Microsoft word - skindisease_medications.doc
Skin Disease/Sign Medications
2000, Derm Facts
Adverse Drug Reaction Probability Scale Question
1. Are there previous conclusive reports of this reaction?
2. Did the adverse event appear after the suspected drug was administered?
3. Did the adverse reaction improve when the drug was discontinued or a
specific antagonist was administered? 4. Did the adverse reaction reappear when the drug was readministered?
5. Are there alternative causes (other than the drug) that could on their own
have caused the reaction? 6. Did the reaction reappear when a placebo was given?
7. Was the drug detected in the blood (or other fluids) in concentrations
known to be toxic? 8. Was the reaction more severe when the dose was increased, or less severe
when the dose was decreased? 9. Did the patient have a similar reaction to the same or similar drugs in any
previous exposure? 1. Was the adverse event confirmed by any objective evidence?
Definite association; score = or > 9
Probable association; score 5 to 8
Possible association; score 1 to 4
Doubtful association; score = or < 0
Naranjo CA, Busto U, Sellers EM, et al. A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther
1981; 30 (2): 239-45.
Drug reaction classification
Type I : immediate-type immunologic reaction: IgE mediated urticaria/angioedema, anaphylactic
shock ex: penicillin
Type II : cytotoxic reaction: 1) drug plus cytotoxic antibodies cause cell lysis (platelets and
leukocytes) ex: cephalosporins, penicillin, rifampin, sulfonamides 2) drug plus antibodies form
immune complexes and cause lysis or phagocytosis ex: chlorpromazine, isoniazid, quinidine,
quinine, salicylamide, sulfonamides, sulfonylureas
Type III : serum sickness, vasculitis: IgG or IgM antibodies form to drug resulting in deposition of
immune complexes in small vessels, activated by complement and recruitment of granulocytes;
onset 5-7 days after drug introduction. Agranulocytosis, alveolitis, arthritis, hemolytic anemia,
nephritis, thrombocytopenia, urticaria-like lesions, vasculitis
Type IV : morbilliform exanthematous reactions: cell-mediated immune reaction by sensitized
lymphocytes reacting with drug, releasing cytokines
angioedema, exanthematous(?),fixed drug(?),Stevens-Johnson s., TEN, urticaria, vasculitis
bullous, exanthematous, fixed drug(?), lichenoid(?), photoallergic, Stevens-Johnson s.(?), TEN(?)
general : arthralgias/arthritis, dyspnea, fever > 40° C, hypotension, lymphadenopathy, wheezing
laboratory : abnormal LFTs, atypical lymphocytes, eosinophilia >1000/ul, lymphocytosis
skin : angioedema, confluent erythema, laryngeal/glossal edema, mucous membrane erosions,
necrosis, Nikolsky’s sign, painful skin, palpable purpura, urticaria
Skin disease & medication
corticosteroids, diethylstilbestrol, estrogen, fusidic acid, hydantoin, INH, insulin, methyl testosterone, niacinamide, nicotinic acid, OCPs, pituitary extract, triazinate
ACTH, actinomycin D, amoxapine, androgens, azathioprine, corticosteroids, cyclosporine,
dactinomycin, dilantin, ethambutol, ethionamide, fluoxymesterone, halogens, haloperidol,
isoniazid,
lithium , medroxyprogesterone, OCPs, phenobarbital,
phenytoin , psoralen, quinine, tar,
trimethadione, vinblastine, vitamin B12 (cyanocobalamin)
chemotherapeutics, cytosine arabinoside, doxorubicin, etoposide, fluorouracil, hydroxyurea, mercaptopurine, methotrexate, mitoxantrone
docetaxel, doxorubicin,
fluorouracil , pentostatin, dactinomycin/vincristine/dacarbazine,
doxorubicin/cytarabine/6-thioguanine, doxorubicin/vincristine, fluorouracil/cisplatin
allergic contact dermatitis cisplatin, daunorubicin, doxorubicin, 5-fluorouracil (topical and IV), mechlorethamine, mitomycin alopecia
allopurinol, anticoagulants, antithyroid drugs, β-blockers, bismuth, boric acid, bromocriptine, carbimazole, chemotherapeutics, chloramphenicol, cimetidine, clomiphene, colchicine, diazoxide, dilantin, ethionamide, fluorobutyrphenone, gentamicin, heavy metals, hydantoin, hypocholesterolemics, indomethacin, interferon-α, levodopa, methyldopa, metoprolol, NSAIDs, OCPs, piroxicam, potassium thiocyanates, propranolol, quinacrine, retinoids, Rozaxane, testosterone, thallium, thyroid drugs, trimethadione, thiouracil, triparanol, valproate, vitamin A
aminocamptothecin, amsacrine, bleomycin, carmustine, chlorambucil, cyclophosphamide,
cytarabine, dacarbazine, dactinomycin, daunorubicin, doxorubicin, epirubicin, etoposide, fluorouracil, hydroxyurea, idarubicin, ifosfamide, irinotecan, mechlorethamine, melphalan, methotrexate, mitomycin, mitoxantrone, paclitaxel, teniposide, thiotepa, topotecan, vinblastine, vincristine, vindesine, vinorelbine
alkylating agents, antimetabolites, bleomycin, boron cyclophosphamide, mitotic inhibitors,
arsenic, barbiturates, bromides, halides, iodides, mercury, penicillin, phenolphthalein, salicylates
amoxicillin, dactinomycin/methotrexate, fluorouracil, furosemide, penicillin, PUVA, sulfasalazine
arsenic, 4,4’-bipyridyl, coal tar, immunosuppressants, nitrogen mustard, petroleum oils, PCB, pitch, psoralen, soot
