination: Induces CYP2C9 |
Anti-infectives | ANTIRETROVIRALS | Maraviroc | Selzentry | OK? | ~50% meetab but does not induce CYP3A4 (Brit J Clin Pharmacol 65S:5,2008; and 66:498,2008) |
Anti-infectives | ANTIRETROVIRALS | Nelfinavir | Viracept | BAD? | www.drugs-porphyria.org: Probably Porphyrinogenic Williams DA: Op. Cit.: Substrate & inducer of CYP3A4, 2C9 |
Anti-infectives | ANTIRETROVIRALS | Nevirapine | Viramune | BAD! | www.drugs-porphyria.org: Probably Porphyrinogenic. >80% metab, by CYP3A4; also metab by CYP2B6. Induces CYP3A4 & 2B6 via transactivation of constitutive androstane receptor (Arch Toxicol 82:667,2008; Drug Metab Disp 8:895,1999; J Pharmacol Exp Therap 320:72,2007) |
Anti-infectives | ANTIRETROVIRALS | Nilotinib | Tasigna | No info | ~30% metab by CYP3A4 (Clin Therapeutics 30:1956,2008) |
Anti-infectives | ANTIRETROVIRALS | Raltegravir | Isentress | OK? | No CYP meetabolism or induction (Drug Metab Disp 35:1657,2007) |
Anti-infectives | ANTIRETROVIRALS | Ritonavir | Norvir | BAD! | www.drugs-porphyria.org: Porphyrinogenic. web.uct.ac.za/depts/porphyria/: Use with Extreme Caution. Substrate of, induces and inhibits CYP3A via human pregnane X receptor transactivation(Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007; Cur Drug Metab 7:375,2006; Arch Toxicol 82:667,2008) |
ANTI-INFECTIVES | ANTIRETROVIRALS | Saquinavir | Fortovase | BAD! | www.drugs-porphyria.org: Possibly Porphyrinogenic. CYP 3A4-metabolized. Inhibitor of CYP 3A4, seemingly not potent. Williams DA. Drug metabolism. In: Foye?s Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007. Substrate of CYP3A4 |
ANTI-INFECTIVES | ANTIRETROVIRALS | Stavudine | Zerit | NO INFO | www.drugs-porphyria.org: Possibly Porphyrinogenic. Furanosyl pyrimidine derivative. No P450 metabolism |
Anti-infectives | ANTIRETROVIRALS | Tenofovir | Viread, Truvada | OK? | www.drugs-porphyria.org: Probably Not Porphyrinogenic USP DI? Drug Info. for the Health Care Pro. - 26th Ed: 70-80% eliminated as unchanged drug http://redpoll.pharmacy.ualberta.ca/drugbank/: Not substrate of CYP3A4 or CYP2C9 |
ANTI-INFECTIVES | ANTIRETROVIRALS | Zalcitabine | Hivid | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use |
ANTI-INFECTIVES | ANTIRETROVIRALS | Zidovudine | Retrovir | BAD? | www.drugs-porphyria.org: Probably Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Extreme Caution www.uq.edu.au/porphyria/: Safe in patients |
ANTI-INFECTIVES | ANTIVIRALS | Acyclovir | Acyclovir | OK! | www.drugs-porphyria.org: Not Porphyrinogenic www.porphyria-europe.com: Safe www.uq.edu.au/porphyria/: Safe in cell culture Patient report: Safe |
ANTI-INFECTIVES | ANTIVIRALS | Adefovir | Hepsera | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic http://redpoll.pharmacy.ualberta.ca/drugbank/: Not a P450 substrate |
ANTI-INFECTIVES | ANTIVIRALS | Amantidine | Many | NO INFO | USP DI? Drug Info. for the Health Care Pro. - 26th Ed: not metabolized www.rxlist.com: Primarily secreted as unchanged drug |
ANTI-INFECTIVES | ANTIVIRALS | Famciclovir | Famvir | OK! | www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use |
ANTI-INFECTIVES | ANTIVIRALS | Ganciclovir | Cytovene | OK! | www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use |
ANTI-INFECTIVES | ANTIVIRALS | Interferon alfa-2B/Ribavirin | Rebetron | OK! | ??? |
Anti-infectives | ANTIVIRALS | Oseltamivir | Tamiflu | OK? | www.drugs-porphyria.org: Not Porphyrinogenic Not a P450 substrate (USP DI? Drug Info. for the Health Care Pro. - 26th Ed; http://redpoll.pharmacy.ualberta.ca/drugbank/) patient report: safe |
Anti-infectives | ANTIVIRALS | Ribavirin | Pegetron (also contains peginterferon) | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic USP DI? Drug Info. for the Health Care Pro. - 26th Ed: not p450 substrate www.rxlist.com: Two pathways of metabolism: (i) reversible phosphorylation in nucleated cells; (ii) degradation via deribosylation and amide hydrolysis to yield a triazole carboxylic acid. Should not involve CYP3A4 or CYP2C9 |
Anti-infectives | ANTIVIRALS | Valacyclovir | Valtrex | OK! | www.drugs-porphyria.org: Not Porphyrinogenic www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use patient report: safe |
ANTI-INFECTIVES | ANTIVIRALS | Zanamivir | Relenza | OK! | www.drugs-porphyria.org: Not Porphyrinogenic http://redpoll.pharmacy.ualberta.ca/drugbank/: Not metabolized |
Anti-infectives | CEPHALOSPORIN | Ceftaroline Fosamil | Teflaro | No info | Incomplete information re metabolism (Drugs 69:809, 2009) |
ANTI-INFECTIVES | CEPHALOSPORINS | Cefaclor | Ceclor | OK! | web.uct.ac.za/depts/porphyria/: Use with Caution |
ANTI-INFECTIVES | CEPHALOSPORINS | Cefazolin | Ancef | OK! | web.uct.ac.za/depts/porphyria/: Use with Caution |
ANTI-INFECTIVES | CEPHALOSPORINS | Cefepime | Maxipime | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Caution |
Anti-infectives | CEPHALOSPORINS | Cefotaxime | Claforan | OK? | Probably not metab by CYP |
ANTI-INFECTIVES | CEPHALOSPORINS | Cefotetan | Cefotan | OK! | USP DI? Drug Info. for the Health Care Pro. - 26th Ed. (2006): Not metabolized by P450 |
ANTI-INFECTIVES | CEPHALOSPORINS | Cefoxitin | Mefoxin | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Caution |
Anti-infectives | CEPHALOSPORINS | Cefpodoxime Proxetil | Vantin | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Caution. Patient report: safe |
Anti-infectives | CEPHALOSPORINS | Ceftazidime | Fortaz | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Caution. Patient report: safe |
ANTI-INFECTIVES | CEPHALOSPORINS | Ceftriaxone | Rocephin | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Caution |
ANTI-INFECTIVES | CEPHALOSPORINS | Cefuroxime | Zinacef | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Caution |
ANTI-INFECTIVES | CEPHALOSPORINS | Cephalexin | Keflex | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Caution Patient reports: Safe |
ANTI-INFECTIVES | CMV AGENTS | Cidofovir | Vistide | OK? | |
ANTI-INFECTIVES | CMV AGENTS | Fosamprenavir | Lexiva | BAD? | |
ANTI-INFECTIVES | CMV AGENTS | Foscarnet | Foscavir | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic USP DI? Drug Info. for the Health Care Pro. - 26th Ed. (2006): No P450 metabolism |
ANTI-INFECTIVES | CMV AGENTS | Valganciclovir | Valcyte | OK! | USP DI? Drug Info. for the Health Care Pro. - 26th Ed. (2006): Undergoes hydrolysis |
Anti-infectives | FLUOROQUINOLONES | Ciprofloxacin | Cipro | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Extreme Caution www.uq.edu.au/porphyria/: Safe in Patients PV Tishler MD clinical data & patient reports: Safe J Appl Toxicol 2005;25:339. Inhibits CYP3A |
Anti-infectives | FLUOROQUINOLONES | Levofloxacin | Levaquin | OK? | www.drugs-porphyria.org: Probably Not Porphyrinogenic PV Tishler MD clinical data & patient report: Safe Drug Metab Disp 1996;24:1134. Undergoes limited metabolism http://biocomp.health.unm.edu/ p450/metabP450diseasep3.pdf: Substrate of CYP1 family |
ANTI-INFECTIVES | FLUOROQUINOLONES | Moxifloxacin | Avelox | OK? | www.drugs-porphyria.org: Probably Not Porphyrinogenic |
Anti-infectives | FLUOROQUINOLONES | Norfloxacin | Noroxin | OK? | www.drugs-porphyria.org: Probably Not Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Extreme Caution www.uq.edu.au/porphyria/: Safe in cell culture J Appl Toxicol 2005;25:339. Inhibits CYP3A |
Anti-infectives | MACROLIDES | Azithromycin | Zithromax | OK? | www.drugs-porphyria.org: Probably Not Porphyrinogenic www.porphyria-europe.com: Safe. 2 patient reports: safe web.uct.ac.za/depts/porphyria/: Use with Extreme Caution USP DI? Drug Info. for the Health Care Pro. - 26th Ed. (2006): Metabolized in liver, but 50% in bile unchanged & 35% metabolized by demethylation Patient reports: safe |
Anti-infectives | MACROLIDES | Clarithromycin | Biaxin | OK? | www.drugs-porphyria.org: Possibly Porphyrinogenic. Inhibitor of CYP3A4 but forms irreversible complexes less readily than erythromycin. Some clinical experience of non-porphyrinogenicity. Two references state non- porphyrinogenicity. web.uct.ac.za/depts/porphyria/: Use with Caution www.uspharmacist.com: Inhibitor of CYP3A4 Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007: Substrate & inhibitor of CYP3A4 Sinz: Cur Drug Metab 2006; 7:375: no human pregnane X receptor activation |
Anti-infectives | MACROLIDES | Erythromycin | Many | BAD! | www.drugs-porphyria.org: Porphyrinogenic www.porphyria-europe.com: Unsafe web.uct.ac.za/depts/porphyria/: Avoid www.uq.edu.au/porphyria/: Unsafe in patients Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007: Substrate of, induces & inhibits CYP3A4. Patient report: Unsafe |
ANTI-INFECTIVES | MISCELLANEOUS | Aztreonam | Azactam | OK? | www.drugs-porphyria.org: Probably Not Porphyrinogenic http://redpoll.pharmacy.ualberta.ca/drugbank/: Metabolized via hydrolysis |
ANTI-INFECTIVES | MISCELLANEOUS | Bacitracin | Many | OK? | |
Anti-infectives | MISCELLANEOUS | Chloramphenicol | Many | BAD! | www.drugs-porphyria.org: Porphyrinogenic www.porphyria-europe.com: Unsafe web.uct.ac.za/depts/porphyria/: Avoid www.uq.edu.au/porphyria/: Unsafe in patients Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007. Substrate of CYP2C9 |
Anti-infectives | MISCELLANEOUS | Clindamycin | Cleocin | BAD? | www.drugs-porphyria.org: Porphyrinogenic web.uct.ac.za/depts/porphyria/: Avoid Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007. Substrate of & induces CYP3A4 Patient report: Safe |
Anti-infectives | MISCELLANEOUS | Dapsone | Leprostatic | BAD! | www.porphyria-europe.com: Unsafe web.uct.ac.za/depts/porphyria/: Avoid www.uq.edu.au/porphyria/: Unsafe in patients Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007. Substrate of CYP3A4 & CYP2C9 |
ANTI-INFECTIVES | MISCELLANEOUS | Daptomycin | Cubicin | NO INFO | |
Anti-infectives | MISCELLANEOUS | Fosfomycin | Monurol | OK? | Mainly not metabolized (Ann Pharmacother 32:215,1998) patient report: safe |
ANTI-INFECTIVES | MISCELLANEOUS | Linezolid | Zyvox | OK? | www.drugs-porphyria.org: Possibly Porphyrinogenic; insufficient data on metabolism but no indications for P450 interaction in vivo. USP DI? Drug Info. for the Health Care Pro. - 26th Ed. (2006): Not metabolized by P450 |
Anti-infectives | MISCELLANEOUS | Meropenem | Meronem | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic www.rxlist.com: 70% excreted as unchanged drug |
ANTI-INFECTIVES | MISCELLANEOUS | Mupirocin | Bactroban | OK? | www.drugs-porphyria.org: Possibly Porphyrinogenic. Probably not significantly absorbed. Probably not metabolized by P450 |
ANTI-INFECTIVES | MISCELLANEOUS | Polymyxin B | Many | OK? | |
ANTI-INFECTIVES | MISCELLANEOUS | Tigecycline | Tygacil | NO INFO | |
Anti-infectives | MISCELLANEOUS | Vancomycin | Vancocin, Others | OK! | www.drugs-porphyria.org: Not Porphyrinogenic www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use www.uq.edu.au/porphyria/: Safe in patients Br J Clin Pharmacol 1990;29:273. Safe |
Anti-infectives | PENEM ANTIBIOTICS | Doripenem | Doribax | OK! | Not a CYP substrate (Clin Therapeut 31:42,2009) |
Anti-infectives | PENEM ANTIBIOTICS | Ertapenem | Invanz | OK? | www.drugs-porphyria.org: Probably Not Porphyrinogenic www.rxlist.com: Does not appear to undergo hepatic metabolism |
Anti-infectives | PENEM ANTIBIOTICS | Imipenem/Cilastatin | Primaxin | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic USP DI? Drug Info. for the Health Care Pro. - 26th Ed. (2006): Not metabolized by P450 |
Anti-infectives | PENICILLINS | Amoxicillin | Many | OK! | www.drugs-porphyria.org: Not Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use www.uq.edu.au/porphyria/: Safe in patients PV Tishler MD clinical data & patient reports: Safe Pregnane X receptor inducer. |
Anti-infectives | PENICILLINS | Amoxicillin/ Clavulanate | Augmentin | OK! | patient report: safe |
ANTI-INFECTIVES | PENICILLINS | Ampicillin | Many | OK! | www.drugs-porphyria.org: Not Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use www.uq.edu.au/porphyria/: Safe in patients |
ANTI-INFECTIVES | PENICILLINS | Ampicillin/Sulbactam | Unasyn | NO INFO | |
ANTI-INFECTIVES | PENICILLINS | Carbenicillin | Geopen | NO INFO | |
Anti-infectives | PENICILLINS | Dicloxacillin | Many | OK? | www.drugs-porphyria.org: Not Porphyrinogenic. Induces CYP3A. |
Anti-infectives | Penicillins | flucloxacillin | Floxapen, etc. | BAD? | Not metabolizd by or inhibits CYP3A, 2C9, but induces CYP3A, PXR |
Anti-infectives | PENICILLINS | Nafcillin | Many | OK? | http://medicine.iupui.edu/flockhart/table.htm: CYP3A inducer. |
ANTI-INFECTIVES | PENICILLINS | Oxacillin | Many | OK? | http://www.rxlist.com/cgi/generic3/oxacillin_cp.htm: Rapidly excreted as unchanged drug |
ANTI-INFECTIVES | PENICILLINS | Penicillin | Many | OK! | web.uct.ac.za/depts/porphyria/: Use www.uq.edu.au/porphyria/: Safe in patients Patient report: Safe |
Anti-infectives | PENICILLINS | Piperacillin | Zosyn, etc. | OK! | www.drugs-porphyria.org: Not Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use. Patient report: safe |
ANTI-INFECTIVES | PENICILLINS | Ticarcillin | Ticar | OK! | www.uq.edu.au/porphyria/: Safe in patients |
ANTI-INFECTIVES | SEPSIS SYNDROME AGENTS - NON-ANTIBIOTIC | Drotrecogin alfa | Xigris | OK? | www.drugs-porphyria.org: Not Porphyrinogenic |
ANTI-INFECTIVES | SULFONAMIDES | Sulfadiazine | Many | BAD! | www.porphyria-europe.com: Unsafe www.uq.edu.au/porphyria/: Unsafe in patients www.porphyriafoundation.com: Unsafe Medicine (Balt) 1992;71:1. Unsafe |
Anti-infectives | SULFONAMIDES | Sulfamethoxazole/ Trimethoprim | Bactrim | BAD! | www.porphyria-europe.com: Unsafe www.uq.edu.au/porphyria/: Unsafe in patients www.porphyriafoundation.com: Unsafe Medicine (Balt) 1992;71:1. Unsafe. CYP2C9 substrate. Pregnane X receptor inducer. |
ANTI-INFECTIVES | SULFONAMIDES | Sulfasalazine | Azulfidine | BAD! | www.porphyria-europe.com: Unsafe www.uq.edu.au/porphyria/: Unsafe in patients www.porphyriafoundation.com: Unsafe Medicine (Balt) 1992;71:1. Unsafe |
ANTI-INFECTIVES | TETRACYCLINES | Demeclocycline | Declomycin | NO INFO | www.drugs-porphyria.org: Probably Porphyrinogenic |
Anti-infectives | TETRACYCLINES | Doxycycline | Vibramycin, others | OK? | www.drugs-porphyria.org: Possibly Porphyrinogenic/Probably Not Porphyrinogenic. Induces Pgrenane X receptor. web.uct.ac.za/depts/porphyria/: Avoid 2 patient reports: safe 1 patient report: unsafe |
Anti-infectives | TETRACYCLINES | Minocycline | Dynacin, Minocin | No info | www.uq.edu.au/porphyria/: Safe in cell culture |
Anti-infectives | TETRACYCLINES | Tetracycline | Many | OK? | web.uct.ac.za/depts/porphyria/: Use with Extreme Caution. Induces CYP3A. 1 patient report: safe |
Anti-infectives | URINARY ANTI-INFECTIVES | Methenamine Mandelate | Many | OK! | www.drugs-porphyria.org: Not Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use patient report: safe |
Anti-infectives | URINARY ANTI-INFECTIVES | Nitrofurantoin | Macrodantin, Macrobid | BAD! | www.drugs-porphyria.org: Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Extreme Caution www.uq.edu.au/porphyria/: Probably Unsafe |
Antidiabetics | Biguanides | Metformin | Glucophage, others | OK! | www.drugs-porphyria.org: Not porphyrinogenic. www.porphyria-europe.com: Safe. web.uct.ac.za/depts/porphyria/: Use. www.uq.edu/au/porphyria/: Safe in animals. Excreted largely unchanged; no hepatic metab (www.clinicalpharmacology-ip.com). Inhibits pregnane X receptor |
Antidiabetics | Dopamine Agonist | Bromocriptine | Cycloset | BAD! | See Bromocriptine, brand name Parlodel, in Central Nervous System Agents, Antiparkinson agents. |
Antidiabetics | DPP-4 Inhibitor | Linagliptin | Tradjenta, Jentadueto | OK? | >75% excreted unchanged. Major meteabolite created via CYP3A4, which is not induced (Drug Metab Disp 2010; 38:667). |
Antidiabetics | DPP-4 Inhibitors | Saxagliptin | Onglyza, Kombiglyze XR | No info | Primarily metab. by CYP3A4/5 (Clin Pharmacokinet 49:573, 2010) |
Antidiabetics | DPP-4 Inhibitors | Sitagliptin | Januvia | OK? | ~80% not metab; rest mainly by CYP3A4 (Drug Metab Disp 35:523,2007) |
Antidiabetics | DPP-4 Inhibitors/ Biguanides | Saxagliptin/ Metformin | Kombiglyze XR | No info | See Saxagliptin |
Antidiabetics | DPP-4 Inhibitors/ Biguanidess | Sitagliptin/ Metformin | Janumet | OK? | See Sitagliptin |
Antidiabetics | GLP-1 Receptor Agonist | Exenatide | Byetta | OK? | Drug is a peptide, with peptide metabolism. Physicians' Desk Reference 2010; 64:648 |