antineoplastic agents, doxorubicin, 5-FU, mithramycin
blue pigmentation; amiodarone, atabrine, bismuth, chloroquine, gold, iron lead, minocycline, mercury, silver
blue: cobalt, indigo, oxalic acid (radiator cleaners), silver nitrate, silvadene
brown: chrysarobin, anthralin, paraphenylenediamine, permanganates, phenothiazines green: copper dust orange: chlorine gas, phenothiazine, trinitrophenylmehtylnitramine red: soda ash, TNT
yellow: dichromate, dinobuton, fluorescein dye, glutaraldehyde,
in order: amoxicillin, trimethoprim-sulfamethoxazole, ampicillin, blood products, penicillin (semi-
synthetic), penicillin G, acetylcysteine, allopurinol, gentamicin, barbiturates, metoclopramide, atropine, heparin, furosemide, diazepam, potassium chloride
acetaminophen, aminophylline, aspirin, codeine, digoxin, diphenhydramine, docusate sodium,
ferrous sulfate, flurazepam, insulin, isosorbide dinitrate, magnesium sulfate, methyldopa, milk of magnesia, nitroglycerin, potassium iodide, prednisone, promethazine, prochlorperazine, propranolol, spironolactone
isoniazid, penicillamine, penicillin, tryptophan
cyclophosphamide/doxorubicin/vincristine, iodides (exacerbate)
aspirin, diclofenac, hydroxyurea (long term), niflumic acid, penicillamine, practolol, tamoxifen, tegafur, tryptophan
acanthosis nigricans, alopecia, annular erythema, bullous, dermatomyositis, eczematous, elastosis
perforans serpiginosa, EM, erythema nodosum, erythrodermic/exfoliative, erythromelalgia, exanthematous (maculopapular), fixed, hidradenitis, hypertrichosis, ichthyosiform, lichenoid, lupus, lymphomatoid, panniculitis, pemphigoid, pemphigus, photosensitivity, pigmented, pityriasiform, porphyria, pseudoporphyria, psoriasiform, purpuric, pustular, sclerodermoid, Stevens-Johnson s., TEN, urticarial, vasculitic
aminophylline, antibiotics, antihistamines, arsenic, β-blockers, carbamazepine, chloral hydrate, disulfiram, diuretics, fluorouracil, gold, HMG-CoA reductase inhibitors, hypoglycemics, meprobamate, mercurials, minoxidil, neomycin, nystatin, penicillin, phenothiazines, procainamide, quinacrine, quinidine, resorcinol, streptomycin, sulfonamides, thiazide diuretics
bleomycin, carboplatin, cis-dichloro-trans-dihydroxy-bis-isopropylamine platinum (CHIP),
(chemotherapeutic agents) chlorambucil, cytarabine, docetaxel, diethylstilbestrol, doxorubicin etoposide, 5-fluorouracil,
hydroxyurea, methotrexate, mitomycin C, mitotane, mitoxantrone, paclitaxel, pentostatin, procarbazine, suramin, thiotepa
chloroquine, cimetidine, estrogens, penicillin, plaquenil, progesterone, salicylates
allopurinol , aminopenicillins,
anticonvulsants (carbamazepine, diphenylhydantoin,
phenobarbital, trimethadione),
barbiturates , busulfan, bleomycin/cisplatin,
bleomycin/cisplatin/vinblastine, carbamazepine, cephalosporin, chlorambucil, cimetidine,
ciprofloxacin, codeine, cyclophosphamide, danazol, diethylstilbestrol, etoposide, furosemide,
glutethimide, griseofulvin,
hydantoins , hydroxyurea, lithium, mechlorethamine (IV),
methotrexate, minoxidil, mitomycin C, mitotane,
NSAIDs , oxyphenbutazone, paclitaxel,
penicillamine,
penicillin , phenobarbital, phenolphthalein, phenothiazines, phenylbutazone,
prazosin, pyritinol, rifampin, salazopyrin, salicylates, streptomycin,
sulfonamides , sulfonylureas,
suramin,
tetracycline , trimethoprim
antihistamines, DNCB, DPCP, IPPD, rosewood,
Rhus , sulfonamides
chemicals : brominated compounds, N-hydroxyphthalamide, phenyl sulfone derivatives,
dinitrochlorobenzene
medications, topical : econazole, ethylenediamine, idoxuridine, iodochlorhydroxyquin, mafenide
acetate, mephenesin, neomycin, povidone iodine, proflavine, promethazine, pyrrolnitrin,
scopolamine, sulfonamide, vitamin E
metals : cobalt, nickel sulfate
plants : poison ivy, primula, terpenes, St. John’s wort
other : epoxy resin, formaldehyde, isopropyl-
p -phenylenediamine, soap, spray cologne,
trichlorethylene, tropical wood (rio rosewood, pao ferro)
amidopyrine, bromides, busulfan, 13-cis-retinoic acid, diethylstilbestrol,
estrogen , gold, halogens,
isotretinoin,
OCPs ,
penicillin , phenacetin, salicylates,
sulfonamides , sulfones, sulfonylureas,
tetracycline , thiazides, vaccines
cisplatin, cyclophosphamide,
cytarabine , daunorubicin, docetaxel, doxifluridine,
doxorubicin ,
etoposide, floxuridine,
fluorouracil , hydroxyurea, idarubicin, lomustine, melphalan,
mercaptopurine, methotrexate, mitomycin, mitotane, paclitaxel, suramin, tegafur, vincristine
bromocriptine, nicardipine, nifedipine, verapamil
acetylsalicylic acid, captopril, clofazimine, co-trimoxazole, etretinate, fenbufen, gentamicin, GM-CSF, ketoconazole, methotrexate, minoxidil, nystatin, oxytetracycline, phenobarbital, quinidine, sulfasalazine, sulfonamides, timolol
allopurinol , amphotericin B, atropine, barbiturates, benzodiazepines, calcium channel blockers,
captopril,
carbamazepine , chloramphenicol, cisplatin, diltiazem, erythromycin, gentamicin, GM-
CSF,
gold , hydantoin, hypoglycemics, isoniazid, lithium, methazolamide,
nitrofurantoin ,
NSAIDs,
penicillins , phenothiazines,
phenylbutazone ,