Antidiabetics | GLP-1 Receptor Agonist | Liraglutide | Victoza | OK? | Polypeptide-fatty acid, metabolized enzymatically. Drug Metab Disp 2010; 38:1944. |
Antidiabetics | Insulin | Insulin detmir | Levemir | OK! | Insulin analog; insulins are ok. |
Antidiabetics | Insulins | Insulins | Insulin | OK! | www.drugs-porphyria.org: Not porphyrinogenic. www.porphyria-europe.com: Safe. web.uct.ac.za/depts/porphyria/: Use. www.uq.au/porphyria/: Safe in patients |
Antidiabetics | Meglitinides | Repaglinide | Prandin | OK? | Metab mainly by CYP2C8, less by CYP3A4. No evidence of inducing CYPs (Clin Pharmacol Therap 77:341,2005; Med Letter 51:41,2009) |
Antidiabetics | Meglitinides/ Biguanides | Repaglinide/ Metformin | PrandiMet | OK? | See Repaglinide |
Antidiabetics | Sulfonylureas | Glimepiride | Amaryl | BAD? | www.drugs-porphyria.org: Possibly porphyrinogenic. Substrate of CYP2C9. Significantly transactivates pregnane X receptor but has a low probability of inducing CYP3A4 (Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007; Curr Drug Meetab 7:375,2006) |
Antidiabetics | Sulfonylureas | Glipizide | Glucotrol | BAD? | www.drugs-porphyria.org: Possibly porphyrinogenic. www.porphyria-europe.com:Safe. web.uct.ac.za/depts/porphyria/: Use with Caution www.uq.edu.au/porphyria/ : Unsafe in patients. Metab by CYP2C9(Pharmacogenetics 9:71,1999) |
Antidiabetics | Sulfonylureas | Glyburide | Micronase, Diabeta, others | OK? | Medicine (Balt) 71:1,1992 - Safe. Major metab by CYP2C9, minor metab by CYP3A4. No evidence for CYP induction (Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed Lemke T and Williams TA. Baltimore, Williams & Wilkins, 6th ed, 2007; Clin Pharm Therap 85:78,2008) |
Antidiabetics | Sulfonylureas/ Biguanides | Glipizide/ Metformin | Metaglip | BAD? | See Glipizide |
Antidiabetics | Sulfonylureas/ Biguanides | Glyburide/ Metformin | Glucovance | OK? | See Glyburide |
Antidiabetics | Thiazolidinediones | Pioglitazone | Actos | BAD? | www.drugs-porphyria.org: Probably porphyrinogenic. USP DI Drug Info. for the Health Care Pro. - 26th ED: Extensively metab by CYP2C8 & 3A4. Induces CYP3A4 & transactivates pregnane X receptor but at concns. higher than usual (Drug Metab Disp 31:439,2003;Curr Drug Metab 7:375,2006; Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007; Drug Metab Dispos 31:439,2003; Mol Pharmavcol 80:518, 2011) |
Antidiabetics | Thiazolidinediones | Rosiglitazone | Avandia | BAD? | www.drugs-porphyria.org: Probably porphyrinogenic. Metab by CYP2C9, CYP2C8. Induces CYP3A4 & 2B6, & does transactivate pregnane X receptor (Pharmaceutical Res 23:1089,2006; Eur J Pharm Sci 11:185,2000; Drug Metab Disp 31:439,2003; Curr Drug Metab 7:375,2006) Patient report: Safe |
Antidiabetics | Thiazolidinediones/ Biguanides | Pioglitazone/ Metformin | Actoplus Met | BAD? | See Pioglitazone |
Antidiabetics | Thiazolidinediones/ Biguanides | Rosiglitazone/ Metformin | Avandamet | BAD? | See Rosiglitazone |
ANTIDOTES | n/a | Deferoxamine | Desferal | OK! | www.drugs-porphyria.org: Not Porphyrinogenic www.rxlist.com: Mostly metabolized by plasma enzymes |
ANTIDOTES | n/a | Dimercaprol | BAL | OK! | web.uct.ac.za/depts/porphyria/: Use www.uq.edu.au/porphyria/: Safe |
ANTIDOTES | n/a | Edetate | Many | OK! | |
ANTIDOTES | n/a | Ipecac | Many | OK? | |
Antidotes | n/a | Physostigmine | Antilirium, others | OK? | |
Antidotes | SMOKING CESSATION | Varenicline | Chantix | OK? | J Clin Pharmacol 2006; 46:991: not a human P450 substrate; mostly excreted unchanged in animals. |
Antineoplastics | ALKYLATING AGENTS | Carboplatin | Paraplatin | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Caution No P450 metabolism. Does not induce CYP3A4 or transactivate pregnane X receptor (USP DI? Drug Info. for the Health Care Pro. - 26th Ed. (2006); Cancer Chemother Pharmacol 64:35,2009). Publ report: safe (Exp Opin Drug Saf 2008; 7:159) |
Antineoplastics | ANTIESTROGENS | Tamoxifen | Nolvadex | BAD? | www.drugs-porphyria.org: Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Extreme Caution www.uq.edu.au/porphyria/: Safe in patients Metab by CYP3A4,2B6,2C9,2D6. Minimally to modestly transactivates pregnane X receptor; inhibits CYP (Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007; Curr Drug Metab 7:375,2006; Clin Therapeutics 30:1385,2008; Cancer Chemother Pharmacol 64:35,2009; Curr Drug Metab 9:598,2008) |
Antineoplastics | ANTIMETABOLITES | Fluorouracil, 5-Fluorouracil | Many | OK? | www.drugs-porphyria.org: Probably Not Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Caution. Safe in patients. Does not induce CYP3A4 or transactivate pregnane X receptor (S Afr Med J 65:924,1984; Cancer Chemother Pharmacol 64:35,2009). Pub rpt: safe (Exp Opin Drug Saf 2008; 7:159). Patient report:as skin cream, safe |
Antineoplastics | ANTIMETABOLITES | Methotrexate | Trexall, Rheumatrex, others | OK? | www.drugs-porphyria.org: Probably Not Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Caution www.uq.edu.au/porphyria/: Unsafe in animals S Afr Med J 1984;65:924. Safe in patients Xenobiotica 1996;26:503. Limited or no interaction with CYP2C9 and CYP3A4 except for inhibition of Cyp3A. No effect on pregnane X receptor (Curr Drug Metab 7:375,2006; Drug Metab Dispos 32:348,2004) |
Antineoplastics | ENZYME INHIBITORS | Imatinib | Gleevac | OK? | www.drugs-porphyria.org: Possibly Porphyrinogenic Metab by CYP3A4, less by 2C9; induces and inhibits both. Does not transactivate pregnane X receptor (Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007; Cancer Chemother Pharmacol 64:35,2009) |
Antineoplastics | MISC. | Denosumab | Xgeva | OK! | Antibody for skeletal mets., osteoporosis. |
Antineoplastics | MITOTIC INHIBITORS | Docetaxel | Taxotere, etc. | OK? | www.drugs-porphyria.org: Probably Porphyrinogenic. Metab mainly by CYP3A4. Does not induce CYP3A, 2C9; weakly inhibits 3A. No to minimal transactivation of human pregnane X receptor (Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007; Pharmacogenetics 8:391,1998; Cur Drug Metab 7:375,2006; Cancer Chemother Pharmacol 64:35,2009. pt report pupblished: safe (Expert Opin Druf Saf 2008; 7:159. Patient report: safe. |
Antineoplastics | MITOTIC INHIBITORS | Etoposide | Eposin, Etopophos, Vepesid | BAD? | www.drugs-porphyria.org: Probably Porphyrinogenic www.uq.edu.au/porphyria/: Safe in patients Extensively metab by & induces CYP3A4. Transactivates pregnane X receptor & induces CYP3A4 in several studies, but not in one study (Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007; Mol Pharmacol 2002;62:439; Clin Therapeutics 30; 1385,2008; Cancer Chemother Pharmacol 64:35,2009) |
Antineoplastics | Mitotic Inhibitors | Gefitinib | Iressa | OK? | Well absorbed. Metabolized by CYP3A. Does not induce/inhibit CYP3a, 2C9. |
Antineoplastics | MITOTIC INHIBITORS | Paclitaxel | Taxol | BAD? | www.drugs-porphyria.org: Probably Porphyrinogenic. Minor metabolism by,& induces CYP3A4. Transactivates and induces pregnane X receptor (Pharmacogenomics 8:803,2007; Clin Cancer Res 11: 6359,2005; Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007; Cancer Chemother Pharmacol 64:35,2009) |
Antineoplastics | NITROGEN MUSTARDS | Cyclophosphamide | Cytoxan | OK? | www.drugs-porphyria.org: Probably Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Caution www.uq.edu.au/porphyria/: Unsafe in animals S Afr Med J 1984;65:924. Safe in patients Mainly metab by CYP2B6,~10% by CYP3A4. Minimally/moderately transactivates pregnane X receptor; strong constitutive androstane receptor activator. Does not induce CYP3A4, but does induce CYP2C9, CYP2B6 (Biochem Pharmacol 59:961,2000; Cancer Chemother Pharmacol 64:35,2009; Curr Drug Metab 9:598,2008; J Pharmacol Exp Therap 320:72, 2007) Patient report: Safe |
Antineoplastics | TOPOISOMERASE I INHIBITORS | Topotecan | Hycamtin | BAD? | www.drugs-porphyria.org: Probably Porphyrinogenic. Does induce CYP3A4 and transactivate pregnane X receptor (Cancer Chemother Pharmacol 64:35,2009) |
Antineoplastics | TOPOSIOMERASE INHIBITORS | irinotecan | Camptosar | BAD? | Major metab by & inhibits CYP3A4, also by CYP2B6. Strongly induces both CYPs in some studies, but neither induces CYP3A4 or transactivates pregnane X receptor in another study (Clin Cancer Res 7:2182,2001; Clin Therapeutics 30:1385,2008; Cancer Chemother Pharmacol 64:35,2009) |
Antineoplastics | TROPOISOMERASE INHIBITORS | Doxorubicin | Doxil, Adriamycin | OK! | Does not induce CYPs or transactivate pregnane X receptor(Canad J Physiol Pharmacol 77:589,1999; Cancer Chemother Pharmacol 64:35,2009). Publ. report: safe (Exp Opin Drug Saf 2008; 7:159) |
Antineoplastics (Cancer Therapies) | ALKYLATING AGENTS | Busulfan | Myleran | BAD! | www.drugs-porphyria.org: Probably Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Extreme Caution Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007. Substrate of CYP3A4 |
Antineoplastics (Cancer Therapies) | ALKYLATING AGENTS | Cisplatin | Platinol, Blastolem, others | OK! | www.drugs-porphyria.org: Not Porphyrinogenic www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use www.uq.edu.au/porphyria/: Safe in patients Does not induce CYP3A4 or trnasactivate pregnane X receptor (Cancer Chemother Pharmacol 64:35,2009). |
ANTINEOPLASTICS (Cancer Therapies) | ALKYLATING AGENTS | Procarbazine | Natulan | BAD! | web.uct.ac.za/depts/porphyria/: Use with Extreme Caution S Afr Med J 1984;65:924. Safe in patients |
ANTINEOPLASTICS (Cancer Therapies) | ALKYLATING AGENTS | Thiotepa | Thioplex | NO INFO | |
ANTINEOPLASTICS (Cancer Therapies) | ANGIOGENESIS INHIBITORS | Bevacizumab | Avastin | OK? | |
Antineoplastics (Cancer Therapies) | ANTIANDROGENS | Flutamide | Eulexin | BAD! | www.drugs-porphyria.org: Possibly Porphyrinogenic. Possibly metabolised by P450. Possibly ALAS-inducer. Metabolized by CYP3A or CYP2C9. Modestly transactivates pregnane X receptor and markedly induces CYP3A4 (J Gastroenterol 2006;41:231; Cancer Chemother Pharmacol 64:35,2009) Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007. Substrate of CYP3A4 |
Antineoplastics (Cancer Therapies) | ANTIBIOTICS | Actinomycin D or Dactinomycin | Cosmegen | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic www.uq.edu.au/porphyria/: Safe in animals |
ANTINEOPLASTICS (Cancer Therapies) | ANTIBIOTICS | Bleomycin | Blenoxane | OK! | www.drugs-porphyria.org: Not Porphyrinogenic http://redpoll.pharmacy.ualberta.ca/drugbank/: Metabolized by CYP1A1 |
Antineoplastics (Cancer Therapies) | ANTIBIOTICS | Idarubicin | Idamycin | BAD? | www.drugs-porphyria.org: Probably Not Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Extreme Caution |
ANTINEOPLASTICS (Cancer Therapies) | ANTIBIOTICS | Mitomycin | Mutamycin | BAD? | www.drugs-porphyria.org: Possibly Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Extreme Caution Insufficient data on metabolism. Little systemic resorption; probably safe for intravesical installation |
ANTINEOPLASTICS (Cancer Therapies) | ANTIBIOTICS | Mitoxantrone | Novantrone | BAD? | www.drugs-porphyria.org: Possibly Porphyrinogenic. Insufficient data on metabolism Largely unmetabolized. web.uct.ac.za/depts/porphyria/: Use with Extreme Caution |
ANTINEOPLASTICS (Cancer Therapies) | ANTIBIOTICS | Plicamycin | Mithracin | NO INFO | |
ANTINEOPLASTICS (Cancer Therapies) | ANTIBODIES | Alemtuzumab | Campath | OK! | www.drugs-porphyria.org: Not Porphyrinogenic http://redpoll.pharmacy.ualberta.ca/drugbank/: Not metabolized |
ANTINEOPLASTICS (Cancer Therapies) | ANTIBODIES | Cetuximab | Erbitux | OK? | |
ANTINEOPLASTICS (Cancer Therapies) | ANTIBODIES | Rituximab | Rituxan | OK! | www.drugs-porphyria.org: Not Porphyrinogenic http://redpoll.pharmacy.ualberta.ca/drugbank/: No liver metabolism |
ANTINEOPLASTICS (Cancer Therapies) | ANTIESTROGENS | Megestrol | Megace | BAD! | |
ANTINEOPLASTICS (Cancer Therapies) | ANTIMETABOLITES | Azacitidine | Vidaza | NO INFO | |
Antineoplastics (Cancer Therapies) | ANTIMETABOLITES | Capecitabine | Xeloda | OK? | Not metab by CYP. Metab to 5-fluorouracil, which does not induce CYPs (Drug Metab Disp 32:762,2004; Canad J Physiol Pharmacol 74:150,1996) |
ANTINEOPLASTICS (Cancer Therapies) | ANTIMETABOLITES | Capecitabine | Xeloda | NO INFO | |
ANTINEOPLASTICS (Cancer Therapies) | ANTIMETABOLITES | Cladribine | Leustatin | OK? | www.drugs-porphyria.org: Probably Not Porphyrinogenic http://redpoll.pharmacy.ualberta.ca/drugbank/: Not P450 substrate |
Antineoplastics (Cancer Therapies) | ANTIMETABOLITES | Cytarabine | Alexan, Cytarabin, Cytocin, others | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic www.rxlist.com: Not P450 substrate |
ANTINEOPLASTICS (Cancer Therapies) | ANTIMETABOLITES | Floxuridine | FUDR | OK? | |
Antineoplastics (Cancer Therapies) | ANTIMETABOLITES | Fludarabine | Fludara, others | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic www.rxlist.com: Not P450 substrate |
ANTINEOPLASTICS (Cancer Therapies) | ANTIMETABOLITES | Pemetrexed | Alimta | NO INFO | |
ANTINEOPLASTICS (Cancer Therapies) | ANTIMETABOLITES | Thioguanine | Lanvis | OK! | S Afr Med J 1984;65:924. Safe in patients |
Antineoplastics (Cancer Therapies) | AROMATASE INHIBITORS | Letrozole | Femara | BAD? | www.drugs-porphyria.org: Possibly Porphyrinogenic. Administered in rather low dose. CYP 3A4 and 2A6-mediated metabolism. Not an inhibitor of CYP19. (Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007) |
Antineoplastics (Cancer Therapies) | ENZYME INHIBITORS | Erlotinib | Tarceva | OK? | Williams DA. ~70% metab by CYP3A4. Modestly transactivates pregnane X receptor but does not induce CYP3A4 (Eur J Clin Pharmacol 64:31,2008; Cancer Chemother Pharmacol 64:35,2009) |
Antineoplastics (Cancer Therapies) | ENZYME INHIBITORS | Lapatinib | Tykerb | OK? | Metab mainly by CYP3A4,3A5. No evidence for CYP induction (Drugs 67:2101,2007) |
Antineoplastics (Cancer Therapies) | ENZYME INHIBITORS | Sorafenib | Nexavar | No info | ~50% metab by CYP3A4, ~50% not metab (PDR 63:784,2009) |
Antineoplastics (Cancer Therapies) | ENZYME INHIBITORS | Sunitinib | Sutent | OK? | ~30% metab by CYP3A4, ~40% not metab (PDR 63:2540,2009; Medical Letter 49:18,2007). Does not induce CYPs (Clin Therapeutics 30:1385,2008) |
ANTINEOPLASTICS (Cancer Therapies) | ENZYMES | Asparaginase | Elspar | OK! | www.drugs-porphyria.org: Not Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Caution |
ANTINEOPLASTICS (Cancer Therapies) | HORMONAL AGENTS | Diethylstilbestrol | Many | NO INFO | |
ANTINEOPLASTICS (Cancer Therapies) | HORMONAL AGENTS | Estramustine | Emcyt | BAD? | www.drugs-porphyria.org: Probably Porphyrinogenic |
ANTINEOPLASTICS (Cancer Therapies) | HORMONAL AGENTS | Testolactone | Teslac | NO INFO | |
Antineoplastics (Cancer Therapies) | IMMUNOMODULATORS | Levamisole | Ergamisol | No info | |
ANTINEOPLASTICS (Cancer Therapies) | INTERLEUKINS | Aldesleukin | Proleukin | OK? | |
ANTINEOPLASTICS (Cancer Therapies) | KERATINOCYTE GROWTH FACTOR | Palifermin | Kepivance | OK? | |
ANTINEOPLASTICS (Cancer Therapies) | MISC. | Arsenic Trioxide | Trisenox | NO INFO | |
ANTINEOPLASTICS (Cancer Therapies) | MISC. | Dacarbazine | Dtic-Dome | BAD? | www.drugs-porphyria.org: Possibly Porphyrinogenic. Not porphyrinogenic in chick embryo model. Like chloroambucil, melphalan, may be safer than other alkylating agents. |
ANTINEOPLASTICS (Cancer Therapies) | MISC. | Hydroxyurea | Hydrea | OK? | S Afr Med J 1984;65:924. Safe in patients |
ANTINEOPLASTICS (Cancer Therapies) | MISC. | Interferon Alfa-2A | Roferon-A | OK! | www.drugs-porphyria.org: Not Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Caution USP DI? Drug Info. for the Health Care Pro. - 26th Ed: Liver metabolism is minor pathway http://medicine.iupui.edu/flockhart/table.htm: Inhibitor of CYP1A2 |
ANTINEOPLASTICS (Cancer Therapies) | MISC. | Interferon Alfa-2B | Intron A | OK! | www.drugs-porphyria.org: Not Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Caution http://medicine.iupui.edu/flockhart/table.htm: Inhibitor of CYP1A2 |
ANTINEOPLASTICS (Cancer Therapies) | MISC. | Interferon Gamma-1B | Actimmune | OK! | www.drugs-porphyria.org: Not Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Caution http://medicine.iupui.edu/flockhart/table.htm: Inhibitor of CYP1A2 |
Antineoplastics (Cancer Therapies) | MISC. | Ixabepilone | Ixempra | BAD? | Highly metab by and induces CYP3A4; weakly transactivates pregnane X receptor (Clin Cancer Res 14:2701,2008; S Mani, pers commun) |
Antineoplastics (Cancer Therapies) | MISC. | oxaliplatin | Eloxatin | OK? | No evidence for CYP metabolism (PDR 63:2731,2009) |