phenytoin, quinidine,
streptomycin ,
sulfonamides , tetracyclines, thiazides, trazodone
allopurinol, aminoglycosides, amiodarone, antimalarials, arsenic, aspirin, aztreonam, BAL,
(exfoliative erythroderma) barbiturates, calcium channel blockers, captopril,
carbamazepine , cefoxitin, cephalosporins,
chlorambucil/busulfan, chloroquine, chlorpromazine, chlorpropamide, cimetidine, cisplatin,
codeine, co-trimoxazole, dapsone, diltiazem, desipramine, diphenylhydantoin, ethylenediamine,
fluorouracil, gold, griseofulvin, hydantoins, imipramine, indinavir, iodine, isoniazid, isotretinoin,
lithium, mefloquine, mephenytoin, mercury, methotrexate, mexiletine, minocycline, neomycin,
nifedipine, nitrofurantoin, penicillin, phenindione,
phenobarbital , phenothiazines,
phenylbutazone,
phenytoin , pyrazolone derivatives, quinacrine, quinidine, ranitidine, rifampin,
streptomycin, sulfonamides, sulfonylureas, terbutaline, thalidomide, thiazides, trimethadione,
trimethoprim, trazodone, vancomycin
acetaminophen,
acetylsalicylic acid , aminosalicylic acid,
ampicillin , anticonvulsants, antifungals,
antimalarials, arsenicals,
aspirin ,
barbiturates , benzodiazepines, butazolidin-alka,
chlordiazepoxide, ciprofloxacin, dacarbazine, dapsone, dextromethorphan,
diflunisal ,
diphenhydramine, erythromycin, fiorinol, fluoroquinolones, gold, heroin, hydroxyurea,
ibuprofen ,
meprobamate, metronidazole, minocycline, naproxen, norfloxacin, NSAIDs, nystatin, OCPs,
opiates, oxyphenylbutazone, paclitaxel (bullous), paracetamol, penicillins, phenacetin,
phenolphthalein , phenylbutazone,
piroxicam , procarbazine, Quaalude, quinidine, quinine,
salicylates,
sulfonamides , sulindac,
tetracycline , tolmetin, trimethoprim-sulfamethoxazole
alizapride, amyl nitrite, asparaginase, bleomycin, bromocriptine, butyl nitrite, capsaicin,
carboplatin, carmustine, cholinergic drugs, cisplatin, cyclophosphamide, cyclosporine,
cyproterone acetate, dacarbazine, didemnin B, diethylstilbestrol, diltiazem, docetaxel,
doxorubicin, etoposide, fluorouracil (IV/topical), flutamide, interferons, leuprolide, lomustine,
metoclopramide, mithramycin, morphine, niacin, nicotinic acid, nifedipine, opiates, paclitaxel,
plicamycin, procarbazine, rifampin, suramin, tamoxifen, teniposide, thyrotropin-releasing
hormone, trimetrexate, vancomycin, verapamil
EtOH following ; β-lactams, calcium carbamide, cefamandole, cefoperazone, chloramphenicol,
chlorpropamide, disulfiram, griseofulvin, industrial chemicals (trichloroetylene,
N -
dimethylformamide,
N -butyraldoxime), ketoconazole, metronidazole, moxalactam, phentolamine,
quinacrine, sulfonylureas
4-hydroxyandrostenedione, danazol, tamoxifen, clomiphene citrate, decapeptyl, leuprolide
dactinomycin, daunorubicin, fluorouracil, methotrexate, tar
cyclosporine, diltiazem, nifedipine,
phenytoin (hydantoin derivatives), verapamil
bleomycin (and combinations), cisplatin, cyclophosphamide (and combinations), methotrexate,
actinomycin, bleomycin, cyclophosphamide, daunorubicin, doxorubicin, melphalan
bleomycin, chloroquine, haloperidol, mephenesin, nafoxidine
ampicillin, erythromycin, penicillin, quinidine, quinine
ACTH, astezolamide, corticosteroids, cyclosporin, diazoxide, diethylstilbestrol, dilantin, fluoxymesterone, hexachlorobenzene, minoxidil, penicillamine, phenytoin, tamoxifen
aspirin, bacteria toxins, chlortetracycline, codeine, compound 48/80, decamethonium, dextran, D-tubocurare, estrogen, EtOH, gallimine, gastrin, meperidine, morphine, NSAIDs, polymyxin antibiotics, quinine, radiocontrast media, scopolamine, snake venom, substance P, thiamin, vancomycin
bleomycin, brequinar sodium, busulfan, carmustine, cisplatin, cyclophosphamide, dactinomycin,
daunorubicin, docetaxel, doxorubicin, fluorouracil, fotemustine, hydroxyurea, ifosfamide, mechlorethamine, methotrexate, mitoxantrone, plicamycin, procarbazine, tegafur, thiotepa, vinorelbine
melanotic : fixed drug eruption
non-melanotic : amiodarone, antimalarials, arsenic, bismuth, gold, iron, lead, mercury,
minocycline, OCPs, PCB poisoning, phenothiazine, silver
busulfan, cisplatin, cyclophosphamide, doxorubicin, fluorouracil, hydroxyurea, tegafur
cyclophosphamide, dibromomannitol, doxorubicin, procarbazine
acetazolamide, anabolic steroids, bromocriptine, corticosteroids, cyclosporine, danazol, diazoxide, digoxin, diphenylhydantoin, dyazide, erythropoietin, estrogen, fenoterol, hydantoin, metyrapone, minoxidil, oxadiazolopyrimidine, penicillamine, phenothiazines, phenytoin, progesterone, psoralen, spironolactone, streptomycin, tacrolimus, testosterone, thyroid hormones
allopurinol, butyrophenone, cimetidine, clofazimine, dyrazine, ergocalciferol,
hydrochlorothiazide, nafoxidine, nicotinic acid, retinoids, triparanol
hypocholesterolemics ; butyrophenones, diazacholesterol, dixyrazine, nicotinic acid, triparanol
amoxicillin, cefazolin, clindamycin, metronidazole
ACE inhibitors, aminosalicylic acid,
antimalarials , antimony, antipsychotics, anti-tuberculous
agents, arsenic, β
-blockers , bismuth, calcium channel blockers, captopril, carbamazepine,