ANTINEOPLASTICS (Cancer Therapies) | MISC. | Pentostatin | Nipent | NO INFO | |
Antineoplastics (Cancer Therapies) | MITOTIC INHIBITORS | Vinblastine | Velban | BAD? | www.drugs-porphyria.org: Possibly Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Extreme Caution www.uq.edu.au/porphyria/: Probably safe in cell culture Extensively metab by CYP3A4. Does not induce CYP3A4 or transactivate pregnane X receptor (Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007; Cancer Chemother Pharmacol 64:35,2009) |
Antineoplastics (Cancer Therapies) | MITOTIC INHIBITORS | Vincristine | Oncovin | OK? | www.drugs-porphyria.org: Possibly Porphyrinogenic. Porphyrinogenic in vitro. Administered in low weekly dose, probably insignificant hepatic exposure. Some clinical reports of non-porphyrinogenicity. web.uct.ac.za/depts/porphyria/: Use with Caution www.uq.edu.au/porphyria/: Probably safe in cell culture S Afr Med J 1984;65:924. Safe in patients USP DI? Drug Info. for the Health Care Pro. - 26th Ed. (2006): Metabolized by CYP3A4. Does not induce CYP3A4 or transactivate pregnane X receptor (Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007; Cancer Chemother Pharmacol 64:35,2009) |
ANTINEOPLASTICS (Cancer Therapies) | MITOTIC INHIBITORS | Vinorelbine | Navelbine | BAD? | www.drugs-porphyria.org: Possibly Porphyrinogenic. Substrate for CYP 3A4. No reports of CYP-induction in humans. Other vinca alkaloids have shown to be porphyrinogenic in vitro. Drug Metab Dispos 2000;28:1121. Major interaction with CYP3A4 |
ANTINEOPLASTICS (Cancer Therapies) | NITROGEN MUSTARDS | Chlorambucil | Leukeran | BAD! | www.drugs-porphyria.org: Possibly Porphyrinogenic. Insufficient data on metabolism. Conflicting references. Considered better tolerated than other alkylating agents generally avoided. One case report of uneventful use in a 54 yr old patient with IAP. web.uct.ac.za/depts/porphyria/: Avoid www.uq.edu.au/porphyria/: Unsafe in animals |
Antineoplastics (Cancer Therapies) | NITROGEN MUSTARDS | Ifosfamide | Ifex | BAD? | www.drugs-porphyria.org: Probably Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Extreme Caution Substrate of CYP3A4. Modestly transactivates pregnane X receptor. Does not induce CYP3A4 but does induce CYP2B6(Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007; Cancer Chemother Pharmacol 64:35,2009; Curr Drug Mdetab 9:598,2008) |
ANTINEOPLASTICS (Cancer Therapies) | NITROGEN MUSTARDS | Mechlorethamine | Mustargen | NO INFO | |
ANTINEOPLASTICS (Cancer Therapies) | NITROGEN MUSTARDS | Melphalan | Alkeran | OK? | www.drugs-porphyria.org: Possibly Porphyrinogenic. Not porphyrinogenic in experimental rat and chicken systems. Two references safe/probably safe. www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use with Caution www.uq.edu.au/porphyria/: Probably safe |
ANTINEOPLASTICS (Cancer Therapies) | NITROSOUREAS | Carmustine | Bicnu | NO INFO | |
ANTINEOPLASTICS (Cancer Therapies) | NITROSOUREAS | Lomustine | Ceenu | BAD! | www.drugs-porphyria.org: Probably Porphyrinogenic http://redpoll.pharmacy.ualberta.ca/drugbank: CYP3A4 substrate |
ANTINEOPLASTICS (Cancer Therapies) | NITROSOUREAS | Streptozocin | Zanosar | NO INFO | |
ANTINEOPLASTICS (Cancer Therapies) | RETINOIDS | Tretinoin | Retin-A | OK? | www.drugs-porphyria.org: Probably Not Porphyrinogenic Williams DA: Op. Cit.: Substrate of CYP3A4 |
Antineoplastics (Cancer Therapies) | Thyroid Cancer-Specific | Radioactive Iodine (I-131) | none | OK! | Patient experience |
ANTINEOPLASTICS (Cancer Therapies) | URINARY TRACT PROTECTIVE AGENTS | Amifostine | Ethyol | OK! | www.drugs-porphyria.org: Not Porphyrinogenic http://redpoll.pharmacy.ualberta.ca/drugbank/: No P450 metabolism |
ANTINEOPLASTICS (Cancer Therapies) | URINARY TRACT PROTECTIVE AGENTS | Mesna | Mesnex | OK? | www.drugs-porphyria.org: Probably Not Porphyrinogenic |
Arthritis | n/a | none | none | ||
Arthritis | n/a | Abatacept | Orencia | OK! | Protein. Not metab by CYPs (PDR 63:921,2009) |
Arthritis | n/a | adalimumab | Humira | OK! | Protein. Not metab by CYPs (PDR 63:442,2009) |
Arthritis | n/a | Celecoxib | Celebrex | BAD? | www.drugs-porphyria.org: Possibly porphyrinogenic. Metab.~80% by CYP2D9, <25% by CYP3A4; transactivates pregnane X receptor & induces CYP3A4 (Clin Pharmacokinetics 42:283, 2003; Durg Metab Disp 33:1567,2005; Clin Pharm Therap 80:298,2006) |
Arthritis | n/a | Certolizumab Pegol | Cimzia | OK! | Protein + polyethylene glycol. Not metab by CYPs (PDR 63:3127,2009) |
Arthritis | n/a | etanercept | Enbrel | OK! | Protein. Not metab by CYPs (PDR 63:569,2009) |
Arthritis | n/a | Golimumab | Simponi | OK! | Protein. No CYP metabolism |
Arthritis | n/a | Leflunomide | Arava | No info | Prob metab by CYPs (www.clinicalpharmacology-ip.com) |
Arthritis | n/a | Allopurinol | Zyloprim | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use www.uq.edu.au/porphyria/: Safe in animals Patient reports: Safe |
Arthritis | n/a | Auranofin | Ridaura | OK? | www.drugs-porphyria.org: Possibly Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Extreme Caution www.uq.edu.au/porphyria/: Unsafe in patients |
Arthritis | n/a | Aurothioglucose | Solganal | OK! | www.drugs-porphyria.org: Not Porphyrinogenic |
Arthritis | n/a | Colchicine | Colsalide | OK! | www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use www.uq.edu.au/porphyria/: Safe in patients Int J Biochem 1985;17:937. Safe in patients Substrate of CYP3A4 (Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007) |
Arthritis | n/a | Gold Sodium Thiomalate | Myochrysin | BAD! | www.drugs-porphyria.org: Possibly Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Extreme Caution www.uq.edu.au/porphyria/: Unsafe in animals |
Arthritis | n/a | Penicillamine | Cuprimine | OK! | www.drugs-porphyria.org: Not Porphyrinogenic www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: use www.uq.edu.au/porphyria/: Safe in patients |
Arthritis | n/a | Probenecid | Benemid | BAD? | www.drugs-porphyria.org: Probably Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Extreme Caution www.uq.edu.au/porphyria/: Probably unsafe Little to no induction of CYPs and no transactivation of pregnane X receptor (Curr Drug Metab 7:375,2006; Drug Metab Dispos 32:348,2004) |
Arthritis | n/a | Sulfinpyrazone | Many | BAD! | web.uct.ac.za/depts/porphyria/: Use with Extreme Caution www.uq.edu.au/porphyria/: Unsafe in cell culture Major metabolism by CYP3A4,2C9. Induces CYP3A4 via transactivation of pregnane X receptor (Drug Metab Disp 29:701,2001; Arch toxicol 82:667,2008; Cur Drug Metab 7:375,2006). Inhibits CYP2C9. |
Arthritis | Gout Treatment | Pegloticase | Krystexxa | OK! | Protein enzyme, with no metabolic problem |
Blood related | ANTICOAGULANTS | Dabigatran | Pradaxa | OK! | No appreciable P450 metab. (Drug Metab Disp 36:386, 2008) |
Blood related | ANTICOAGULANTS | Fondaparinux | Arixtra | OK? | www.drugs-porphyria.org: Probably Not Porphyrinogenic USP DI? Drug Info. for the Health Care Pro. - 26th Ed: 77% eliminated unchanged. Patient report: safe |
Blood related | Bleeding retardant | Tranexamic acid | Lystela, etc. | OK! | Mostly excreted unchanged |
Blood related | Plasma Replacement | Hydroxyethyl starch | Voluven | OK! | Not metabolized in any injurious way. |
BLOOD RELATED THERAPY | ANTICOAGULANTS | Abciximab | Reopro | OK! | www.drugs-porphyria.org: Not Porphyrinogenic |
BLOOD RELATED THERAPY | ANTICOAGULANTS | Argatroban | Argatroban | OK? | USP DI? Drug Info. for the Health Care Pro. - 26th Ed: CYP3A4/5 is not an important elimination pathway |
BLOOD RELATED THERAPY | ANTICOAGULANTS | Bivalirudin | Angiomax | OK? | USP DI? Drug Info. for the Health Care Pro. - 26th Ed: Clearance from plasma does not seem to involve liver |
Blood related therapy | ANTICOAGULANTS | Clopidogrel | Plavix | OK? | Metab by a number of CYPs. CYP3A4 and 2C19 are probably the most important, but their relative contributions are unknown. Does not induce CYP3A4 (Drug Metab Pharmacokinet 23:412,2008; Drug Metab Rev 37:99,2005; WC Lau, Pers Commun; MP Knadler, Pers Commun) |
BLOOD RELATED THERAPY | ANTICOAGULANTS | Dalteparin | Fragmin | OK! | www.drugs-porphyria.org: Not Porphyrinogenic |
BLOOD RELATED THERAPY | ANTICOAGULANTS | Dipyridamole | Persantine | OK! | www.drugs-porphyria.org: Not Porphyrinogenic www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use www.uq.edu.au/porphyria/: Safe in cell culture |
BLOOD RELATED THERAPY | ANTICOAGULANTS | Enoxaparin | Lovenox | OK! | www.drugs-porphyria.org: Not Porphyrinogenic www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use |
Blood related therapy | ANTICOAGULANTS | Eptifibatide | Integrilin | OK! | www.drugs-porphyria.org: Not Porphyrinogenic Clin Ther 1998;20:307. Polypeptide; deamidation probably via hydrolysis, not inlving P450 |
BLOOD RELATED THERAPY | ANTICOAGULANTS | Heparin | Many | OK! | www.drugs-porphyria.org: Not Porphyrinogenic www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use www.uq.edu.au/porphyria/: Safe in patients |
Blood related therapy | ANTICOAGULANTS | Lepirudin | Refludan | OK! | Polypeptide. Not metab by CYPs |
BLOOD RELATED THERAPY | ANTICOAGULANTS | Protamine | Protamine | OK! | |
Blood related therapy | ANTICOAGULANTS | Ticlopidine | Ticlid | OK? | www.drugs-porphyria.org: Probably Porphyrinogenic http://medicine.iupui.edu/flockhart/table.htm: Similar to (and see discussion of) clopidogrel |
BLOOD RELATED THERAPY | ANTICOAGULANTS | Warfarin | Coumadin | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use www.uq.edu.au/porphyria/: Safe in patients Williams DA. Drug metabolism. In: Foye?s Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007. Substrate of CYP3A4 & 2C9 |
BLOOD RELATED THERAPY | HEMATOPOIETICS | Cyanocobalamin | Vitamin B12 | OK! | www.drugs-porphyria.org: Probably Porphyrinogenic PV Tishler, MD clinical data: Safe |
BLOOD RELATED THERAPY | HEMATOPOIETICS | Epoetin Alfa | Epogen | OK! | www.drugs-porphyria.org: Not Porphyrinogenic www.porphyria-europe.com: Safe |
Blood related therapy | HEMATOPOIETICS | Filgrastim (G-CSF) | Neupogen | OK! | (G-C web.uct.ac.za/depts/porphyria/) www.drugs-porphyria.org: Not Porphyrinogenic |
BLOOD RELATED THERAPY | HEMATOPOIETICS | Multivitamins | Many | OK! | |
BLOOD RELATED THERAPY | HEMOSTATICS | Aminocaproic Acid | Amicar | OK! | web.uct.ac.za/depts/porphyria/: Use www.uq.edu.au/porphyria/: Safe in patients |
BLOOD RELATED THERAPY | HEMOSTATICS | Aprotinin | Trasylol | OK! | www.drugs-porphyria.org: Not Porphyrinogenic |
BONES | BISPHOSPHONATES | Alendronate | Fosamax | OK! | USP DI? Drug Info. for the Health Care Pro. - 26th Ed. (2006): Not metabolized Patient reports: safe |
Bones | Bisphosphonates | Ibandronate | Boniva | OK? | Bisphosphonates are not metabolized. |
BONES | BISPHOSPHONATES | Zoledronic Acid | Zometa | OK! | www.drugs-porphyria.org: Not Porphyrinogenic USP DI? Drug Info. for the Health Care Pro. - 26th Ed: No P450 inhibition in vitro |
Bones | Bisphosponates | Risedronate | Actonel | OK? | Bisphosphonates are not metabolized |
Cardiovascular | ACE INHIBITORS | Enalapril (Enalaprilat) | Vasotec | OK! | www.drugs-porphyria.org: Not Porphyrinogenic 2 Patient reports: Safe No transactivation of pregnane X receptor (Curr Drug Metab 6:375,2006) |
Cardiovascular | ACE INHIBITORS | Lisinopril | Prinivil | OK! | www.drugs-porphyria.org: Not Porphyrinogenic P4 atient reports: Safe No transactivation of pregnane X receptor (Curr Drug Metab 6:375,2006) |
Cardiovascular | ACE INHIBITORS | Ramipril | Altace | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic Patient reports: Safe |
Cardiovascular | ANGIOTENSIN II RECEPTOR ANTAGONISTS | Candesartan Cilexetil | Atacand | OK! | www.drugs-porphyria.org: Not Porphyrinogenic www.porphyria-europe.com: Safe, Metab by CYP2C9. |
Cardiovascular | ANGIOTENSIN II RECEPTOR ANTAGONISTS | Losartan | Cozaar | OK! | www.drugs-porphyria.org: Possibly Porphyrinogenic. >2 clinical reports: safe. Substrate of mainly CYP2C9, lesser of CYPs 3A4, 3A5. No data pointing to CYP induction. Safe in cell culture. (Biochem Pharmacol 1999;58:887;Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007) |
Cardiovascular | ANGIOTENSIN II RECEPTOR ANTAGONISTS | Olmesartan | Benicar | OK! | Virtually not metabolized (PDR 63:1009,2009). 1 patient report: safe |
Cardiovascular | ANGIOTENSIN II RECEPTOR ANTAGONISTS | Valsartan | Diovan | OK! | www.drugs-porphyria.org: Not Porphyrinogenic USP DI? Drug Info. for the Health Care Pro. - 26th Ed: Some metabolism by CYP2C9. Patient reports: Safe |
Cardiovascular | ANGIOTENSIN RECEPTOR ANTAGONISTS | Eprosartan | Teveten | OK! | 98% excreted unchanged, 2% as glucuronide. |
Cardiovascular | ANTIADRENERGICS | Doxazosin | Cardura | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Caution PV Tishler MD clinical data: Safe Br J Clin Pharmacol 1997;43:339. Safe at <10mg/d. patient report: safe (5 yrs) |
Cardiovascular | ANTIHYPERLIPIDEMIC AGENTS | Atorvastatin | Lipitor | OK? | www.drugs-porphyria.org: Patient report - safe Mainly metab by CYP3A4, but very low likelihood of CYP3A4 induction (Clin Pharmacol Therap 80:565,2006; Curr Drug Metab 7:375,2006) 4 patient reports: Safe |
Cardiovascular | ANTIHYPERLIPIDEMIC AGENTS | Colestipol | Colestid | OK! | Not absorbed. Patient reports: safe |
Cardiovascular | ANTIHYPERLIPIDEMIC AGENTS | Fluvastatin | Lescol | OK? | Mainly metab by CYP2C9, also 3A4. Minimal transactivation of pregnane X receptor (Clin Pharmacol Therap 80:565,2006; Curr Drug Metab 7:375,2006) |
Cardiovascular | Antihyperlipidemic Agents | Lovastatin | Mevacor, etc | BAD? | Readily absorbed by liver. Metabolized by & induces CYP3A, 2C9. Induces PXR. |
Cardiovascular | ANTIHYPERLIPIDEMIC AGENTS | Pravastatin | Pravachol | OK? | www.drugs-porphyria.org: Possibly Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Extreme Caution. Substrate of CYP3A, but excreted mostly unchanged, and does not induce CYPs (Mol Pharmacol 65:1302,2004;Clin Pharm Therap 80:565,2006) Experience of P. Tishler, MD and others - safe |
Cardiovascular | ANTIHYPERLIPIDEMIC AGENTS | Rosuvastatin | Crestor | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic www.porphyria-europe.com: Safe. Metab by CYP2C9; not metab. by CYP3A4,5. patient report: safe |
Cardiovascular | ANTIHYPERLIPIDEMIC AGENTS | Simvastatin | Zocor, others | OK? | www.drugs-porphyria.org: Patient experience - safe web.uct.ac.za/depts/porphyria/: Use with Extreme Caution www.uq.edu.au/porphyria/: Unsafe in animals Unsafe in cell culture (Biomed Pharmacother 43:135,1989). Mainly metab by CYP3A4,but very low likelihood of CYP3A4 induction (Clin Pharm Therap 80:565,2006;Curr Drug Metab 7:375,2006); strong pregnane xenobiotic activator (J Pharm Exp Therap 320:72, 2007). Patient reports: Safe |
Cardiovascular | ANTIOGENSIN RECEPTOR ANTAGONISTS | Telmisartan | Micardis | OK! | Only metabolite is glucuronide (J Clin Pharm 2000: 40 (12 pt 1), 1312. |
Cardiovascular | BETA BLOCKERS (includes some ophthalmic preparations) | Labetalol | Normodyne, Trandate | OK! | www.drugs-porphyria.org: Not Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use www.uq.edu.au/porphyria/: Safe in patients patient report: safe |
Cardiovascular | BETA BLOCKERS (includes some ophthalmic preparations) | Metoprolol | Lopressor | OK! | web.uct.ac.za/depts/porphyria/: Use www.uq.edu.au/porphyria/: Safe in patients PV Tishler MD clinical data & patient report: Safe Medicine (Balt)1992;71:1. Safe. Induces CYP3A. |
Cardiovascular | CALCIUM CHANNEL BLOCKERS | Amlodipine | Norvasc | OK? | www.drugs-porphyria.org: Probably Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Extreme Caution Not safe in patients (Ann Pharmacother 1997;31:253) Safe at <10mg/d (Br J Clin Pharmacol 1997;43:339) Substrate of & induces CYP3A4 (Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007. Induces pregnane X receptor. 4 patient reports: Safe, certainly at 5 mg/day. |
Cardiovascular | CALCIUM CHANNEL BLOCKERS | Diltiazem | Cardizem | BAD? | www.drugs-porphyria.org: Probably Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Caution www.uq.edu.au/porphyria/: Probably unsafe Substrate of & inhibitor of CYP3A4. Modest transactivation of pregnane X receptor, but low probability of CYP3A4 induction (Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007; http://medicine.iupui.edu/clinpharm/ddis/; Curr Drug Metab 7:375,2006) |
Cardiovascular | CALCIUM CHANNEL BLOCKERS | Felodipine | Plendil | BAD? | www.drugs-porphyria.org: Probably Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Extreme Caution Substrate of & inducer of CYP3A4. Modest transactivator of pregnane X receptor, metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007; Curr Drug Metab 7:375,2006) |
Cardiovascular | CALCIUM CHANNEL BLOCKERS | Nicardipine | Cardene | BAD! | Induces CYP3A4, 2C9; inhibits 3A. Transactivates pregnane X receptor (Drug Metab Disp 29:1325,2001) |
Cardiovascular | CALCIUM CHANNEL BLOCKERS | Nifedipine | Procardia, Adalat | BAD! | www.drugs-porphyria.org: Probably Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Extreme Caution www.uq.edu.au/porphyria/: Unsafe in patients www.porphyriafoundation.com: Unsafe Medicine (Balt) 1992;71:1. Safe Clin Sci (Lond) 1985;69:581. Unsafe in cell culture Substrate of CYP3A4. Induces CYP3A4, 2C9 via transactivation of pregnane X receptor (Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007; Drug Metab Disp 29:1325,2001) Patient report: safe |
Cardiovascular | CALCIUM CHANNEL BLOCKERS | Verapamil | Verapamil, Tarka | OK? | Metab by & inhibits induction of CYP3A4.(http://medicine.iupui.edu/clinpharm/ddis/; Amer J Therap 16:155, 2009; Curr Drug Metab 5:543,2004) |
Cardiovascular | DIURETICS | Furosemide | Lasix | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use with Caution www.uq.edu.au/porphyria/: Unsafe in patients PV Tishler MD clinical data & patient reports: Safe Medicine (Balt) 1992;71:1. Safe |
Cardiovascular | DIURETICS | Spironolactone | Aldactone | BAD? | www.drugs-porphyria.org: Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Caution www.uq.edu.au/porphyria/: Unsafe in animals Safe (Medicine (Balt) 1992;71:1, 1992). Induces CYP3A. Transactivates pregnane X receptor (Expert Opin Drug Metab Toxicol 4:895,2008) |
Cardiovascular | DIURETICS | Torsemide | Demadex, others | OK? | ~75% metab, mostly by CYP2C9 (Br J Clin Pharm 50:573,2000; Clin Pharmacol Therap 76:557,2004). 2 Patient reports: safe |
Cardiovascular | IMPOTENCE AGENTS | Sildenafil | Viagra | BAD? | www.drugs-porphyria.org: Possibly Porphyrinogenic Major metab by CYP3A4, less by CYP2C9; weak inhibitors of both (Drug Metab Disp 36:986,2008). Patient report: Safe |
Cardiovascular agents | ACE INHIBITORS | Benazepril | Lotensin | OK! | Patient report: safe |
Cardiovascular agents | ACE INHIBITORS | Captopril | Capoten | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic. Patient report: safe No transactivation of pregnane X receptor (Curr Drug Metab 6:375,2006) |
Cardiovascular agents | ACE INHIBITORS | Trandolapril | Mavik | OK! | |
Cardiovascular agents | ANGIOTENSIN II RECEPTOR ANTAGONISTS | Irbesartan | Avapro, Avalide | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic Mostly not metab by CYPs. Some metab by CYP2C9, but doessnot induce any CYP (Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007; PDr 63:892,2009) |
Cardiovascular agents | ANTIADRENERGICS | Clonidine | Catapres | BAD! | www.drugs-porphyria.org: Probably Porphyrinogenic www.porphyria-europe.com: Unsafe web.uct.ac.za/depts/porphyria/: Avoid www.uq.edu.au/porphyria/: Unsafe in patients and cell culture |
Cardiovascular agents | ANTIADRENERGICS | Methyldopa | Aldomet | BAD! | www.drugs-porphyria.org: Porphyrinogenic www.porphyria-europe.com: Unsafe web.uct.ac.za/depts/porphyria/: Avoid Patient report: Unsafe |
Cardiovascular agents | ANTIADRENERGICS | Prazosin | Minipress | OK! | www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use www.uq.edu.au/porphyria/: Probably safe Medicine (Balti) 1992:71:1. Safe |
Cardiovascular agents | ANTIADRENERGICS | Terazosin | Hytrin | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Caution No transactivation of pregnane X receptor (Curr Drug Metab 6:375,2009) |
Cardiovascular agents | ANTIANGINAL AGENTS | Isosorbide Dinitrate | Imdur | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Caution |
Cardiovascular agents | ANTIANGINAL AGENTS | Nitroglycerin | Many | OK? | Not a CYP substrate (Biochem. J 1993; 292:545) |
Cardiovascular agents | ANTIARRHYTHMICS | Adenosine | Many | OK! | www.drugs-porphyria.org: Not Porphyrinogenic USP DI? Drug Info. for the Health Care Pro. - 26th Ed. (2006): Not metabolized by P450 |
Cardiovascular agents | ANTIARRHYTHMICS | Amiodarone | Many | BAD? | www.drugs-porphyria.org: Probably Porphyrinogenic web.uct.ac.za/depts/porphyria/: Avoid www.uq.edu.au/porphyria/: Unsafe in cell culture Gen Pharmacol 1999;32:259. Safe Probably mostly metab by CYP3A4. Induces but more strongly inhibits CYP3A4 (J Pharm Pharm Sci 11:147,2008; Clin Pharm Therap 77:63, 2005) |
Cardiovascular agents | ANTIARRHYTHMICS | Bretylium | Bretylol | OK? | |
Cardiovascular agents | ANTIARRHYTHMICS | Disopyramide | Norpace | BAD? | www.drugs-porphyria.org: Probably Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Caution www.uq.edu.au/porphyria/: Probably safe |
Cardiovascular agents | ANTIARRHYTHMICS | Flecainide | Tambocor, others | OK! | www.drugs-porphyria.org: Possibly Porphyrinogenic. Metabolized by CYP2D6. No data pointing to CYP-induction (http://medicine.iupui.edu/clinpharm/ddis/) |
Cardiovascular agents | ANTIARRHYTHMICS | Ibutilide | Corvert | OK? | www.drugs-porphyria.org: Possibly Porphyrinogenic Circulation 1998;97:493. Metabolic pathway does not seem to involve CYP3A4 or CYP2D6 |
Cardiovascular agents | ANTIARRHYTHMICS | Lidocaine | Xylocaine | OK? | www.drugs-porphyria.org: Porphyrinogenic metab by CYP3A4, 1A2. May ihibit its metab (Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007: Pharmacol 1990; 255:1385; Curr Drug Metab 5:543, 2004) |
Cardiovascular agents | ANTIARRHYTHMICS | Mexiletine | Mexitil | OK? | www.drugs-porphyria.org: Possibly Porphyrinogenic. Metabolized by CYP2D6, 1A2. No data pointing to CYP-induction (Clin Pharmacokinet 46:985,2007) |
Cardiovascular agents | ANTIARRHYTHMICS | Moricizine | Ethmozine | No info | |
Cardiovascular agents | ANTIARRHYTHMICS | Procainamide | Pronestyl | OK! | www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use www.uq.edu.au/porphyria/: Safe in cell culture |
Cardiovascular agents | ANTIARRHYTHMICS | Propafenone | Rhthmol | BAD? | www.drugs-porphyria.org: Possibly Porphyrinogenic Metabolized by CYP2D6, 3A4, others; relative importances not known (Curr Drug Metab 5:543,2004; Clin Pharmacokinet 46:985,2007) |
Cardiovascular agents | ANTIARRHYTHMICS | Quinidine | Many | OK? | www.drugs-porphyria.org: Probably Porphyrinogenic Substrate of CYP3A4. Minimal transactivation of pregnane X receptor (Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007; Curr Drug Metab 7:375,2006) |
Cardiovascular agents | ANTIARRHYTHMICS | Tocainide | Tonocard | No info | |
Cardiovascular agents | ANTIHYPERLIPIDEMIC AGENTS | Cholestyramine | Questran | OK! | Not absorbed from GI tract |
Cardiovascular agents | ANTIHYPERLIPIDEMIC AGENTS | Clofibrate | Atromid-S | OK! | www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use with Caution www.uq.edu.au/porphyria/: Safe in cell culture |
Cardiovascular agents | ANTIHYPERLIPIDEMIC AGENTS | Ezetimibe | Zetia, Vitorin | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic USP DI? Drug Info. for the Health Care Pro. - 26th Ed. (2006): Undergoes minimal oxidation. Extensively metabolized but not by CYP (PDR 63:2149,2009) Patient report: Safe |
Cardiovascular agents | ANTIHYPERLIPIDEMIC AGENTS | Gemfibrozil | Lopid | OK? | www.drugs-porphyria.org: Probably Not Porphyrinogenic www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use with Caution Metab by CYP2C8. Minimally transactivates pregnane X receptor (Drug Metab Disp 34:191,2006; Curr Drug Metab 7:375,2006) |
Cardiovascular agents | ANTIHYPERLIPIDEMIC AGENTS | Niacin | Many | No info | USP DI? Drug Info. for the Health Care Pro. - 26th Ed: Not P450 substrate |
Cardiovascular agents | ANTIHYPERTENSIVE - RENIN INHIBITOR | Aliskiren | Tekturna | OK? | ~20% metab, mainly by CYP3A4; does not induce CYP3A4 (Pharmacol Rpts 60:623,2008; J clin Pharmacol 48:1323,2008) |
Cardiovascular agents | ANTIHYPERTENSIVE- DUAL AGENT | Aliskiren/ Amlodipine | Tekamlo | BAD? | See individual drug listings. |
Cardiovascular agents | BETA BLOCKERS | Nebivolol | Bystolic | OK? | Extensively metab by CYP2D6 (Med Letter 50:17,2008). Patient experience: safe |
Cardiovascular agents | BETA BLOCKERS (includes some ophthalmic preparations) | Acebutolol | Many | OK! | web.uct.ac.za/depts/porphyria/: Use Medicine (Balt)1992; 71:1. Safe biocomp.health.unm.edu/p450/metabP450diseasep4.pdf: Substrate/inhibitor of CYP2D6 |
Cardiovascular agents | BETA BLOCKERS (includes some ophthalmic preparations) | Atenolol | Tenormin | OK! | www.drugs-porphyria.org: Not Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use www.uq.edu.au/porphyria/ safe in patients PV Tishler MD clinical data & patient reports: Safe Medicine (Balt) 1992;71:1. Safe |
Cardiovascular agents | BETA BLOCKERS (includes some ophthalmic preparations) | Betaxolol | Many | OK! | www.drugs-porphyria.org: Possibly Porphyrinogenic |
Cardiovascular agents | BETA BLOCKERS (includes some ophthalmic preparations) | Carteolol | Many | OK! | web.uct.ac.za/depts/porphyria/: Use |
Cardiovascular agents | BETA BLOCKERS (includes some ophthalmic preparations) | Esmolol | Brevibloc | OK! | www.drugs-porphyria.org: Not Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use |
Cardiovascular agents | BETA BLOCKERS (includes some ophthalmic preparations) | Nadolol | Corgard | OK! | web.uct.ac.za/depts/porphyria/: Use |
Cardiovascular agents | BETA BLOCKERS (includes some ophthalmic preparations) | Pindolol | Visken | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use |
Cardiovascular agents | BETA BLOCKERS (includes some ophthalmic preparations) | Propranolol | Inderal | OK! | www.drugs-porphyria.org: Not Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use PV Tishler MD clinical data & patient report: Safe Safe (Br J Clin Pharmacol 1997;43:339) Safe (Medicine (Balt) 1992;71:1) Substrate of CYP3A4 & other CYPs. Does not transactivate pregnane X receptor (Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007; Curr Drug Metab 7:375,2006; http://medicine.iupui.edu/clinpharm/ddis/) |
Cardiovascular agents | BETA BLOCKERS (includes some ophthalmic preparations) | Sotalol | Betapace, others | OK! | www.drugs-porphyria.org: Not Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use Medicine (Balt) 1992;71:1. Safe |
Cardiovascular agents | BETA BLOCKERS (includes some ophthalmic preparations) | Timolol | Blocadren | OK! | www.drugs-porphyria.org: Not Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use www.uq.edu.au/porphyria/: Safe in cell culture Medicine (Balt)1992;71:1. Safe |
Cardiovascular agents | CALCIUM CHANNEL BLOCKERS | Amlodipine/ olmesartan | Azor | BAD? | See amlodipine |
Cardiovascular agents | CALCIUM CHANNEL BLOCKERS | Bepridil | Vascor | BAD! | www.uq.edu.au/porphyria/: Unsafe in cell culture Williams DA: Op. Cit.: Substrate of CYP3A4 |
Cardiovascular agents | CALCIUM CHANNEL BLOCKERS | Clevidipine | Cleviprex | OK? | Unlikely inducer of CYPs at therapeutic doses (Drug Metab Disp 34:734,2006) |
Cardiovascular agents | CALCIUM CHANNEL BLOCKERS | Nimodipine | Nimotop | BAD! | www.drugs-porphyria.org: Probably Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Extreme Caution Substrate of CYP3A4 (Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007) |
Cardiovascular agents | CARDIAC GLYCOSIDES | Digoxin | Lanoxin | OK! | www.drugs-porphyria.org: Not Porphyrinogenic www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use with Caution www.uq.edu.au/porphyria/: Safe in patients Medicine (Balt) 1992;71:1. Safe |
Cardiovascular agents | DIURETICS | Acetazolamide | Diamox | OK! | web.uct.ac.za/depts/porphyria/: Use www.uq.edu.au/porphyria/: Safe in patients & cell culture |
Cardiovascular agents | DIURETICS | Amiloride | Midamor, Moduretic, others | OK! | www.drugs-porphyria.org: Not Porphyrinogenic www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use www.uq.edu.au/porphyria/: Safe in patients |
Cardiovascular agents | DIURETICS | Bumetanide | Bumex | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use www.uq.edu.au/porphyria/: Safe in patients Patient report: Safe |
Cardiovascular agents | DIURETICS | Eplerenone | Inspra | BAD? | ~95% metab, mainly by CYP3A4. (Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007; J Clin Pharmacol 45:810,2005; Am J Therapeutics 16:255,2009) |
Cardiovascular agents | DIURETICS | Ethacrynic Acid | Edecrin | OK! | www.uq.edu.au/porphyria/: Safe in patients http://www.emedicine.com/MED/topic1880.htm: Safe in porphyria |
Cardiovascular agents | DIURETICS | Hydrochlorothiazide | Many | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use with Caution www.uq.edu.au/porphyria/: Safe in patients PV Tishler MD clinical data & patient reports: Safe |
Cardiovascular agents | DIURETICS | Metolazone | Zaroxolyn | BAD? | web.uct.ac.za/depts/porphyria/: Use with Extreme Caution |
CARDIOVASCULAR AGENTS | DIURETICS | Triamterene | Dyrenium | OK! | www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use |
Cardiovascular agents | DOPAMINE D1 RECEPTOR AGONISTS | Fenoldopam | Corlopam | No info | |
Cardiovascular agents | IMPOTENCE AGENTS | Tadalafil | Cialis | OK? | www.drugs-porphyria.org: Probably Not Porphyrinogenic www.premiumdrugs.com/globalcart/ html/media/docs/cialis-pi-us.pdf: metabolized primarily by CYP3A4 |
Cardiovascular agents | IMPOTENCE AGENTS | Vardenafil | Levitra | No info | Major metab by CYP3A4, 3A5 (Drug Metab Disp 36:986,2008) |
Cardiovascular agents | MISC. | Diazoxide | Hyperstat | OK! | www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use www.uq.edu.au/porphyria/: Safe in cell culture |
Cardiovascular agents | MISC. | Tolazoline | Priscoline | OK! | www.uq.edu.au/porphyria/: Safe in patients http://www.emedicine.com/MED/topic1880.htm: Safe in porphyria |
Cardiovascular agents | PHOSPHODIESTERASE INHIBITORS | Milrinone | Primacor | No info | |
Cardiovascular agents | THROMBOLYTIC ENZYMES | Alteplase | Activase | OK! | www.drugs-porphyria.org: Not Porphyrinogenic www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use with Caution |
Cardiovascular agents | THROMBOLYTIC ENZYMES | Streptokinase | Many | OK! | www.drugs-porphyria.org: Not Porphyrinogenic www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use |
Cardiovascular agents | THROMBOLYTIC ENZYMES | Tenecteplase | Tnkase | OK! | www.drugs-porphyria.org: Not Porphyrinogenic |
Cardiovascular agents | VASODILATORS | Hydralazine | Apresoline | BAD! | www.drugs-porphyria.org: Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Extreme Caution www.uq.edu.au/porphyria/: Unsafe in patients |
Cardiovascular agents | VASODILATORS | Minoxidil | Many | BAD? | www.drugs-porphyria.org: Possibly Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Extreme Caution |
Cardiovascular agents | VASODILATORS | Nitroprusside | Nipride | OK? | web.uct.ac.za/depts/porphyria/: Use with Caution Redox Rep 2004;9:360: No P450 metabolism |
Cardiovascular agents | VASOPRESSORS | Dobutamine | Dobutrex, others | OK! | www.drugs-porphyria.org: Not Porphyrinogenic www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use |
Cardiovascular agents | VASOPRESSORS | Dopamine | Intropin, others | OK! | www.drugs-porphyria.org: Not Porphyrinogenic www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use |
Cardiovascular agents | VASOPRESSORS | Ephedrine | Many | OK! | www.drugs-porphyria.org: Not Porphyrinogenic |
Central nervous system | ANTICONVULSANTS | Carbamazepine | Tegretol | BAD! | www.drugs-porphyria.org: Porphyrinogenic www.porphyria-europe.com: unsafe web.uct.ac.za/depts/porphyria/: Avoid www.uq.edu.au/porphyria/: Unsafe in patients Unsafe/risky in patients (Epilepsia 33:108,1992; Neurology 32:1409,1982; Neurology 45:1216,1995). Major metab by CYP3A4. Induces CYP3A4 via transactivation of constitutive androstane receptor & kpregnane X receptor. Also induces CYP2C9, other CYPs. (Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007; Arch toxicol 82:667,2008; Clin Therapeutics 30:1385,2008) Patient report: Safe (low dose) |
Central nervous system | ANTICONVULSANTS | Gabapentin | Neurontin | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use PV Tishler MD clinical data & patient reports: Safe Not a substrate for & does not induce CYPs (Fundam Clin Pharmacol 14:301,2000; Clin Therapeutics 30:1385,2008) |