chloroquine, dapsone, demeclocycline, color film processors,
furosemide ,
gold , hydroxyurea,
hypoglycemics, iodide (contrast), isoniazid, ketoconazole, levamisole, lithium, mercury,
methyldopa, NSAIDs, paraphenylenediamine,
penicillamine , phenothiazines, phenytoin,
propranolol, pyrimethamine, quinidine, quinine,
spironolactone , streptomycin, sulfasalazine,
sulfonylureas, tegafur, tetracycline,
thiazides
aminoglycosides, color film developer, dental restoration materials, gold, mercury, silver
ACE inhibitors, allopurinol, cyanamide, dental restoration materials, gold salts, ketoconazole, methyldopa, NSAIDs, penicillamine, sulfonylureas
lichenoid-photodistributed 5-FU, carbamazepine, chlorpromazine, diazoxide, ethambutol, furosemide, pyritinol, quinidine,
amiodarone, ampicillin, captopril, cefamandole, cyclosporine, diclofenac, glibenclamid, glucophage (?), IFN-γ, IL-2, iodine, lithium, penicillin G, phenytoin, somatostatin,
trimethoprim/sulfamethoxasole, vancomycin, vigabatrin
allopurinol, aminoglutethimide, β-blockers, captopril, carbamazepine, chlorthalidone,
chlordiazepoxide, chlorpromazine, cimetidine, clofibrate, diethylstilbestrol, dilantin,
ethosuximide, gold, griseofulvin, hydantoin,
hydralazine , hydroxyurea, isoniazid, leuprolide,
levodopa, lithium, lovastatin, methyldopa, methysergide, nitrofurantoin, OCPs, penicillamine,
penicillin, phenothiazines, phenylbutazone, phenytoin,
procainamide (25%), quinidine, reserpine,
streptomycin, sulfonamides, tegafur, tetracycline, thiouracil, trimethadione
gold, photosensitizing medications, thiazides
subacute cutaneous mastocytosis, cutaneous
provoke; anticholinergic medications, EtOH, narcotics, polymyxin B sulfate, salicylates
amoxicillin 5%, trimethoprim-sulfamethoxazole 3%, ampicillin 3%, blood products 2%, semi-
synthetic penicillins 2%, penicillin G 2%, acetylcysteine 0.9%, allopurinol 0.8%, gentamicin 0.5%, barbiturates 0.4%, metoclopramide 0.3%, atropine 0.2%, heparin 0.1%, furosemide 0.05%, diazepam 0.04%, potassium chloride 0.03%
acetaminophen, aminophylline, antacids, aspirin, codeine, digoxin, diphenhydramine, docusate
sodium, ferrous sulfate, flurazepam, insulin, isosorbide dinitrate, magnesium, methyldopa, milk of Magnesia, nitroglycerin, potassium iodide, prednisone, prochlorperazine, promethazine, propranolol, spironolactone
AZT, bleomycin, cyclophosphamide, ketoconazole, minocycline, psoralen
blue : antimalarials, argyria, arsenic, chlorpromazine, ketoconazole, mercury, sulfa
yellow : amphotericin B, beta-carotene, chromium salts, dinitrophenol, DNCB, fluorescein,
penicillamine, tars, tetracycline
bleomycin, chlorambucil, cyclophosphamide, cytarabine, doxorubicin, lomustine, mitoxantrone
inhibition of sulfhydryl group of homogentisic acid oxidase; hydroquinone, mepacrine, phenol, quinacrine, resorcinol
doxycycline, 8-methoxypsoralen, minocycline, tetracycline, thiazides
bromine, iodine, penicillin, phenacetin, pyritinol, sulfathiazole
anticonvulsants, antidepressants, chloramphenicol, 5-fluorouracil, isoniazid, 6-mercaptopurine, sulfapyridine
ampicillin, captopril,
furosemide , penicillamine, penicillin, phenacetin, psoralens, PUVA, sulfa
drugs, thiol derivatives
pemphigus, drug-induced aminophenazone, ampicillin, aminopyrine, aspirin (with ampicillin,indomethacin, penicillin,
rifampin), aurothioglucose, azapropazone, captopril, cephalexin, ceftraxone sodium, digoxin,
enalapril, ethambutol HCL, 5-FU (topical), furosemide, gold sodium thiomalate, heroin,
hydantoin, ibuprofen, indomethacin, interleukin 2, interferon β, isoniazid, levodopa, lysine
acetylsalicylate, meprobamate, mercaptopropionylglycine, methimazole, nalidixic acid, nifedipine,
optalidon, oxyphenylbutazone, pentachlorophenol,
penicillamine , penicillin, phenacetin,
phenylbutazone, phosphamide, phenobarbital, piroxicam, practolol, progesterone, propranolol,
pyritinol, rifampin, sulfasalazine, thiopronine, thiopyridoxine, tincture of benzoin
pemphigus erythematosus penicillamine pemphigus vegetans
penicillamine, penicillin, rifampin, thiopronine
amiodarone, antidepressants, antifungals, antimalarials, benzodiazepines, griseofulvin,
hypoglycemics, musk ambrette, 6-methylcoumarin, NSAIDs, OCPs, PABA esters, phenothiazines, sulfonamides, sulfonylureas, thiazides, vinblastine
amiodarone, antidepressants, chloroquine, fluoroquinolones, fluorouracil, griseofulvin, methotrexate, nalidixic acid, NSAIDs, phenothiazines, sulfonamides, sulfonylureas, tetracyclines, thiazides, vinblastine (
also see following section )
medications ;
amiodarone , anthracene, benoxaprofen, brequinar sodium, chloroquine,
chlorpromazine, dacarbazine, dactinomycin, demeclocycline, doxorubicin, doxycycline, 5-
fluorouracil, furosemide, griseofulvin, HCTZ, hydroxyurea, methotrexate, mitomycin C, nalidixic
acid, naproxen,
NSAIDs , PABA,
phenothiazines , piroxicam, porphyrins, procarbazine, psoralen,
quinidine, sulfanilamide,
sulfonamides , sulfonylureas, tegafur, tetracycline, thiazides,
tolbutamide, vinblastine
other ; dye (eosin, methylene blue), fumocoumarins (fragrance, lime, celery, parsnip, fig),
hemotroporphyrin, tar