Central nervous system | ANTICONVULSANTS | Phenytoin | Dilantin | BAD! | www.drugs-porphyria.org: Porphyrinogenic www.porphyria-europe.com: Unsafe web.uct.ac.za/depts/porphyria/: Avoid www.uq.edu.au/porphyria/: Unsafe in patients Unsafe in patients (Neurology 45:1216,1995; Epilepsia 33:108,1992) Substrate & inducer of CYP3A4 & CYP2C9. Strongly activates constitutive androstane receptor & pregnane X receptor, & induces CYP3A4. (Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007; JBC 279:29295,2004; Arch Toxicol 82:667,2008) 1 Patient report: Safe. 1 patinet report: unsafe |
Central nervous system | ANTICONVULSANTS | Pregabalin | Lyrica | OK! | >90% non-metabolized (PDR 63:2527,2009). Patient reports: safe |
Central nervous system | ANTICONVULSANTS | Topiramate | Topomax | BAD? | www.drugs-porphyria.org: Probably porphyrinogenic. www.porphyria.uct.ac.za: Use only with extreme caution. 30-40% metabolized, some by CYP2C9; metab by CYP3A4 probably minimal, but induces CYP3A4 via transactivation of pregnane X receptor (Pharmacokinet 45:1061,2006; Epilepsia 46:378,2005; Arch Toxicol 82:667,2008; Clin Therapeutics 30:1385,2008) 1 patient report: safe |
Central nervous system | ANTICONVULSANTS | Valproic Acid | Depakene, Stavzor | OK? | www.drugs-porphyria.org: Porphyrinogenic web.uct.ac.za/depts/porphyria/: Avoid www.porphyriafoundation.com: Unsafe Largely not CYP metab; some metab by multiple CYP2C9 but not CYP3A4. Induces CYP3A. Does not transactivate pregnane X receptor. (Clin Therapeutics 30:1385,2008; Curr Drug Metab 7:375,2006) |
Central nervous system | ANTIPARKINSON AGENTS | Ropinirole | Roquid | OK? | ~90% metab by CYP1A2, small amt by CYP3A (Clin Pharmacokinet 39:243,2000). 1 patient report: safe. |
Central nervous system | Antispasmodic | Trospium | Sanctura | OK! | Ester hydrolysis, with probably littel/no P450 metabolism. 1 patient report: safe. |
Central nervous system | BENZODIAZEPINES | Alprazolam | Xanax | OK? | www.drugs-porphyria.org: Probably Not Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Caution www.uq.edu.au/porphyria/: Unsafe in cell culture Mainly metab by CYP3A4, but does not transactivate pregnane X receptor (USP DI? Drug Info. for the Health Care Pro. - 26th Ed; Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007; Curr Drug Metrab 7:375,2006) >1Patient reports: Safe |
Central nervous system | BENZODIAZEPINES | Diazepam | Valium | OK? | www.drugs-porphyria.org: Probably Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Caution www.uq.edu.au/porphyria/: Unsafe in patients Medicine (Balt) 1992;71:1. Safe Substrate of CYP3A4,2B6,2C9. Modest transactivator of pregnane X receptor, but low prediction of CYP3A4 inducibility (Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007; Curr Drug Metab 7:375,2006; Curr Drug Metab 9:598,2008) 2 Patient reports: Safe |
Central nervous system | BENZODIAZEPINES | Temazepam | Restoril | OK! | www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use www.uq.edu.au/porphyria/: Safe in patients Substrate of CYP3A4 (Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007) 2 Patient reports: Safe |
Central nervous system | BENZODIAZEPINES | Triazolam | Halcion | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use www.uq.edu.au/porphyria/: Safe in animals Medicine (Balt) 1992;71:1. Safe Substrate of CYP3A4 (Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007). 1 patientreport: safe. |
Central nervous system | HYPNOTICS (Sleeping Medications) | Chloral Hydrate | Many | OK! | www.porphyria-europe.com: Safe www.uq.edu.au/porphyria/: Safe in patients Peter V. Tishler, MD, clinical experience: safe patient report: safe |
Central nervous system | HYPNOTICS (Sleeping Medications) | Zolpidem | Ambien, Edluar, Intermezzo, Zolpimist | OK! | www.drugs-porphyria.org: Possibly Porphyrinogenic CYP3A substrate. Moderate transactivator of pregnane X receptor, but low prediction of CYP3A4 inducibility (Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007;http://medicine.iupui.edu/flockhart/table.htm; Curr Drug Metab 7:375,2006) 6 Patient reports: safe |
Central nervous system | MIGRAINE THERAPY | Sumatriptan | Imitrex | OK? | www.drugs-porphyria.org: Possibly Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Caution 2 patient reports: safe |
Central nervous system | NARCOTICS (Pain Therapies) | Fentanyl | Duragesic | OK? | www.drugs-porphyria.org: Probably Not Porphyrinogenic www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use www.uq.edu.au/porphyria/: Safe in animals Substrate of & induces CYP3A4 (Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007).Induces pregnane X receptor Patient reports: Safe |
Central nervous system | NARCOTICS (Pain Therapies) | Methadone | Many | OK! | www.drugs-porphyria.org: Possibly Porphyrinogenic www.porphyria-europe.com: safe web.uct.ac.za/depts/porphyria/: Use Metab by CYP3A, less by 2C9. |
Central nervous system | NARCOTICS (Pain Therapies) | Tramadol | Ultram, Ultracet, Ryzolt, etc. | No info | Largely metab by CYP3A4,2D6 (Eur J Clin Pharm 62:513,2006). Patient report: safe |
Central nervous system | NONSTEROIDAL ANTI-INFLAMMATORY AGENTS -NSAIDs (Pain, Arthritis Therapies, etc.) | Acetaminophen | Tylenol | OK! | www.porphyriafoundation.com: Safe PV Tishler MD clinical data & patient reports: Safe Induces constitutive androstene receptor. |
Central nervous system | NONSTEROIDAL ANTI-INFLAMMATORY AGENTS -NSAIDs (Pain, Arthritis Therapies, etc.) | Ibuprofen | Advil, Motrin | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic www.porphyria-europe.com: Safe. Metab by CYP2C9,2C8. PV Tishler MD clinical data & patient reports: Safe at low dose used intermittently, BUT one acute attack at high, prolonged dose (Drug Metab Disp 33:1567, 2005) patient reports: safe |
Central nervous system agents | AMPHETAMINES | Dextroamphetamine | Dexedrine | OK? | |
Central nervous system agents | Anti-Glaucoma | Brinzolamide/ Brimonidine | Simbrinza | BAD! | Brinzolamide is a sulfonamide, and thus this is contraindicated |
Central nervous system agents | ANTICONVULSANTS | Clonazepam | Klonopin | BAD! | www.drugs-porphyria.org: Probably Not Porphyrinogenic www.porphyria-europe.com: safe web.uct.ac.za/depts/porphyria/: Use with Caution www.uq.edu.au/porphyria/: Probably unsafe www.porphyriafoundation.com: unsafe Epilepsia 1992;33:108. porphyrogenic but safe in lose dosages Neurology 1982;32:1409. safe in low dosages Greatly induces CYP2B. Substrate of but does not induce CYP3A or 2C9 (Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007; Drug Metab Dispos 25:750,1997) |
Central nervous system agents | ANTICONVULSANTS | Divalproex | Depakote | OK? | Dimer of valproic acid. See Valproic acid. |
Central nervous system agents | ANTICONVULSANTS | Ethosuximide | Zarontin | BAD? | www.drugs-porphyria.org: Probably Porphyrinogenic www.porphyria-europe.com: Unsafe web.uct.ac.za/depts/porphyria/: Use with Extreme Caution www.uq.edu.au/porphyria/: Unsafe in patients www.porphyriafoundation.com: Unsafe Unsafe in animals (Neurology 1981;31:480) Substrate of CYP3A4, but does not transactivate pregnane X receptor. Minor metab by CYP2C9, other CYPs (Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007; Curr Drug Metab 7:375, 2006; Clin Therapeutics 30:1385,2008) |
Central nervous system agents | ANTICONVULSANTS | Felbamate | Felbatol | BAD! | www.drugs-porphyria.org: Probably Porphyrinogenic www.porphyriafoundation.com: Unsafe Metab mainly by CYP3A4, also 2C9, others. Induces CYP3A4 but does not transactivate pregnane X receptor (Fundam Clin Pharmacol 14:301,2000; Curr Drug Metab 7:375,2006; Clin Therapeutics 30:1385,2008) |
Central nervous system agents | ANTICONVULSANTS | Fosphenytoin | Cerebyx | BAD! | www.drugs-porphyria.org: Porphyrinogenic Metab mainly by CYP2C9, also CYP3A4, others. Induces CYP2C9,3A4 (Clin Therapeutics 30:1385,2008. Same as Phenytoin. |
Central nervous system agents | ANTICONVULSANTS | Levetiracetam | Keppra | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic www.porphyria-europe.com: Safe Not a substrate for & does not induce CYPs (Fundam Clin Pharmacol 14:301,2000; Clin Therapeutics 30:1385,2008) |
Central nervous system agents | ANTICONVULSANTS | Methsuximide | Celontin | BAD! | www.uq.edu.au/porphyria/: Unsafe in patients Neurology 1981;31:480. Unsafe in animals |
Central nervous system agents | ANTICONVULSANTS | Oxcarbazepine | Trileptal | BAD! | www.drugs-porphyria.org: Probably Porphyrinogenic www.porphyria-europe.com: Unsafe web.uct.ac.za/depts/porphyria/: Avoid Induces CYP3A4 (Fundam Clin Pharmacol 14:301,2000) |
Central nervous system agents | ANTICONVULSANTS | Phenobarbital | Luminal | BAD! | www.drugs-porphyria.org: Porphyrinogenic www.porphyria-europe.com: Unsafe web.uct.ac.za/depts/porphyria/: Avoid Strongly activates constitutive androstane receptor, pregnane X receptor, & induces CYP3A4 (BBRC 277:1, 2000; Arch Toxicol 82:667,2008) |
Central nervous system agents | ANTICONVULSANTS | Primidone | Mysoline | BAD! | www.drugs-porphyria.org: Porphyrinogenic www.porphyria-europe.com: Unsafe web.uct.ac.za/depts/porphyria/: Avoid www.uq.edu.au/porphyria/: Unsafe in patients www.porphyriafoundation.com: Unsafe Neurology 1981;31:480. Unsafe in animals. Metab by CYP3A4 to phenobarbital (BAD!!); induces CYP3A4 (Clin Therapeutics 30:1385,2008) |
Central nervous system agents | ANTICONVULSANTS | Zonisamide | Zonegran | BAD? | Major metab by CYP3A4; also CYP2C19. (Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007; Clin Therapeutics 30:1385,2008) |
Central nervous system agents | ANTIMYASTHENIC AGENTS | Ambenonium | Mytelase | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic |
Central nervous system agents | ANTIMYASTHENIC AGENTS | Edrophonium | Tensilon | OK! | |
Central nervous system agents | ANTIMYASTHENIC AGENTS | Guanidine | Guanidine | NO INFO | |
Central nervous system agents | ANTIMYASTHENIC AGENTS | Neostigmine | Prostigmine | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use |
Central nervous system agents | ANTIMYASTHENIC AGENTS | Pyridostigmine | Mestinon | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Caution. Patient report: safe |
Central nervous system agents | ANTIPARKINSON AGENTS | Amantadine | Symmetrel | OK! | www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use |
Central nervous system agents | ANTIPARKINSON AGENTS | Benztropine | Cogentin | NO INFO | |
Central nervous system agents | ANTIPARKINSON AGENTS | Bromocriptine | Parlodel | BAD! | www.drugs-porphyria.org: Probably Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Extreme Caution www.uq.edu.au/porphyria/: Unsafe in cell culture Metab by CYP3A4 (Clin Therapeutics 28:1065,2006) |
Central nervous system agents | ANTIPARKINSON AGENTS | Entacapone | Comtan, Stalevo | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic. Not metab by CYPs (PDR 63:2208, 2009) |
Central nervous system agents | ANTIPARKINSON AGENTS | Levodopa | Many | OK! | web.uct.ac.za/depts/porphyria/: Use with Caution USP DI? Drug Info. for the Health Care Pro. - 26th Ed: Not P450 substrate http://www.ukmi.nhs.uk/NewMaterial/ html/docs/entacapo.pdf: Main metabolic pathway does not involve P450 |
Central nervous system agents | ANTIPARKINSON AGENTS | Levodopa/ Carbidopa | Sinemet | OK! | |
Central nervous system agents | ANTIPARKINSON AGENTS | Pergolide | Permax | No info | metab by CYP3A4 (Clin Therapeutics 28:2065,2006) |
Central nervous system agents | ANTIPARKINSON AGENTS | Pramipexole | Mirapex | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic www.rxlist.com: ~90% excreted unchanged. No CYP metab (Eur J Neurol 7 Suppl 1:15,2000) |
Central nervous system agents | ANTIPARKINSON AGENTS | Rotigotine | Neupro (patch) | OK? | Metab by multiple CYPs. Does not induce CYP3A4, 2C9 (PDR 63:3149,2009) |
Central nervous system agents | ANTIPARKINSON AGENTS | Selegiline | Emsam, Eldepryl, Zelapar | BAD? | www.drugs-porphyria.org: Probably Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Extreme Caution Metab by CYP2B6, which may involve pregnane X receptor |
Central nervous system agents | ANTIPARKINSON AGENTS | Trihexyphenidyl | Artane | BAD? | www.drugs-porphyria.org: Possibly Porphyrinogenic web.uct.ac.za/depts/porphyria/: Avoid |
Central nervous system agents | BENZODIAZEPINES | Chlordiazepoxide | Librium | BAD! | web.uct.ac.za/depts/porphyria/: Use with Extreme Caution www.uq.edu.au/porphyria/: Unsafe in patients Medicine (Balt) 1992;71:1. Safe |
Central nervous system agents | BENZODIAZEPINES | Estazolam | Prosom | OK? | www.uq.edu.au/porphyria/: Cell cuture - probably safe PV Tishler MD clinical data: Safe Metab. almost exclusively by CYP3A4 (https://online.epocrates.com/front_porch/; Xenobiotica 35:455,2005) |
Central nervous system agents | BENZODIAZEPINES | Flurazepam | Dalmane | BAD! | web.uct.ac.za/depts/porphyria/: Use with Extreme Caution www.uq.edu.au/porphyria/: Unsafe in patients |
Central nervous system agents | BENZODIAZEPINES | Lorazepam | Ativan | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use www.uq.edu.au/porphyria/: Probably safe Not metab by CYPs (Curr Drug Metab 9:827,2008) PV Tishler MD clinical data: Safe Medicine (Balt) 1992;7:1. Safe |
Central nervous system agents | BENZODIAZEPINES | Oxazepam | Serax | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Caution www.uq.edu.au/porphyria/: Probably unsafe. Not metab by CYPs (Curr Drug Metab 9:827,2008) |
Central nervous system agents | HYPNOTICS (Sleeping Medications) | Butabarbital | Butisol | BAD! | www.porphyria-europe.com: Unsafe. See phenobarbital |
Central nervous system agents | HYPNOTICS (Sleeping Medications) | Butalbital | Fiorinal | BAD! | See phenobarbital |
Central nervous system agents | HYPNOTICS (Sleeping Medications) | Eszopiclone | Lunesta | OK? | Substrate of CYP3A4 (Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007) |
Central nervous system agents | HYPNOTICS (Sleeping Medications) | Ethchlorvynol | Placidyl | BAD! | |
Central nervous system agents | HYPNOTICS (Sleeping Medications) | Pentobarbital | Nembutal | BAD! | www.porphyria-europe.com: Unsafe Patient report: Unsafe See Phenobarbital |
Central nervous system agents | HYPNOTICS (Sleeping Medications) | Ramelteon | Rozerem | BAD? | Patient report - bad. Minor metab. by CYP3A4. |
Central nervous system agents | HYPNOTICS (Sleeping Medications) | Secobarbital | Seconal | BAD! | www.porphyria-europe.com: Unsafe Induces CYP3A4 (Arch Toxicol 82:667,2008) See Phenobarbital |
Central nervous system agents | HYPNOTICS (Sleeping Medications) | Zaleplon | Sonata | BAD! | www.drugs-porphyria.org: Possibly Porphyrinogenic Metabolized by CYP3A4 (Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007; Xenobiotica 2002;32:835) Patient reports: Safe |
Central nervous system agents | MIGRAINE THERAPY | Ergotamine | Cafergot | BAD! | www.porphyria-europe.com: Unsafe web.uct.ac.za/depts/porphyria/: Avoid www.uq.edu.au/porphyria/: Unsafe in patients www.porphyriafoundation.com: Unsafe Substrate of CYP3A4 (Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007) |
Central nervous system agents | MIGRAINE THERAPY | Isometheptene/ Dichloralphenazone | Midrin, others | BAD? | Isometheptene www.uq.edu.au/porphyria/: Unsafe in animals Dichloralphenazone www.uq.edu.au/porphyria/: Unsafe in patients |
Central nervous system agents | MIGRAINE THERAPY | Naratriptan | Amerge | NO INFO | www.drugs-porphyria.org: Possibly Porphyrinogenic |
Central nervous system agents | MIGRAINE THERAPY | Rizatriptan | Maxalt | OK? | www.drugs-porphyria.org: Possibly Porphyrinogenic No significant interaction with CYPs. Primary metabolism does not involve CYPs (PDR 63:2056,2009; www.cbg-meb.nl/uk/docs/nieuws/par-maxalt.pdf) |
Central nervous system agents | MIGRAINE THERAPY | Zolmitriptan | Zomig | OK? | www.drugs-porphyria.org: Possibly Porphyrinogenic. Insufficient data on metabolism. One report (Swedish) of tolerance. Xenobiotica 1999;29:847. Metabolized almost entirely by CYP1A2. Sinz M: Cur Drug Metab 2006; 7:375. No activation of pregnane X receptor. |
Central nervous system agents | NARCOTICS (Pain Therapies) | Alfentanil | Alfenta | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use Substrate ~equally of CYP3A4, 3A5 (Williams DA. Drug metabolism. In: Foye?s Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007; Drug Metab Disp 33:303,2005) |
Central nervous system agents | NARCOTICS (Pain Therapies) | Buprenorphine | Buprenex, Suboxone, Subutex | OK! | www.drugs-porphyria.org: Not Porphyrinogenic www.porphyria-europe.com: Safe www.uq.edu.au/porphyria/: Safe in patients PV Tishler MD clinical data: Safe Ann Fr Anesth Reanim 1989;8:525. Safe Substrate of CYP3A4 (Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007) |
Central nervous system agents | NARCOTICS (Pain Therapies) | Butorphanol | Stadol | OK! | |
Central nervous system agents | NARCOTICS (Pain Therapies) | Codeine | Many | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use www.uq.edu.au/porphyria/: Safe in patients PV Tishler MD clinical data & patient report: Safe Substrate of CYP3A4 (Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007) |
Central nervous system agents | NARCOTICS (Pain Therapies) | Hydrocodone | Vicodin, others | OK! | see Respiratory Agents/antitussive Agents |
Central nervous system agents | NARCOTICS (Pain Therapies) | Hydromorphone | Dilaudid | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic |
Central nervous system agents | NARCOTICS (Pain Therapies) | Meperidine | Demerol | OK! | PV Tishler MD clinical data: Safe JAMA 1965;194:1037. Safe in patients |
Central nervous system agents | NARCOTICS (Pain Therapies) | Morphine | Many | OK! | www.drugs-porphyria.org: Not Porphyrinogenic www.porphyria-europe.com: safe web.uct.ac.za/depts/porphyria/: Use www.uq.edu.au/porphyria/: Safe in patients PV Tishler MD clinical data: Safe |
Central nervous system agents | NARCOTICS (Pain Therapies) | Nalbuphine | Nubain | OK! | www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use |
Central nervous system agents | NARCOTICS (Pain Therapies) | Oxycodone | Oxycontin, Percocet, Percodan, others | OK! | www.drugs-porphyria.org: Possibly Porphyrinogenic www.uq.edu.au/porphyria/: Unsafe in animals PV Tishler MD clinical data & patient reports: Safe |
Central nervous system agents | NARCOTICS (Pain Therapies) | Pentazocine | Talwin | BAD! | web.uct.ac.za/depts/porphyria/: Avoid www.uq.edu.au/porphyria/: Unsafe in patients |
Central nervous system agents | NONSTEROIDAL ANTI-INFLAMMATORY AGENTS -NSAIDs (Pain, Arthritis Therapies, etc.) | Aspirin | Many | OK! | www.drugs-porphyria.org: Not Porphyrinogenic www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use www.uq.edu.au/porphyria/: Safe in patients www.porphyriafoundation.com: Safe PV Tishler MD clinical data & patient reports: Safe |
Central nervous system agents | NONSTEROIDAL ANTI-INFLAMMATORY AGENTS -NSAIDs (Pain, Arthritis Therapies, etc.) | Diclofenac | Voltaren | BAD? | www.drugs-porphyria.org: Probably Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Extreme Caution www.uq.edu.au/porphyria/: Unsafe in patients www.porphyriafoundation.com: Unsafe PV Tishler MD clinical data: Safe Biomed Pharmacother 43:135,1989 - Unsafe in cell culture Limited metab by CYP2C9, ?2C8 (Drug Metab Disp 33:1567, 2005) |
Central nervous system agents | NONSTEROIDAL ANTI-INFLAMMATORY AGENTS -NSAIDs (Pain, Arthritis Therapies, etc.) | Indomethacin | Indocin | OK! | web.uct.ac.za/depts/porphyria/: Use www.uq.edu.au/porphyria/: Probably safe. ~50% metab by CYP2C9 (Drug Metab Disp 33:1567, 2005). Medicine (Balt) 71:1, 1992 - Safe in some, not safe in others |
Central nervous system agents | NONSTEROIDAL ANTI-INFLAMMATORY AGENTS -NSAIDs (Pain, Arthritis Therapies, etc.) | Ketoprofen | Orudis, Oruvail, others | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use with Caution Probably not metab by CYPs PV Tishler MD clinical data: Safe (Drug Metab Disp 33:1567,2005) |
Central nervous system agents | NONSTEROIDAL ANTI-INFLAMMATORY AGENTS -NSAIDs (Pain, Arthritis Therapies, etc.) | Ketorolac Tromethamine | Toradol | BAD! | www.drugs-porphyria.org: Possibly Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Extreme Caution Eksp Klin Farmakol. 2005;68:56. CYP2C substrate |
Central nervous system agents | NONSTEROIDAL ANTI-INFLAMMATORY AGENTS -NSAIDs (Pain, Arthritis Therapies, etc.) | Naproxen | Naprosyn, Aleve | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use www.uq.edu.au/porphyria/: Safe in patients and animals 20-40% metab by CYP2C9 (<50% of this), other CYPs Patient reports: Safe (Drug Metab Disp 33:1567,2005) |
Central nervous system agents | NONSTEROIDAL ANTI-INFLAMMATORY AGENTS -NSAIDs (Pain, Arthritis Therapies, etc.) | Sulindac | Clinoril | OK! | www.drugs-porphyria.org: Possibly Porphyrinogenic www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use www.uq.edu.au/porphyria/: Safe in animals Minimal CYP2D9 metab (Drug Metab Disp 33:1567,2005) |
CONTRAST MEDIA | n/a | Diatrizoate Meglumine | Hypaque | OK! | |
CONTRAST MEDIA | n/a | Ethiodized Oil | Ethiodol | OK! | |
CONTRAST MEDIA | n/a | Ferumoxides | Endorem | OK! | |
CONTRAST MEDIA | n/a | Gadopentetate Dimeglumine | Magnevist | OK! | |
CONTRAST MEDIA | n/a | Iodipamide Meglumine | Chlorografin, Sinografin | OK! | |
Contrast media | n/a | Iodixanol | Visipaque | OK! | www.drugs-porphyria.org: Not Porphyrinogenic www.fda.gov/medwatch/SAFETY/ 2003/03DEC_PI/Visipaque_PI.pdf: No metabolism |
CONTRAST MEDIA | n/a | Iohexol | Omnipaque | OK! | www.drugs-porphyria.org: Not Porphyrinogenic |
CONTRAST MEDIA | n/a | Iopanoic Acid | Telepaque | OK! | |
CONTRAST MEDIA | n/a | Iopromide | Ultravist | OK! | www.drugs-porphyria.org: Not Porphyrinogenic |
Dermatologicals | ACNE | Isotretinoin | Accutane, Sotret, Amnesteem, Claravis | BAD? | web.uct.ac.za/depts/porphyria/: Use with Extreme Caution Substrate of CYP3A4. Minimally transactivates pregnane X receptor, and has low proability of inducing CYP3A4 (Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007; Curr Drug Metab 7:375,2006) |
Dermatologicals | ANTIPSORIATICS - SYSTEMIC | Acitretin | Soriatane | BAD? | www.drugs-porphyria.org: Possibly Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Extreme Caution |
Dermatologicals | Dermatosis, allergy, psoriasis | desoximetasone | topicort | OK? | Topical corticosteroid. 1 patinet report: safe |
Diagnostic | n/a | Methacholine | Provocholine, others | OK! | |
Diagnostic | Imaging | Gadobutrol | Gadavist | OK! | MRI contrast agent that is not metabolized |
Gastrointestinal | ANTIDIARRHEAL AGENTS | Rifaximin | Xifaxan | OK! | >99% excreted in feces unabsorbed/unchanged (PDR 65:2911, 2011). Induces pregnane X receptor. |
Gastrointestinal | ANTIEMETICS (Vomiting Therapies) | Dronabinol | Marinol | BAD? | Major metab by CYP3A4 & 2C9 (Williams DA. Induces pregnane X receptor. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007) |
Gastrointestinal | ANTIEMETICS (Vomiting Therapies) | Meclizine | Antivert, Bonine | OK! | >3 patient reports: safe. Induces & inhibits constitutive androstene receptor. |
Gastrointestinal | ANTISPASMODICS | Dicyclomine | Bental, others | OK! | www.uq.edu.au/porphyria/: Safe in patients Patient reports: Safe |
Gastrointestinal | ANTISPASMODICS | Hyoscyamine | Levsin, others | OK! | 3 patient reports: safe |
Gastrointestinal | H-2 ANTAGONISTS, PPIs (Reflux, Ulcer Therapies) | Cimetidine | Tagamet | OK! | www.drugs-porphyria.org: Not Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Caution www.uq.edu.au/porphyria/: Probably unsafe Clin Chim Acta 1995;234:171. Safe in patients Ann Int Med 2005; 143:694. Safe and possibly therapeutic during acute attack. PV Tishler, MD clinical data & patient reports: Safe Substrate % inhibitor of CYP3A4 but does not transactivate pregnane X receptor (Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007; Curr Drug Metab 7:375,2006) |
Gastrointestinal | H-2 ANTAGONISTS, PPIs (Reflux, Ulcer Therapies) | Famotidine | Pepcid | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Caution www.uq.edu.au/porphyria/: Safe in patients Patient reports: Safe |
Gastrointestinal | H-2 ANTAGONISTS, PPIs (Reflux, Ulcer Therapies) | Omeprazole | Prilosec | OK! | www.drugs-porphyria.org: Possibly Porphyrinogenic www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Substrate & inducer of CYP3A4. Significantly transactivates pregnane X receptor, but has low probability of inducing CYP3A4 (Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007; Curr Drug Metab 7:375, 2006; Drug Safety 29:769, 2006) 7 patient reports: safe |
Gastrointestinal | H-2 ANTAGONISTS, PPIs (Reflux, Ulcer Therapies) | Rabeprazole | Aciphex | OK? | www.drugs-porphyria.org: Probably Porphyrinogenic Major metab is nonenzymatic. Minor metab via CYP2C19,3A4. Modestly transactivates pregnane X receptor, but has low probability of inducing CYP3A4 (Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007; Curr Drug Metab 7:375,2006; Drug Safety 29:769, 2006). 1 patient report: safe |
Gastrointestinal | H-2 ANTAGONISTS, PPIs (Reflux, Ulcer Therapies) | Ranitidine | Zantac | OK! | www.drugs-porphyria.org: Not Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Caution www.uq.edu.au/porphyria/: Probably unsafe www.porphyriafoundation.com: Safe PV Tishler MD clinical data: Safe |
Gastrointestinal | LAXATIVES | Bisacodyl | Dulcolax | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use with Caution PV Tishler MD clinical data: Safe |
Gastrointestinal | POTASSIUM REMOVING RESINS | Sodium Polystyrene Sulfonate | Kayexalate | OK! | patient report: safe |
Gastrointestinal therapies | ANTI-INFLAMMATORY AGENTS | Infliximab | Remicade | OK! | www.drugs-porphyria.org: Not Porphyrinogenic Protein; no CYP metab |
Gastrointestinal therapies | ANTI-INFLAMMATORY AGENTS | Mesalamine | Rowasa, Pentasa, Asacol, others | OK! | <30% absorbed; not metab by CYPs |
Gastrointestinal therapies | ANTI-INFLAMMATORY AGENTS | Olsalazine | Dipentum | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic metab to mesalamine which has no CYP metab |
GASTROINTESTINAL THERAPIES | ANTIDIARRHEAL AGENTS | Diphenoxylate | Lomotil | OK! | www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use www.uq.edu.au/porphyria/: Safe in patients |
GASTROINTESTINAL THERAPIES | ANTIDIARRHEAL AGENTS | Kaolin-Pectin | Kaopectate | OK! | web.uct.ac.za/depts/porphyria/: Use www.uq.edu.au/porphyria/: Safe in patients |
GASTROINTESTINAL THERAPIES | ANTIDIARRHEAL AGENTS | Loperamide | Imodium | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use www.uq.edu.au/porphyria/: Safe in cell culture Patient report: Safe |
Gastrointestinal therapies | ANTIEMETICS (Vomiting Therapies) | Cyclizine | Merezine | OK! | www.drugs-porphyria.org: Probably Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use www.uq.edu.au/porphyria/: Safe in patients |
Gastrointestinal therapies | ANTIEMETICS (Vomiting Therapies) | Dimenhydrinate | Dramamine | BAD! | www.porphyria-europe.com: unsafe web.uct.ac.za/depts/porphyria/: Avoid www.uq.edu.au/porphyria/: Unsafe in patients |
Gastrointestinal therapies | ANTIEMETICS (Vomiting Therapies) | Ondansetron | Zofran | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use with Caution PV Tishler MD clinical data & patient reports: Safe Substrate of CYP3A4. Modestly transactivates pregnane X receptor but has a low probability of inducing CYP3A4 (Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007; Curr Drug Metab 7:375,2006) |
Gastrointestinal therapies | ANTIEMETICS (Vomiting Therapies) | Palonosetron | Aloxi | OK? | |
Gastrointestinal therapies | ANTIEMETICS (Vomiting Therapies) | Scopolamine | Transderm-Scop, Scopace, Meldemar, others | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use |
Gastrointestinal therapies | ANTIEMETICS (Vomiting Therapies) | Thiethylperazine | Torecan | OK? | www.drugs-porphyria.org: Probably Not Porphyrinogenic |
Gastrointestinal therapies | ANTIEMETICS (Vomiting Therapies) | Trimethobenzamide | Tigan | No info | |
GASTROINTESTINAL THERAPIES | ANTISPASMODICS | Atropine | Many | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use www.uq.edu.au/porphyria/: Safe in patients www.porphyriafoundation.com: Safe |
GASTROINTESTINAL THERAPIES | ANTISPASMODICS | Belladonna Alkaloids | Many | BAD? | web.uct.ac.za/depts/porphyria/: Avoid |
Gastrointestinal therapies | GASTROINTESTINAL MOTILITY STIMULANTS | Alvimopan | Entereg | OK? | Hepatic/CYP metab unlikely (Clin Pharmacol Therap 83:770,2008; PDR 63:3293,2009; pkg insert) |
Gastrointestinal therapies | GASTROINTESTINAL MOTILITY STIMULANTS | Lubiprostone | Amitiza | OK? | No CYP metabolism or induction (PDR 63:3082,2007) |
Gastrointestinal therapies | GASTROINTESTINAL MOTILITY STIMULANTS | Metoclopramide | Reglan | OK? | www.drugs-porphyria.org: Probably Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Caution www.uq.edu.au/porphyria/: Probably unsafe www.porphyriafoundation.com: Unsafe Lancet 1981;2:91 Not safe However, ~80% not metab by CYP (www.clinicalpharmacology-ip.com) |
Gastrointestinal therapies | H-2 ANTAGONISTS, PPIs (Reflux, Ulcer Therapies) | Esomeprazole | Nexium | OK! | www.drugs-porphyria.org: Possibly Porphyrinogenic. www.porphyria.uct.ac.za: Use with extreme caution. PV Tishler MD clinical data & patient report: Safe. Major metabolic path via CYP2C19, minor via CYP3A4 (Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007) . |
Gastrointestinal therapies | H-2 Antagonists, PPIs (Reflux, Ulcer Therapies) | Lansoprazole | Pravacid | OK? | www.drugs-porphyria.org: Probably porphyrinogenic. www.porphyria.uct.ac.za: Use but with caution. Metabolsim mainly via CYP2C19. Sinz M: Cur Drug Metab 2006; 7:375: Moderate activation of pregnane X receptor but low prediction of clinical induction. |
Gastrointestinal therapies | H-2 ANTAGONISTS, PPIs (Reflux, Ulcer Therapies) | Pantoprazole | Protonix | OK! | www.drugs-porphyria.org: Possibly Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Caution Metabolized by CYP2C19, 3A4. No evidence for CYP3A4 inducibility (Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007; Drug Safety 29:769,2006) 2 Patient reports: Safe |
GASTROINTESTINAL THERAPIES | LAXATIVES | Senna | Senokot | OK! | www.drugs-porphyria.org: Not Porphyrinogenic www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use www.uq.edu.au/porphyria/: Safe in patients |
GASTROINTESTINAL THERAPIES | PHOSPHATE BINDER AGENTS | Sevelamer | Renagel | OK? | www.drugs-porphyria.org: Not Porphyrinogenic |
Gastrointestinal therapies | PROSTAGLANDINS | Misoprostol | Cytotec | OK? | www.drugs-porphyria.org: Probably Not Porphyrinogenic Not metab by and does not affect CYPs (www.clinicalpharmacology-ip.com) |
Hormones | CORTICOSTEROIDS | Dexamethasone | Decadron | OK? | www.drugs-porphyria.org: Possibly Porphyrinogenic www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use Substrate of CYP3A4. Induces CYP3A4, 2C9 via transactivation of pregnane X receptor (modest). Patient report: Safe. MAY BE UNSAFE if used for prolonged periods. (Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007; Arch Toxicol 82:667,2008) |
Hormones | CORTICOSTEROIDS | Methylprednisolone | Medrol,others | OK? | www.drugs-porphyria.org: Possibly Porphyrinogenic www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use Substrate & inhibitor of CYP3A4. Induces CYP3A4 via transactivation of pregnane X receptor. Patient report: Safe. MAY BE UNSAFE if used for prolonged periods. (Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007; Arch Toxicol 82:667,2008) |
Hormones | ESTROGENS | Ethinyl Estradiol | Many | OK? | web.uct.ac.za/depts/porphyria/: Use with Extreme Caution www.uq.edu.au/porphyria/: Probably safe PV Tishler MD clinical data & patient report: Safe Horm Metab Res 1995;27:379. Safe in patients Mass. College of Pharmacy databse: Substrate & inhibitor of CYP3A4. Inducer of pregnane X receptor. |
Hormones | ORAL CONTRACEPTIVES | Birth Control Pills | Many | BAD! | web.uct.ac.za/depts/porphyria/: Use with Extreme Caution www.uq.edu.au/porphyria/: Unsafe in patients www.porphyriafoundation.com: Unsafe Substrate of CYP3A4 (Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007) 1Patient report: Safe. 3 patient reports: unsafe - ethinyl estradiol/drospirenone (Yasmin), ethinyl estradiol-desogestrel (Orthocoept), ethinyl estradiol-norgestimate (Orcho Cyclen) unsafe |
Hormones | PROGESTINS | Levonorgestrel | Many | BAD! | www.drugs-porphyria.org: Possibly Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Extreme Caution. Metab by CYP3A4. |
Hormones | PROGESTINS | Norethindrone | Loestrin | No info | JAMA 1965;194:1037. Safe in patients USP DI? Drug Info. for the Health Care Pro. - 26th Ed. (2006): Undergoes reduction in liver; induces CYP2C9. |
Hormones | PROGESTINS | Progesterone | Many | BAD! | www.drugs-porphyria.org: Probably Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Extreme Caution www.porphyriafoundation.com: Unsafe Patient report: unsafe. Induces CYP3A, pregnane X receptor |