bergamot, carrot (wild), cow parsnip, dill, fennel, gas plant, Persian lines, rue (common)
amiodarone -slate blue,
argyria -slate blue,
bismuth -blue black on gingival margin,
bleomycin -
flagellate pigmentation,
chloroquine -blue gray,
minocycline -brown, gray, blue black in acne scar,
plaquenil -blue black,
tetracycline -blue cutaneous osteomas
ACTH, arsenic, minocycline, OCPs, phenytoin
cathaxanthin, phenazopyridine, quinacrine
acetylsalicylic acid, arsenic, barbiturates, β-blockers, bismuth, captopril, clonidine, gold,
griseofulvin, isoniazid, isotretinoin, ketotifen, mercurials, methoxypromazine, metronidazole, NSAIDs, omeprazole, penicillamine, penicillin, pyribenzamine, salvarsan, tripelennamine
cisplatin (
also see following section )
androgens, busulfan, chloroquine, cyclophosphamide, dapsone, diethylstilbestrol, estrogen, EtOH, furosemide, griseofulvin, hexachlorobenzene, hydroxychloroquine, methotrexate, nalidixic acid, naproxen, OCPs, pyridoxine, quinidine, quinine, rifampin, sulfonylureas, tetracycline, 2,4,5-trichlorophenol (
also see following section
chlorambucil, cyclophosphamide(
also see following section )
antimicrobials : acyclovir, ampicillin,
antimalarials , cephalosporins, chloroquine, colistin,
erythromycin , halofantrine, ketoconazole, lomefloxacin, metronidazole, miconazole, polymyxin
B, sulfonamides, suramin
cardiovascular : amiodarone, beta-blockers, captopril, clonidine, diazoxide, diphenoxylate,
dobutamine, enalapril, naftazone,
quinidine diuretics : furosemide, HCTZ
hormones : anabolic steroids, dexamethasone, estrogen,
OCP s, progesterone, testosterone
miscellaneous : allopurinol,
aspirin , bleomycin,
chlorpropamide , colchicine, coumarin, heparin,
imipramine, NSAIDs,
phenothiazines , probenecid,
tolbutamide opiates : butorphanol, cocaine, fentanyl, heroin, morphine
vitamins : etretinate, isotretinoin, niacin, vitamin B complex
ACE inhibitors, anticonvulsants, antidepressants, benzodiazepines, beta blockers, calcium channel blockers, dilantin, H1 & H2 antagonists, lipid-lowering agents, lithium, NSAIDs, phenothiazines, steroids
furosemide, nalidixic acid, tetracycline
following section ) psoriasiform, induce or
ACE inhibitors, acetylsalicylic acid, ampicillin, antimalarials, arsenic, chloroquine, codeine,
cyclosporine, etretinate, gold, ibuprofen, interferons, interleukins, iodine, lithium, methoxsalen, morphine, penicillamine, pindolol, practolol, propranolol, quinidine
antimalarials , β
-blockers , captopril, chlorthalidone, clonidine, corticosteroids (withdrawal),
digoxin, indomethacin,
lithium , NSAIDs
antimalarials, β-blockers, lithium, steroid withdrawal
aminoglutethimide, lithium, OCPs, steroid withdrawal
anticonvulsants, aspirin, barbiturates, benzoate, carbamides, chloroquine, chlorothiazide, chlorpromazine, coumadin, gold, griseofulvin, heparin, iodides, methotrexate, NSAIDs, phenothiazines, phenylbutazone, quinidine, quinine, sedatives, sulfonamides, tartrazine, thiazides
acetaminophen, amoxicillin, ampicillin, bromides, carbamazepine, cefaclor, erythromycin, imipenam, iodides, nifedipine, penicillin, quinidine
antibiotics ; azithromycin, cephalosporin, chloramphenicol, ciprofloxacin, doxycycline,
erythromycin, isoniazid, itraconazole, norfloxacin, penicillin, streptomycin, sulfasalazine,
terbinafine, trimethoprim, vancomycin,
others ; acetaminophen, allopurinol, carbamazepine, chromium picolinate, diclofenac, diltiazem,
disulfiram, enalapril, furosemide, hydroxychloroquine, mercury, nifedipine, phenytoin, quinidine
bleomycin, chlorambucil, cyclophosphamide (+dactinomycin, vincristine, doxorubicin, cisplatin, bleomycin, triazinate), dactinomycin, dactinomycin and amethopterin, doxorubicin, doxorubicin and cyclophosphamide, fluorouracil, fluorouracil and cisplatin, hydroxyurea, 6-mercaptopurine, methotrexate
bleomycin, cyclophosphamide, cytarabine,
dactinomycin , daunorubicin,
doxorubicin , docetaxel,
edatrexate, etoposide (VP-16), 5-fluorouracil, hydroxyurea, idarubicin, lomustine, melphalan,
methotrexate, paclitaxel, tamoxifen, trimetrexate, vinblastine
allopurinol, ampicillin, barbiturates, chloroquine, diflunisal, dilantin, gentamicin, gold salts, isoniazid, meclofenamate, penicillin, phenothiazines, phenylbutazone, piroxicam, quinidine, streptomycin, sulfonamides, thiazides, thiouracil, trimethoprim/sulfamethoxasole,
ampicillin, aspirin, barbiturates, benzodiazepines, chlorpromazine, dapsone, erythromycin, gentamicin, gold salts, griseofulvin, isoniazid, phenothiazines, thiazides
amphetamines, arsenic, β-adrenergic blockers, bleomycin (and combinations), clonidine, cyanamide, ergotamine, EtOH, heavy metals, methysergide, OCPs, tobacco, vincristine, vinyl chloride
aminophylline, amyl nitrite, cyclosporine, diazoxide, dipyridamole, EtOH, glutamate, hydralazine, iodides, isoprel, isordil, nicotinic acid, nitrate, papaverine, reserpine, theophylline, vasodilators
aldactone, chrysotherapy, griseofulvin, penicillamine, piroxicam, procainamide, sulfonylureas, thiazides