Hormones, hormone-like | ANDROGENS | Danazol | Danocrine | BAD! | www.drugs-porphyria.org: Probably Porphyrinogenic www.porphyria-europe.com: Unsafe web.uct.ac.za/depts/porphyria/: Avoid www.uq.edu.au/porphyria/: Unsafe in patients www.porphyriafoundation.com: Unsafe J Clin Endocrinol Metab 1981;52:549. Exacerbates acute porphyria J Clin Endocrinol Metab 1979;48:123. Unsafe in patients |
HORMONES, HORMONE-LIKE | ANDROGENS | Methyltestosterone | Many | BAD! | web.uct.ac.za/depts/porphyria/: Use with Extreme Caution |
HORMONES, HORMONE-LIKE | ANDROGENS | Nandrolone | Deca-Durabolin | BAD! | www.drugs-porphyria.org: Porphyrinogenic www.uq.edu.au/porphyria/: Probably unsafe |
HORMONES, HORMONE-LIKE | ANDROGENS | Oxandrolone | Oxandrin | BAD? | |
HORMONES, HORMONE-LIKE | ANDROGENS | Stanozolol | Winstrol | BAD? | www.drugs-porphyria.org: Not Porphyrinogenic |
Hormones, hormone-like | ANDROGENS | Testosterone | Many | BAD! | www.drugs-porphyria.org: Porphyrinogenic Substrate of CYP3A4 & CYP2C9. Modestly transactivates pregnane X receptor (Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007; Curr Drug Metab 7:375,2006) |
HORMONES, HORMONE-LIKE | CORTICOSTEROIDS | Betamethasone | Many | OK! | www.drugs-porphyria.org: Not Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Caution |
HORMONES, HORMONE-LIKE | CORTICOSTEROIDS | Cortisone | Many | OK! | |
HORMONES, HORMONE-LIKE | CORTICOSTEROIDS | Fludrocortisone | Florinef | OK! | www.drugs-porphyria.org: Possibly Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Caution |
Hormones, hormone-like | CORTICOSTEROIDS | Hydrocortisone | Many | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use www.uq.edu.au/porphyria/: Probably safe Substrate of CYP3A4 (Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007) |
Hormones, hormone-like | CORTICOSTEROIDS | Prednisolone | Many | OK? | Substrate of CYP3A4. Induces CYP3A4 via transactivation of pregnane X receptor. Patient report: Safe. MAY BE UNSAFE if used for prolonged periods. (Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007; Arch Toxicol 82:667,2008) |
Hormones, hormone-like | CORTICOSTEROIDS | Prednisone | Many | OK! | www.drugs-porphyria.org: Possibly Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use Substrate of CYP3A4. Weakly transactivates pregnane X receptor (Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007; Curr Drug Metab 7:375, 2006) Patient reports: Safe |
HORMONES, HORMONE-LIKE | CORTICOSTEROIDS | Triamcinolone | Aristocort | OK! | www.drugs-porphyria.org: Not Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Caution |
HORMONES, HORMONE-LIKE | ESTROGENS | Estrogens, Conjugated | Many | OK! | www.drugs-porphyria.org: Possibly Porphyrinogenic |
Hormones, hormone-like | ESTROGENS | Estropipate | Ogen, Ortho-est | No info | |
HORMONES, HORMONE-LIKE | LHRH/GNRH AGONISTS | Goserelin | Zoladex | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic |
HORMONES, HORMONE-LIKE | LHRH/GNRH AGONISTS | Leuprolide | Lupron | OK? | Protein, metabolized by proteolysis |
HORMONES, HORMONE-LIKE | LHRH/GNRH AGONISTS | Nafarelin | Synarel | OK! | www.drugs-porphyria.org: Possibly Porphyrinogenic www.porphyria-europe.com: Safe |
HORMONES, HORMONE-LIKE | OVULATION STIMULANTS | Clomiphene | Clomid | OK! | web.uct.ac.za/depts/porphyria/: Use www.uq.edu.au/porphyria/: Safe in patients |
Hormones, hormone-like | PARATHYROID | Calcitonin | Miacelcin, Calcimar, Fortical | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use www.porphyria-europe.com: Safe Patient report: Safe |
HORMONES, HORMONE-LIKE | PITUITARY | Chorionic Gonadotropin | Pregnyl | OK! | www.drugs-porphyria.org: Possibly Porphyrinogenic |
HORMONES, HORMONE-LIKE | PITUITARY | Desmopressin | DDAVP | OK! | www.drugs-porphyria.org: Not Porphyrinogenic |
HORMONES, HORMONE-LIKE | PITUITARY | Ergonovine | Ergotrate | OK! | |
HORMONES, HORMONE-LIKE | PITUITARY | Menotropins | Repronex | OK! | |
HORMONES, HORMONE-LIKE | PITUITARY | Methylergonovine | Methergine | OK! | |
HORMONES, HORMONE-LIKE | PITUITARY | Oxytocin | Pitocin | OK! | www.drugs-porphyria.org: Not Porphyrinogenic www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use www.uq.edu.au/porphyria/: Safe in patients |
HORMONES, HORMONE-LIKE | PITUITARY | Urofollitropin | Fertinorm | OK! | |
HORMONES, HORMONE-LIKE | PITUITARY | Vasopressin | Pitressin | OK! | |
HORMONES, HORMONE-LIKE | PROGESTINS | Medroxyprogesterone | Provera | BAD! | www.drugs-porphyria.org: Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Extreme Caution |
Hormones, hormone-like | SELECTIVE ESTROGEN RECEPTOR MODULATORS (SERMs) | Raloxifene | Evista | BAD? | www.drugs-porphyria.org: Probably Porphyrinogenic. Chang: Drug Metab Disp 2006; 34:2073: bound to P-gycoprotein & activated by CYP3A4. Sinz M: Cur Drug Metab 2006; 7:375: Little activation of human pregnane X receptor & low prediction of clinical induction. |
HORMONES, HORMONE-LIKE | SOMATOSTATIC AGENTS | Octreotide | Sandostatin | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use |
HORMONES, HORMONE-LIKE | SPERMICIDES (VAGINAL) | Nonoxynol-9 | Many | NO INFO | |
HORMONES, HORMONE-LIKE | THYROID | Levothyroxine | Levoxyl, Synthroid | OK! | www.drugs-porphyria.org: Not Porphyrinogenic www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use PV Tishler MD clinical data & patient reports: Safe |
HORMONES, HORMONE-LIKE | THYROID | Liothyronine | Cytomel | OK! | web.uct.ac.za/depts/porphyria/: Use |
Hormones, hormone-like | THYROID | Methimazole | Tapazole | No info | Metab by liver, presumably by CYPs; inhibits several CYPs also (Drug Metab Dispos 1997;25:390) |
Hormones, hormone-like | THYROID | Propylthiouracil (PTU) | Procasil, Propacil, others | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic www.porphyria-europe.com: safe web.uct.ac.za/depts/porphyria/: Use www.uq.edu.au/porphyria/: Safe in patients |
Immunologic | IMMUNOSUPPRESSIVE AGENTS | Sirolimus | Rapamune | BAD? | www.drugs-porphyria.org: Possibly Porphyrinogenic metab mainly by & induces CYP3A4, also CYP3A5 (Drug Metab Disp 35:350,2007. Induces pregnane X receptor. |
IMMUNOLOGIC AGENTS | ANTIMICROBIAL VACCINES | Anti-Thymocyte Globulin, Lymphocyte Immune Globulin | none | OK? | |
IMMUNOLOGIC AGENTS | ANTIMICROBIAL VACCINES | Haemophilus B | none | OK? | |
IMMUNOLOGIC AGENTS | ANTIMICROBIAL VACCINES | Hepatitis A | none | OK? | www.drugs-porphyria.org: Not Porphyrinogenic |
IMMUNOLOGIC AGENTS | ANTIMICROBIAL VACCINES | Hepatitis B | none | OK! | www.drugs-porphyria.org: Not Porphyrinogenic |
IMMUNOLOGIC AGENTS | ANTIMICROBIAL VACCINES | Influenza | none | OK! | www.drugs-porphyria.org: Not Porphyrinogenic |
IMMUNOLOGIC AGENTS | ANTIMICROBIAL VACCINES | Japanese Encephalitis | none | OK? | |
IMMUNOLOGIC AGENTS | ANTIMICROBIAL VACCINES | Measles, Mumps & Rubella | none | OK! | www.drugs-porphyria.org: Not Porphyrinogenic |
IMMUNOLOGIC AGENTS | ANTIMICROBIAL VACCINES | Meningococcal | none | OK? | |
IMMUNOLOGIC AGENTS | ANTIMICROBIAL VACCINES | Mumps | none | OK! | |
IMMUNOLOGIC AGENTS | ANTIMICROBIAL VACCINES | Pneumococcal | none | OK! | |
IMMUNOLOGIC AGENTS | ANTIMICROBIAL VACCINES | Polio | none | OK! | |
IMMUNOLOGIC AGENTS | ANTIMICROBIAL VACCINES | Rabies | none | OK? | |
IMMUNOLOGIC AGENTS | ANTIMICROBIAL VACCINES | Typhoid | none | OK? | www.drugs-porphyria.org: Not Porphyrinogenic |
IMMUNOLOGIC AGENTS | ANTIMICROBIAL VACCINES | Typhoid VI Polysaccharide | none | OK? | www.drugs-porphyria.org: Not Porphyrinogenic |
IMMUNOLOGIC AGENTS | ANTIMICROBIAL VACCINES | Varicella | none | OK! | www.drugs-porphyria.org: Not Porphyrinogenic |
IMMUNOLOGIC AGENTS | ANTIMICROBIAL VACCINES | Yellow Fever | none | OK? | www.drugs-porphyria.org: Not Porphyrinogenic |
IMMUNOLOGIC AGENTS | ANTIVENINS | Antivenin Crotalidae Polyvalent | AntiveninPolyvalent | OK? | |
IMMUNOLOGIC AGENTS | ANTIVENINS | Antivenin Latrodectus Mactans | none | OK? | |
IMMUNOLOGIC AGENTS | ANTIVENINS | Antivenin Micrurus Fulvius | none | OK? | |
IMMUNOLOGIC AGENTS | ANTIVIRAL MONOCLONAL ANTIBODIES | Palivizumab | Synagis | OK? | www.drugs-porphyria.org: Not Porphyrinogenic |
IMMUNOLOGIC AGENTS | IMMUNE GLOBULINS | Cytomegalovirus | none | OK? | (web.uct.ac.za/depts/porphyria/: Use) |
IMMUNOLOGIC AGENTS | IMMUNE GLOBULINS | Hepatitis B | none | OK? | (web.uct.ac.za/depts/porphyria/: Use) www.drugs-porphyria.org: Not Porphyrinogenic |
IMMUNOLOGIC AGENTS | IMMUNE GLOBULINS | Immune Globulin IV | none | OK? | (web.uct.ac.za/depts/porphyria/: Use) www.drugs-porphyria.org: Not Porphyrinogenic |
IMMUNOLOGIC AGENTS | IMMUNE GLOBULINS | Rabies | none | OK? | (web.uct.ac.za/depts/porphyria/: Use) |
IMMUNOLOGIC AGENTS | IMMUNE GLOBULINS | Tetanus | none | OK? | (web.uct.ac.za/depts/porphyria/: Use) |
IMMUNOLOGIC AGENTS | IMMUNOMODULATORS | Thalidomide | Thalomid | NO INFO | |
Immunologic agents | IMMUNOSUPPRESSIVE AGENTS | Azathioprine | Imuran | OK? | www.drugs-porphyria.org: Probably Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use www.uq.edu.au/porphyria/: Safe in animals J Clin Pharmacol 2001;41:113. Safe Not metab by CYPs (www.clinicalpharmacology-ip.com) |
Immunologic agents | IMMUNOSUPPRESSIVE AGENTS | Cyclosporine | Sandimmune | OK? | www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use with Extreme Caution www.uq.edu.au/porphyria/: Unsafe in animals J Clin Pharmacol 2001;41:113. Safe Major metab by CYP3A4,3A5. Does not transactivate pregnene X receptor (Biochem Pharmacol 68:1889,2004; Curr Drug Metab 7:375,2006) |
Immunologic agents | IMMUNOSUPPRESSIVE AGENTS | Mycophenolate Mofetil | CellCept | OK? | J Clin Pharmacol 2001;41:113. Safe ~85% nonmetab by CYP, with minor contribution of CYP3A4/5 (Clin Pharmacokinet 46:13,2007; Therapeutic Drug Monitor 26:600,2004) |
Immunologic agents | IMMUNOSUPPRESSIVE AGENTS | Tacrolimus | Prograf, Protopic | BAD? | www.drugs-porphyria.org: Possibly Porphyrinogenic J Clin Pharmacol 2001;41:113. Safe Major metab by CYP3A4, 3A5 (Pharmacogenetics & Genomics 19:458,2009) |
Immunologic agents | TOXOIDS | Diphtheria + Tetanus Toxoids & Acellular Pertussis Adsorbed, Hepatitis B (recombinant) & Inactivated Polioviruis Vaccine Combined | Pediatrix | OK! | All component parts of this vaccine are safe individually as well. |
NARCOTIC ANTAGONISTS | n/a | Naloxone | Narcan | OK! | www.drugs-porphyria.org: Possibly Porphyrinogenic. Opioid derivative metabolised by a series of CYPs, mainly 3A4. Two references: Use www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use |
OPHTHALMIC AGENTS (intraocular) | n/a | Acetylcholine | Miochol | OK! | |
OPHTHALMIC AGENTS (intraocular) | n/a | Apraclonidine | Iopidine | OK! | www.drugs-porphyria.org: Not Porphyrinogenic |
OPHTHALMIC AGENTS (intraocular) | n/a | Betaxolol | Many | OK! | |
OPHTHALMIC AGENTS (intraocular) | n/a | Bimatoprost | Lumigan | OK! | |
OPHTHALMIC AGENTS (intraocular) | n/a | Brimonidine | Alphagan | OK! | www.drugs-porphyria.org: Not Porphyrinogenic |
OPHTHALMIC AGENTS (intraocular) | n/a | Cyclopentolate | Cyclogyl | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic |
OPHTHALMIC AGENTS (intraocular) | n/a | Dapiprazole | Rev-Eyes | OK! | |
OPHTHALMIC AGENTS (intraocular) | n/a | Dorzolamide | Trusopt | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic www.drugs.com: excreted primarily as unchanged drug |
OPHTHALMIC AGENTS (intraocular) | n/a | Fluorescein | Many | OK! | www.drugs-porphyria.org: Not Porphyrinogenic |
OPHTHALMIC AGENTS (intraocular) | n/a | Homatropine | Many | OK! | |
OPHTHALMIC AGENTS (intraocular) | n/a | Latanoprost | Xalatan | OK! | www.drugs-porphyria.org: Not Porphyrinogenic |
OPHTHALMIC AGENTS (intraocular) | n/a | Naphazoline | Many | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic |
OPHTHALMIC AGENTS (intraocular) | n/a | Pilocarpine | Many | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic |
OPHTHALMIC AGENTS (intraocular) | n/a | Travoprost | Travatan | OK! | www.drugs-porphyria.org: Not Porphyrinogenic |
OPHTHALMIC AGENTS (intraocular) | n/a | Trifluridine | Viroptic | OK! | |
OPHTHALMIC AGENTS (intraocular) | n/a | Tropicamide | Mydriacyl | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic |
Psychiatric | ANTI-DEPRESSANT | Desvenlafaxine | Pristiq | OK? | <5% metab by CYP3A4 (PDR 63:3247,2009). No CyP3A4 inhibition. (CNS Drugs 2012:26:39) |
Psychiatric | ANTI-DEPRESSANT | Duloxetine | Cymbalta | OK? | ~97% metab by CYP1A2, 2D6 (Drug Metab Disp 31:1142,2003). No effect on activity of CyP3A4 or 2C9 (CNS Drugs 2012; 26:39) 2 Patient reports:safe. Report of questionable patient: unsafe. |
Psychiatric | ANTI-DEPRESSANT | Mirtazapine | Remeron | OK! | www.drugs-porphyria.org: Possibly Porphyrinogenic. 1/4 not metab, 1/3 metab by CYP2D6, rest by CYP3A4, 1A2. Moderate activation of pregnane X receptor but low prediction of clinical induction (Clin Pharmacogenet 38:461,2000; Cur Drug Metab 7:375,2006). Patient reports: safe |
Psychiatric | ANTI-DEPRESSANT | Venlafaxine | Effexor | OK? | www.drugs-porphyria.org: Possibly porphyrinogenic. www.porphyria.uct.ac.za: Use only with extreme caution. Fogelman SM: Neuropsychopharm 1999; 20:480: Major metabolism via CYP2D6 (90%), 2C19 (9%); or also CYP3A4 (CNS Drugs 2012; 26:39). Sinz M: Cur Drug Metab 2006; 7:375: No activation of pregnane X receptor. |
Psychiatric | MISC. | Asenapine | Saphris | No info | Metab by CYPs; proportion by CYP3A4 unknown (Drug Metab Disp 39:580, 2011) |
Psychiatric | MISC. | Bupropion | Wellbutrin, Zyban | OK? | www.drugs-porphyria.org: Unlikely Porphyrinogenic. USP DI? Drug Info. for the Health Care Pro. - 26th Ed: Metabolized primarily by CYP2B6 (also CNS Drugs 2012; 26:39) & CYP2D6; Moderately transactivates pregnane X receptor but has low probability of inducing CYP3A4 (Curr Drug Metab 9:598,2008; http://medicine.iupui.edu/clinpharm/ddis/) |
Psychiatric | MISC. | Clozapine | Clozaril | OK? | www.drugs-porphyria.org: Probably Not Porphyrinogenic. Metab. mainly by CYP1A2, to lesser extent by CYP3A & other CYPs. Induces CYP 3A, 2C9. Minimal transactivation of pregnane X receptor (Eur J Pharm Sci 20:451, 2003; Curr Drug Metab 11:516, 2010; Toxicol Lett 82:203, 2011) |
Psychiatric | MISC. | Dexmedetomidine | Precedex | OK? | ~14% metab. by CYP2A6, remainder by glucuronidation. |
Psychiatric | MISC. | Iloperidone | Fenapt | No info | 99% metab, mainly by CYP2D6, less so by CYP3A4 (Curr Drug Metab 11:516, 2010) |
Psychiatric | Misc. | Olanzapine | Zyprexa | OK? | www.drugs-porphyria.org: Probably not porphyrinogenic. www.porphyria_europe.com: Safe. Minor metab. by CYP1A2, 2D6 ?3A4. Moderate activation of pregnane X receptor & low prediction of clinical induction (Basic Clin Pharmacol Toxicol 100:4,2007; Cur Drug Metab 7:375,2006; Curr Drug Metab 11:516,2010) |
Psychiatric | Misc. | Quetiapine | Seroquel | BAD? | www.drugs-porphyria.org: Possibly Porphyrinogenic. Metab. mainly by CYP3A4. No evidence for its induction. (http://medicine.iupui.edu/clinpharm/ddis/; Basic Clin Pharmacol Toxicol 100:4,2007) Patient report: safe |
Psychiatric | Misc. | resperidone | Resperdal, etc. | OK? | Major metab via CyP2D6. Weak inhibition of Cyp3A, PXR. |
Psychiatric | MISC. | Risperidone | Risperdal | OK? | www.drugs-porphyria.org: Probably Porphyrinogenic. Spina E: Basic Clin Pharmacol Toxicol 2007; 100:4: Substrate mainly of CYP2D6, less of 3A4. Sinz M. Cur Durg Metab 2006; 7:375: No activation of pregnane X rerceptor. Toxicol Lett 203:82, 2011: modest activation of pregnane X receptor (1/5 that of rifampin). |
Psychiatric | MISC. | Trazodone | Desyrel | BAD? | web.uct.ac.za/depts/porphyria/: Use with Extreme Caution www.uq.edu.au/porphyria/: Unsafe in animals Substrate of CYP3A4 (Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007; http://medicine.iupui.edu/clinpharm/ddis/) |
Psychiatric | MISC. | Ziprasidone | Geodon | BAD? | www.drugs-porphyria.org: Possibly Porphyrinogenic 1/3 metabolized by CYP3A4 (www.rxlist.com; J Clin Psychopharm 23:229,2003) |
Psychiatric | PHENOTHIAZINES | Chlorpromazine | Thorazine | OK! | www.drugs-porphyria.org: Not Porphyrinogenic www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use www.uq.edu.au/porphyria/: Safe in patients PV Tishler MD clinical data: Safe JAMA 1965;194:1042. Safe in patients Substrate of CYP3A4. Does not or does moderately transactivate pregnane X receptor. and does transactivate constitutive androgen receptor (Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007; Curr Drug Metab 7:375,2006; Xenobiotica 37:1196,2007; J Pharmacol Exp Therap 320:72, 2007) |
Psychiatric | SELECTIVE SEROTONIN REUPTAKE INHIBITORS (SSRIs) | Citalopram | Celexa | OK? | www.drugs-porphyria.org: Possibly Porphyrinogenic. Substrate of CYP3A. web.uct.ac.za/depts/porphyria/: Use with Caution. 1 Patient report: safe. 1 patient report: unsafe |
Psychiatric | SELECTIVE SEROTONIN REUPTAKE INHIBITORS (SSRIs) | Escitalopram | Lexapro | No info | Major metabolism by CYP2C19, CYP3A4; no inhibition of CYP3A4 (CNS Drugs 2012; 26:39) |
Psychiatric | SELECTIVE SEROTONIN REUPTAKE INHIBITORS (SSRIs) | Fluoxetine | Prozac | OK! | www.drugs-porphyria.org: Not Porphyrinogenic www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use with Caution www.uq.edu.au/porphyria/: Safe in patients Substrate of CYP2C9 (Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007) Does not induce pregnane X receptor (Toxicol Lett 203:82, 2011) Patient reports: safe |
Psychiatric | SELECTIVE SEROTONIN REUPTAKE INHIBITORS (SSRIs) | Paroxetine | Paxil | OK? | www.drugs-porphyria.org: Probably Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Caution Does not induce pregnane-X-receptor (Toxicol Lett 203:82, 2011). |
Psychiatric | SSELECTIVE SEROTONIN REUPTAKE INHIBITORS (SSRIs) | Fluvoxamine | Luvox | OK? | Prob ~65% metab by CYP2D6 + alcohol dehydrogenase (Xenobiotica 37:169,2007). Inhibits CYP3A4. |
Psychiatric | TRICYCLICS | Amitriptyline | Elavil | OK! | www.drugs-porphyria.org: Probably Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Extreme Caution www.uq.edu.au/porphyria/: Probably unsafe Substrate of many CYPs, including CYP3A4, but does not transactivate pregnane X receptor (http://medicine.iupui.edu/clinpharm/ddis/; Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007; Curr Drug Metab 7:375, 2006) patient reports: safe |
Psychiatric | TRICYCLICS | Imipramine | Tofranil | OK? | www.drugs-porphyria.org: Probably Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Extreme Caution www.uq.edu.au/porphyria/: Probably unsafe Metab by CYP2C19, 2D6, 3A4. (http://medicine.iupui.edu/clinpharm/ddis/; Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007) |
Psychiatric medications | AGENTS FOR CHEMICAL DEPENDENCY | Disulfiram | Antabuse | OK? | www.drugs-porphyria.org: Probably Porphyrinogenic Eur J Clin Chem Clin Biochem 1997;35:427. Safe in patients Major metabolism by CYP3A4/3A5. Inhibits but probably does not induce CYPs (Alcohol Clin Exp Res 22:1212,1998; Arch Toxicol 82:667,2008) |
Psychiatric medications | AGENTS FOR CHEMICAL DEPENDENCY | Naltrexone | Vivitrol | OK? | No CYP metabolism (PDR 63:988, 2009) |
Psychiatric medications | ANTIDEMENTIA AGENTS | Donepezil | Aricept | OK? | www.drugs-porphyria.org: Possibly Porphyrinogenic www.drugs.com: ~80% metab via CYP2D6, 3A4 (www.clinicalpharmacology-ip.com; Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007) |
Psychiatric medications | ANTIDEMENTIA AGENTS | Memantine | Namenda | OK? | www.drugs-porphyria.org: Probably Not Porphyrinogenic www.rxlist.com: ca. 50% excreted unchanged; no significant metabolic role for CYPs |
Psychiatric medications | MISC. | Aripiprazole | Abilify | No info | Metab mainly by CYP3A4,2D6 (Curr Drug Metab 9:410,2008) |
Psychiatric medications | MISC. | Dextroamphetamine | Dexedrine | BAD? | Substrate of CYP3A4 (Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007) |
Psychiatric medications | MISC. | Haloperidol | Haldol | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic. www.porphyria-europe.com: Safe. web.uct.ac.za/depts/porphyria/: Use. www.uq.edu.au/porphyria/: Probably unsafe. Substrate mainly of 3A4, also 3A5, 3A7. Moderate activation of human pregnane X receptor & low prediction of clinical induction. (Chem Res Toxicol 2006; 19:914; Cur Drug Metab 2006; 7:375) |
Psychiatric medications | MISC. | Lithium | Eskalith, Lithobid | OK! | www.drugs-porphyria.org: Not Porphyrinogenic www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use www.uq.edu.au/porphyria/: Safe in patients |
PSYCHIATRIC MEDICATIONS | MISC. | Methylphenidate | Ritalin | OK? | www.drugs.com: Major metabolic route probably does not involve P450 |
Psychiatric medications | MISC. | Paliperidone | Invega | OK? | 60% excreted unchanged. Small amt metab by CYP2D6,?other CYPs (Drug Metab Disp 36:769,2008) |
PSYCHIATRIC MEDICATIONS | MISC. | Phenelzine | Nardil | BAD! | web.uct.ac.za/depts/porphyria/: Use with Extreme Caution www.uq.edu.au/porphyria/: Unsafe in animals |
PSYCHIATRIC MEDICATIONS | PHENOTHIAZINES | Fluphenazine | Prolixin | OK! | www.drugs-porphyria.org: Not Porphyrinogenic www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use |
PSYCHIATRIC MEDICATIONS | PHENOTHIAZINES | Perphenazine | Trilafon | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Caution |
Psychiatric medications | PHENOTHIAZINES | Prochlorperazine | Compazine, Compro, Combid, others | OK! | www.drugs-porphyria.org: Not Porphyrinogenic www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use www.uq.edu.au/porphyria/: Safe in patients PV Tishler MD clinical data: Safe |
Psychiatric medications | PHENOTHIAZINES | Thioridazine | Mellaril | OK! | www.drugs-porphyria.org: Possibly Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Caution www.uq.edu.au/porphyria/: Safe in patients Polish J Pharmacol 2001;53:615. Metabolized by CYP2D6;inhibits CYP1A2 and CYP3A2 |
Psychiatric medications | SELECTIVE SEROTONIN REUPTAKE INHIBITORS (SSRIs) | Sertraline | Zoloft | OK? | www.drugs-porphyria.org: Possibly Porphyrinogenic Substrate of CYP3A4 but minimially transactivates pregnane X receptor (Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007; Curr Drug Metab 7:375,2006. |
Psychiatric medications | TRICYCLICS | Doxepin | Sinequan, Adepin, others | OK? | Medicine (Balt)1992;71:1. Safe Patient report: Safe |
Psychiatric medications | TRICYCLICS | Nortriptyline | Aventyl | OK? | www.drugs-porphyria.org: Probably Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Extreme Caution www.uq.edu.au/porphyria/: Probably unsafe. Metab by CYP2D6. Does not transactivate pregnane X receptor (http://medicine.iupui.edu/clinpharm/ddis/; Curr Drukg Metab 7:375,2006) |
Respiratory | ANTIASTHMATIC AND BRONCHODILATOR AGENTS | Albuterol | Ventolin, Proventil, others | OK! | PV Tishler MD clinical data, 3 patient reports: Safe https://online.epocrates.com/front_porch/: Metabolized extensively by P450. Does not transactivate pregnane X receptor (Curr Drug Metab 7:375,2006) |
Respiratory | ANTIASTHMATIC AND BRONCHODILATOR AGENTS | Budesonide | Pulmicort, Rhinocort, Entocort | OK! | www.drugs-porphyria.org: Not Porphyrinogenic PV Tishler MD clinical data & patient report: Safe Metab by CYP3A |
Respiratory | ANTIASTHMATIC AND BRONCHODILATOR AGENTS | Fluticasone | Flovent | OK! | www.drugs-porphyria.org: Not Porphyrinogenic PV Tishler MD clinical data & patient reports: Safe Substrate of CYP3A4 (Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007) |
Respiratory | ANTIASTHMATIC AND BRONCHODILATOR AGENTS | Formoterol | Foradil, Perforomist | OK? | Secondary metab via 4 CYPs (PDR 63:1025,2009), inc. CYP2C9 |
Respiratory | ANTIASTHMATIC AND BRONCHODILATOR AGENTS | Montelukast | Singulair | OK! | www.drugs-porphyria.org: Possibly Porphyrinogenic Substrate of CYP3A4 & CYP2C9. No inhibition of CYP2C9, 3A4. Moderate transactivation of pregnane X receptor but low prediction of CYP3A4 induction (Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007; Curr Drug Metab 7:375, 2006) Patient report: Safe |
Respiratory | ANTIASTHMATIC AND BRONCHODILATOR AGENTS | Zafirlukast | Accolate | BAD? | Substrate of CYP2C9. Induces pregnane X receptor. (Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007) |
Respiratory | ANTIHISTAMINES | Cetirizine | Zyrtec | OK! | Mainly excreted unchanged. Does not induce CYPs (Cur Med Therap 15:2193,2008; Med Letter 49:97,2007). 1 patient report: safe. |
Respiratory | ANTIHISTAMINES | Chlorpheniramine | Chlor-Trimeton, others | OK! | www.uq.edu.au/porphyria/: Safe in patients Metab by CYP2D6, CYP3A4, 2D9 (Pharmacogenetics 1999;9:71; J Pharm Pharmacol 49:257,1997) Patient report: Safe |
Respiratory | ANTIHISTAMINES | Diphenhydramine | Benadryl | OK! | www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use Patient reports: Safe |
Respiratory | ANTIHISTAMINES | Fexofenadine | Allegra | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic USP DI? Drug Info. for the Health Care Pro. - 26th Ed. (2006): Ca. 1% metabolized by P450, ~5% total. Patient reports: Safe |
Respiratory | ANTIHISTAMINES | Loratadine | Claritin | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use with Caution Substrate of CYP3A4, 2C9. Moderate transactivator of pregnane X receptor, but low probability of inducing CYP3A4 (Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007; Curr Drug Mertab 7:375,2006) 3 Patient reports: safe |
Respiratory | ANTITUSSIVES (Cough Therapies) | Benzonatate | Tessalon, etc. | OK? | patient report: safe |
Respiratory | ANTITUSSIVES (Cough Therapies) | Dextromethorphan | Many | OK! | www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use Metab by CYP3A4. |
Respiratory | Asthma Treatment | Fluticasone | Advair | OK? | fluticasone = corticosteroid; salmeterol, brochodilator, metab via CYP3A. Used by inhalation. 1 patient report: safe. |
RESPIRATORY AGENTS | ANTIASTHMATIC AND BRONCHODILATOR AGENTS | Aminophylline | Many | BAD! | www.drugs-porphyria.org: Probably Porphyrinogenic web.uct.ac.za/depts/porphyria/: Avoid |
Respiratory agents | ANTIASTHMATIC AND BRONCHODILATOR AGENTS | Arformoterol | Brovana | OK? | Secondary metab via 4 CYPs (PDR 63:2990,2009) |
Respiratory agents | ANTIASTHMATIC AND BRONCHODILATOR AGENTS | Beclomethasone (Inhalant) | Beclovent, Vanceril, others | OK! | www.uq.edu.au/porphyria/: Safe in patients PV Tishler MD clinical data: Safe |
Respiratory agents | ANTIASTHMATIC AND BRONCHODILATOR AGENTS | Cromolyn | Intal, others | OK? | |
Respiratory agents | ANTIASTHMATIC AND BRONCHODILATOR AGENTS | Flunisolide (Inhalant) | Aerobid, Nasalide, Nasarel | No info | |
Respiratory agents | ANTIASTHMATIC AND BRONCHODILATOR AGENTS | Ipratropium | Atrovent | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic http://www.bidocs.com/renetnt:/Prescribing+ Information/PIs/Atrovent+Nasal+03/ATR03.pdf: Metabolized via hydrolysis patient report: safe |
Respiratory agents | ANTIASTHMATIC AND BRONCHODILATOR AGENTS | Salmeterol | Serevent | OK? | www.drugs-porphyria.org: Probably Not Porphyrinogenic Substrate of CYP3A4 (Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007) |
RESPIRATORY AGENTS | ANTIASTHMATIC AND BRONCHODILATOR AGENTS | Terbutaline | Brethine | OK! | www.drugs-porphyria.org: Not Porphyrinogenic Eur. J. Clin. Pharmacol. 1993;45 :483. No metabolism in liver |
Respiratory agents | ANTIASTHMATIC AND BRONCHODILATOR AGENTS | Theophylline | Many | BAD? | www.drugs-porphyria.org: Probably Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Extreme Caution www.uq.edu.au/porphyria/: Unsafe in patients Medicine (Balt) 1992;71:1. Safe Substrate of CYP3A4, but does not transactivate pregnane X receptor (Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007; Curr Drug Metab 7:375,2006) |
Respiratory agents | ANTIHISTAMINES | Azatadine | Optimine, Trinalin, others | No info | |
RESPIRATORY AGENTS | ANTIHISTAMINES | Cyproheptadine | Periactin | OK! | www.drugs-porphyria.org: Possibly Porphyrinogenic |
Respiratory agents | ANTIHISTAMINES | Hydroxyzine | Atarax, Vistaril | BAD! | www.drugs-porphyria.org: Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Extreme Caution www.uq.edu.au/porphyria/: Unsafe in patients |
Respiratory agents | ANTIHISTAMINES | Levocetirizine | Xyzal | OK! | Mainly excreted unchanged. Does not induce CYPs (Curr Med Therap 15:2193, 2008; Med Letter 49:97,2007) |
RESPIRATORY AGENTS | ANTIHISTAMINES | Promethazine | Phenergan | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use www.uq.edu.au/porphyria/: Probably unsafe Curr Drug Metab 2003;4:105. Metabolized by CYP2D6 |
Respiratory agents | ANTITUSSIVES (Cough Therapies) | Hydrocodone | Many | OK! | Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007. Substrate of CYP3A4 Patient reports: Safe |
Respiratory agents | EXPECTORANTS | Guaifenesin | Robitussin | OK! | www.drugs-porphyria.org: Possibly Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Extreme Caution PV Tishler MD clinical data & patient report: Safe |
RESPIRATORY AGENTS | MUCOLYTICS | Acetylcysteine | Mucomyst | OK! | www.drugs-porphyria.org: Not Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use PV Tishler MD clinical data: Safe Eur J Clin Chem Clin Biochem 1997;35:427. Safe |
RESPIRATORY AGENTS | NASAL AGENTS - SYSTEMIC AND TOPICAL | Oxymetazoline | Afrin | OK? | www.drugs-porphyria.org: Probably Not Porphyrinogenic www.uq.edu.au/porphyria/: Unsafe in patients |
RESPIRATORY AGENTS | NASAL AGENTS - SYSTEMIC AND TOPICAL | Phenylephrine | Many | OK! | www.drugs-porphyria.org: Probably Not Porphyrinogenic |
RESPIRATORY AGENTS | NASAL AGENTS - SYSTEMIC AND TOPICAL | Pseudoephedrine | Sudafed | OK! | www.porphyria-europe.com: Safe web.uct.ac.za/depts/porphyria/: Use www.uq.edu.au/porphyria/: Safe in patients Patient reports: Safe |
URINARY TRACT | ANALGESICS | Phenazopyridine | Pyridium | NO INFO | |
URINARY TRACT | ANTISPASMODICS | Bethanechol | Urecholine | NO INFO | |
Urinary tract | ANTISPASMODICS | Darifenacin | Enablex | BAD? | Significantly metab by CYP3A4, 2D6. No evidence of CYP induction (Clin Pharmacokinet 45:325,2006) |
Urinary tract | ANTISPASMODICS | Oxybutynin | Oxytrol, Ditropan | BAD! | www.drugs-porphyria.org: Possibly Porphyrinogenic web.uct.ac.za/depts/porphyria/: Use with Extreme Caution www.drugs.com: Metabolized primarily in liver by CYP3A4 Substrate of CYP3A4 (Williams DA. Drug metabolism. In: Foye's Principles of Medicinal Chemistry, ed. Lemke T and Williams DA. Baltimore, Williams & Wilkins, 6th ed., 2007) |
Urinary tract | ANTISPASMODICS | Solifenacin | Vesicare | OK? | Metab primarily by CYP3A4. No evidence of any CYP induction (Br J Clin Pharmacol 59:647,2004) |
Urinary tract | ANTISPASMODICS | Tolterodine | Detrol | OK? | www.drugs-porphyria.org: Safe in one patient, but possibly porphyrinogenic. Metab by CYP2D6,3A4; CYP3A4 may be increased in CYP2D6 poor metabolizers (Drug Metab Disp 26:289,1998) Patient report to Peter Tishler, MD - safe |
Urinary tract | PROSTATIC HYPERTROPHY | Dutasteride | Avodart | BAD? | Extensively metab by CYP3A4,3A5 (PDR 63:1359,2009). 2 patient reports: unsafe |
Urinary tract | PROSTATIC HYPERTROPHY | Tamsulosin | Flomax | BAD? | Extensively metab by CYP3A4,2D6 (Xenobiotica 28:909, 1998; PDR 63:848,2009). |
Urinary tract | PROSTATIC HYPERTROPHY (also Baldness) | Finasteride | Proscar, Propecia | OK! | www.drugs-porphyria.org:Possibly porphyrinogenic. www.porphyria.uct.ac.za: Use only with extreme caution. Metab mainly by CYP3A4. Little activation of pregnane X receptor (Huskey SW: Drug Metab Disp 1996; 24:695; Sinz M. Cur Drug Metab 2006; 7:375) |
Anti-infectives | ANTIRETROVIRALS | nirmatrelvir tablets and ritonavir tablets | PAXLOVID | BAD! | PAXLOVID ( nirmatrelvir tablets; ritonavir tablets has not been approved, but has been authorized for emergency use by FDA under an EUA, for the treatment of mild-to-moderate COVID-19 in adults and pediatric patients (12 years of age and older weighing at least 40 kg) with positive results of direct SARS-CoV-2 viral testing, and who are at high risk for progression to severe COVID-19, including hospitalization or death. see comments on ritonavir in the drug database. |
Diagnostic drugs | Thyrotropin | THYROTROPIN ALFA inj pdr | OK! |
This information is not intended as a substitute for medical professional help or advice but is to be used only as a reference.
Definitions
OK! = very likely to be safe for prolonged use by individuals with an acute porphyria, based on consistent evidence
OK? = probably safe for prolonged use by individuals with an acute porphyria, based on evidence that is either inconsistent or insufficient to be conclusive
BAD? = probably unsafe for prolonged use by individuals with an acute porphyria, based on evidence that is either inconsistent or insufficient to be conclusive
BAD! = very likely to be unsafe for prolonged use by individuals with an acute porphyria, based on consistent evidence
NO INFO = evidence insufficient for deriving any conclusion