aliphatic hydrocarbons, aromatic hydrocarbons, bleomycin, carbidopa, cyclohexylamines, docetaxel, penicillamine, silica, trichlorethylene, valproic acid, vinyl chloride
bleomycin, polyvinylchloride, tryptophan, vitamin K (IM)
arsenic, cimetidine, gold, methyldopa, neuroleptics, phenothiazines
(inflammation) serum sickness vasculitis
cephalosporins, penicillin, sulfa, thiazides
β-lactam antibiotics, cefaclor, dilantin, penicillin, sulfonamides
amsacrine, bleomycin, cyclophosphamide, cytarabine, dactinomycin, daunorubicin, docetaxel,
(chemotherapeutic agents) doxorubicin, edatrexate, epirubicin, floxuridine, fluorouracil, hydroxyurea (high-dose), idarubicin,
mechlorethamine, 6-mercaptopurine, methotrexate, mithramycin, mitomycin, paclitaxel, procarbazine, tegafur, 6-thioguanine, tomudex, topotecan, vinblastine, vincristine
all-trans-retinoic acid, GM-CSF, minocycline, OCPs
carmustine, hydroxyurea, nifedipine, OCPs
NSAIDs, phenothiazines, quinidine, thiazides
purpura
toxic epidermal necrolysis
allopurinol , amoxapine,
ampicillin , anti-tuberculosis drugs, asparaginase,
aspirin , barbiturates,
bleomycin,
carbamazepine , cephalosporins, chlorambucil, chloramphenicol, chlorpropamide,
ciprofloxacin, cladribine, cytarabine, dapsone, dicloxacillin, dilantin, disulfiram, doxorubicin,
doxycycline, erythromycin, fansidar, 5-fluorouracil, gold, griseofulvin, hydantoin, hypoglycemics,
imipramine, methotrexate, minipress, mithramycin, nitrofurantoin, NSAIDs,
oxicam derivatives ,
penicillamine, penicillin,
phenobarbital , phenolphthalein, phenybutazone,
phenytoin ,
plicamycin, procarbazine, quinine, rifampin, streptomycin,
sulfonamides , suramin, tetracycline,
thiobendazole, trimethoprim/sulfadoxine, trimethoprim/sulfamethoxasole, valproic acid,
vancomycin
With HIV infection ; clindamycin, erythromycin, fluconazole, phenobarbital, valproic acid,
vancomycin
barbiturates, ergotamine, halogens, methotrexate
etoposide/cyclophosphamide, methotrexate, methotrexate/cyclophosphamide/fluorouracil, suramin
ACE inhibitors, acetylsalicylic acid, ACTH, animal sera, azo dyes, barbiturates, benzoates,
benzocaine, calcium channel blockers, cephalosporin, chloramphenicol, chlorpromazine,
cimetidine, corticotropin, curare, dextran, enzymes, fluoxetine, griseofulvin, hormones, hydantoin,
hydralazine, imipramine, indomethacin, insulin, mechlorethamine (nitrogen mustard), mesna,
NSAIDs ,
opiates ,
penicillin , phenolphthalein, phenothiazines, phenylbutazone, pollen vaccines,
polymyxin B, polypeptide procainamide, promethazine quinidine,
radiocontrast dye , salicylates,
streptomycin, sulfonamides, tetracycline, trazodone, trimethoprim
acetic acid, alcohol, balsam of Peru, benzoic acid, caterpillar hair, cinnamic acid, cinnamic
aldehyde, cobalt chloride, dimethyl sulfoxide, insect sting, methyl nicotinate, moth, sodium benzoate, sorbic acid, trafuril
amsacrine, L-asparaginase, bleomycin, busulfan, carboplatin, chlorambucil, cisplatin,
cyclophosphamide, cytarabine, daunorubicin, diaziquone, didemnin B, diethylstilbestrol, docetaxel, doxorubicin, epirubicin, etoposide, 5-fluorouracil, mechlorethamine, melphalan, methotrexate, mitomycin C, mitotane, mitoxantrone, paclitaxel, pentostatin procarbazine, teniposide, thiotepa, trimetrexate, vincristine, zinostatin
ampicillin, chlorothiazide, phenytoin, thiouracil
allopurinol, aminosalicylic acid, busulfan, cimetidine, clindamycin, corticosteroids,
cyclophosphamide, cytarabine, diltiazem, gold, griseofulvin, heparin, hexamethylene bisacetamide, hydantoins, hydralazine, hydroxyurea, indomethacin, insulin, iodides, ketoconazole, levamisole, 6-mercaptopurine, methotrexate, mitoxantrone, nifedipine, NSAIDs, OCPs, penicillin, phenothiazines, phenylbutazone, procainamide, propylthiouracil, quinidine, quinine, serum, sotalol, streptokinase, streptomycin, sulfonamides, tamoxifen, tetracycline, thiazides, vaccine (influenza), vancomycin, vitamins
amoxapine, arsenic, barbiturates, bromides, captopril, chemotherapeutic agents, dipyridamole, furosemide, griseofulvin, iodides, mercury, nalidixic acid, NSAIDs, penicillamine, penicillin, phenolphthalein, phenytoin, PUVA, salicylates, sulfonamides, thiazides, thioridazine
anticholinergics, antihistamines, hypnotics, sedatives
Photosensitizing medications, categorical
(see sulfonamides and tetracyclines) ciprofloxacin, clofazimine, erythromycin ethylsuccinate +
sulfisoxazole, ethionamide, gentamicin, hexachlorophene, interferon α-2B, nalidixic acid, norfloxacin, pyrazinamide, trimethoprim, trimethoprim +sulfamethoxasole
amitripyline, amoxapine, chlordiazepoxide, +amitripyline, desipramine, doxepin, imipramine,
isocarboxazid, maprotiline, nortriptyline, perphenazine +amitripyline, protriptyline, trimipramine
fentichlor, flucytosine, griseofulvin, jadit, multifungin
astemizole, azatadine, bromodipheyhydramine +codeine, brompheniramine, buclizine, carbinoxamine, chlorpheniramine, chlorpheniramine +D-pseudoephedrine, chlorpheniramine +phenylpropanolamine, clemastine, cyclizine, cyclobenzaprine, cyproheptadine, dexchlorpheniramine, dimenhydrinate, diphenhydramine, diphenylpyraline, doxylamine, hydroxyzine, meclizine, methapyrilene, methdilazine, orphenadrine, pheniramine, phenylpropanolamine +chlorpheniramine, phenylpropanolamine +pheniramine +pyrilamine, promethazine, pyrilamine, terfenadine, trimeprazine, tripelennamine, triprolidine
dacarbazine, floxuridine, fluorouracil, flutamide, methotrexate, vinblastine
acetophenazine, butaperazine, carphenazine, chlorpromazine, chlorprothixene, ethopropazine,
fluphenazine, haloperidol, mesoridazine, methdilazine, methotrimeprazine, nabilone, perphenazine,
piperacetazine, prochlorperazine, promazine, promethazine, propiomazine, thiethylperazine,
thioridazine, thiothixene, trifluoperazine, triflupromazine, trimeprazine
see hypertensive and cardiac agents
amiodarone, atenolol +chlorthalidone, captopril, clorthalidone +reserpine, diltiazem, enalapril,
enalapril +hydrochlorothiazide, furosemide, guanethidine +hydrochlorothiazide, indapamide, labetalol, labetalol +hydrochlorothiazide, metoalazone, metoprolol, minoxidil, nadolol +bendrofumethiazide, nifedipine, propranolol +hydrochlorothiazide, quinethazone, quinidine gluconate, quinidine sulfate, timolol +hydrochlorothiazide, triamterene
auranofin, diclofenac, diflunisal, fenoprofen, flurbiprofen, gold compounds, ibuprofen,
indomethacin, ketoprofen, meclofenamate, naproxen, phenylbutazone, piroxicam, sulindac, suprofen, tolmetin
estrogens ; chlorotrianisene, diethylstilbestrol, estradiol, estrogens (conjugated and esterified),
estropipate
progesterones ; ethinyl estradiol, medroxyprogesterone, megestrol, norethindrone, norgestrel,
quinestrol
sulfacytine, sulfadiazine, sulfadoxine, sulfadoxine +pyrimethamine, sulfamethizole, sulfamethoxazole, sulfapyridine, sulfasalazine, sulfinpyrazone, sulfisoxazole, sulfone
acetohexamide, chlorpropamide, glipizide, glyburide, tolazamide, tolbutamide
6-Acetoxy-2,4,-dimethyl-m dioxane, benzophenones, cinnamates, oxybenzone, paba esters, PABA (para-aminobenzoic acid)
chloretracycline, demeclocycline, docycycline, methacycline, minocycline, oxytetracycline, tetracycline
bendroflumethiazide, benzthiazide, chlorothiazide, chlorthalidone, cyclothiazide, hydrochlorothiazide, hydroflumethiazide, poythiazide, rauwolfia serpentina +bendroflumenthiazide, reserpine +chlorothiazide, reserpine +hydralazine +hydrochlorothiazide, reserpine +hydrochlorothiazide, trichlormethiazide
Photosensitizing medications, alphabetical
acetazolamide, acetohexamide, acetophenazine, amiodarone, amitripyline, amoxapine, astemizole, atenolol +chlorthalidone, auranofin, azatadine,
bendroflumethiazide, benzophenones, benzthiazide, bromodiphenhydramine +codeine, brompheniramine, buclizine, butaperazine,
captopril, carbamazepine, carbinoxamine, carphenazine, chlordiazepoxide + amitriptyline, chloretracycline, chlorothiazide, chlorotrianisene, chlorpheniramine, chlorpheniramine + phenylpropanolamine, chlorpheniramine + pseudoephedrine, chlorpromazine, chlorpropamide, chlorprothixene, chlorthalidone, cinnamates, ciprofloxacin, clemastine, clofazime, clorthalidone + reserpine, cyclobenzaprine, cyclizine, cyclothiazide, cyproheptadine
dacarbazine, danazol, demeclocycline, dexchlorpheniramine, diclofenac, diflunisal, diltiazem, dimenhydrinate, 6-Acetoxy-2,4,-dimethyl-m dioxane, diphenhydramine, diphenylpyraline, doxylamine, diethylstilbestrol, desipramine, doxepin, doxycycline
enalapril, enalapril +hydrochlorothiazide, erythromycin ethylsuccinate + sulfisoxazole, ethionamide, ethoproopazine, estradiol, estrogens (conjugated and esterified), estropipate ethinyl estradiol
fentichlor, fenoprofen, floxuridine, flurbiprofen, flucytosine, fluorouracil, fluphenazine, flutamide, furosemide
gentamicin, glipizide, glyburide, gold compounds, griseofulvin, guanethidine +hydrochlorothiazide
haloperidol, hexachlorophene, hydrochlorothiazide, hydroflumethiazide, hydroxyzine
ibuprofen, imipramine, indapamide, indomethacin, interferon α-2B, isocarboxazid, isotretinoin,
labetalol, labetalol +hydrochlorothiazide, lovastatin
maprotiline, meclizine, meclofenamate, medroxyprogesterone, megestrol, mesoridazine, methacycline, methapyrilene, methazolamide, methdilazine, methotrexate, methotrimeprazine, methoxsalen, metoalazone, metoprolol, minocycline, minoxidil, multifungin
nabilone, nadolol +bendrofumethiazide, nalidixic acid, naproxen, nifedipine, norethindrone, norfloxacin, norgestrel, nortroptyline
orphenadrine, oxybenzone, oxytetracycline
PABA (para-aminobenzoic acid), perphenazine, perphenazine + amitriptyline, pheniramine, phenylbutazone, phenylpropanolamine + chlorpheniramine, phenylpropanolamine + pheniramine + pyrilamine, phenytoin, piperacetazine, piroxicam, polythiazide, prochlorperazine, promazine, promethazine, propiomazine, propranolol + hydrochlorothiazide, protriptyline, pyrazinamide, pyrilamine
quinestrol, quinethazone, quinidine gluconate, quinidine sulfate, quinine,
rauwolfia serpentina + bendroflumenthiazide, reserpine +chlorothiazide, reserpine +hydralazine +hydrochlorothiazide, reserpine +hydrochlorothiazide,
selegiline, sulfacytine, sulfadiazine, sulfadoxine, sulfadoxine +pyrimethamine, sulfamethizole, sulfamethoxazole, sulfapyridine, sulfasalazine, sulfinpyrazone, sulfisoxazole, sulfone, sulindac, suprofen
terfenadine, tetracycline, thiethylperazine, thioridazine, thiothixene, timolol +hydrochlorothiazide, tolazamide, tolbutamide, tolmetin, tretinoin, triamterene, trichlormethiazide, trifluoperazine, triflupromazine, trimeprazine, trimethoprim, trimethoprim +sulfamethoxasole, trimipramine, trioxsalen, tripelennamine, triprolidine
*Modified from Levine JI. Medications that increase sensitivity to light; a 1990 listing. Rockville, Md; US Dept. of Health and Human Services
Porphyria; drugs that may precipitate acute porphyria
alcuronium,
alphaxalone ,
alphadolone , alprazolam, aluminum preparations, amidopyrine, aminoglutethimide,
aminophylline,
amitripyline ,
amylobarbitone ,
amphetamines , antipyrine, apronalide,
auranofin ,
aurothiomalate , azapropazone
baclofen,
barbiturates ,
bemegride , bendrofluazide, benoxaprofen, benzbromarone,
benzylthiouracil ,
bepridil ,
bromocriptine, busulphan,
butylscopolamine
captopril,
carbamazepine ,
carbromal ,
carisoprodol , cefuroxime, cephalexin, cephalosporins, cephradine,
chlorambucil,
chloramphenicol ,
chlordiazepoxide ,
chlormezanone , chloroform, chlorpropamide, cimetidine,
cinnarizine, clemastine,
clobazam ,
clomipramine HCL ,
clonazepam ,
clorazepate , cocaine, colistrin, co-
trimoxazole, cyclophosphamide, cycloserine, cyclosporine
danazol,
dapsone , dexfenfluramine, dextropropoxyphene, diazepam, dichloralphenazone, diclofenac NA,
diethylpropion, dihydralazine, dihydroergotamine,
dimenhydrinate ,
diphenhydramine , dothiepin HCL,
doxycycline,
dydrogesterone
econazole NO3 ,
enalapril , enflurane, ergometrine maleate,
ergot compounds , ergotamine tartrate,
erythromycin ,
estramustine , ethamsylate,
ethanol , ethionamide, ethosuximide,
ethotoin , etidocaine, etomidate
flufenamic acid, flunitrazepam, fluroxine, furosemide
glutethimide, gold preparations, griseofulvin
halothane, hydantoins (phenytoin, ethotoin, mephenytoin), hydralazine, hydrochlorothiazide, hyoscine N-butyl bromide
imipramine, isoniazid, isopropylmeprobamate
mephenezine, meprobamate, mercury compounds, methoxyflurane, methsuximide, methyldopa, methyprylone, metoclopramide, metyrapone, metronidazole
nalidixic acid, nikethamide, novobiocin, nitrazepam, nitrofurantoin
oral contraceptives, oxazolidinediones (paramethadione and trimethadione), oxazepam
pancuronium, paraldehyde, pargyline, pentazocine, pentylenetetrazol, pethidine, phenoxybenzamine, phenylbutazone, phenylhydrazine, primidone, probenecid, progesterone, propanidid, pyrazinamide, pyrazolones (amidopyrine, antipyrine, isopropylantipyrine, dipyrone, sodium phenyl dimethyl pyrazolone), pyrimethamine
spironolactone, steroids, succinimides (ethosuximide, methsuximide, phensuximide), sulphonal, sulfonamides, sulfonylureas, sulthiame
tetracyclines, theophylline, tolazamide, tolbutamide, tranylcypromine, trional, troxidone
Porphyria; drugs thought to be safe in acute porphyria
acetazolamide, adrenaline, amethocaine, amytriptyline, aspirin, atropine
biguanides (phenformin, metformin), bromides, bumetanide, bupivicaine, buprenorphine
cephalexin, cephalosporins, chloral hydrate, chloramphenicol, chlormethiazole, chlorpheniramine, chloroquine, chlorpromazine, chlorothiazide, clofibrate, clonazepam, codeine, colchicine, corticosteroids, cyclizine
dexamethasone, diamorphine, diazepam, diazoxide, digitalis, diphenhydramine, dicoumarol anticoagulant, droperidol, digoxin
ibuprofen, imipramine, indomethacin, insulin
mecamylamine, meclizine, mefenamic acid, mersalyl, methadone, methylphenidate, morphine
naproxen, neostigmine, nitrofurantoin, nitrous oxide, nortriptyline
parpcetamol, paraldehyde, penicillins, penicillamine, petinidine, phenoperidine, phenylbutazone, prednisolone, procaine, prisocaine, promethazine, propantheline bromide, propanidid, primaquine, prochlorperazine, promazine, propoxyphene, propanolol, prostigmine, pyrimethamine
rauwolfia alkaloids, reserpine, resorcinol, rifampicin
salicylates, streptomycin, succinylcholine
tetracycline, tetraethylammonium bromide, thiouracil, trifluoperazine, thiazides, trifluoperazine, tripelennamine, tubocurarine
Michael R. Moore, Tschudy DP, Ann Intern Med 1975; 83: 851-64.
Pseudoporphyria; associated drugs; categories
nalidixic acid, tetracycline, oxytetracycline
furosemide, chlorthalidone, butemide, triamterene/hydrochlorothiazide
naproxen, diflunisal, ketoprofen, nabumetone, oxaprozin
barbiturates, colchicine, chronic renal failure, hemodialysis, ultraviolet A radiation/sunbeds
brewer’s yeast, pyridoxine, iron preparations
Pseudoporphyria; associated drugs; alphabetical
barbiturates, brewer’s yeast, busulfan, butemide
carisoprodol/aspirin, chlorthalidone, chronic renal failure, cola, colchicine, cyclosporine
tetracycline, tolbutamide, triamterene/hydrochlorothiazide
Pseudoporpyria; drugs thought to be safe
Checketts SR, et al. Cutis 1999;63:223-5.
Source: http://www.dermadvocate.net/library/reference/derm-facts/pdfs/Skindisease_medications.pdf
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