LEKOVI KOJI SE MOGU DAVATI BOLESNICIMA OBOLELIM OD AKUTNEINTERMITENTNE PORFIRIJE

BOLESTI I TEGOBE KATEGORIJA LEKA VRSTA LEKA

Specifično lečenje

Bolovi

Stomačne tegobe

Bolesti srca i cirkulacije

Neuroze i psihoze

Analgetici

Antiulkusni lekovi

Antiemetici

Opstipacija

Antihipertenzivi,antiaritmici i koronarni dilatatori

Kardiotonici

Diuretici

Cirkulatorni poremećaji

Drugo

Antipsihotici

Ugljeni hidratiHematin (HEMODONIN,NORMOSANG, PANHEMATIN)Propranolol (INDERAL)Folna kis. (FOLAN)

Acetilsaliclna kiselina(ASPIRIN, ACETISAL,ANDOL, MIDOL i dr.)MorfinPetidin (DOLANTIN)

Cimetidin (BELOMET)Metoklopramid (KLOMETOL,REGLAN, VENTROMET)

Hlorpromazin (LARGACTIL)

Neostigmin (PROSTIGMIN)

Diltiazem (CORTIAZEM RET)Prazosin (VASOFLEX)Diazoksid (HYPERSTAT)Labetalol (LAMITOL)Na-nitroprusidRezerpinPropranolol (INDERAL)Metoprolol (PRESOLOL)Prokainamid (NOVOCAMID)Verapamil (VEPAMIL, ISOPTIN)

Digitalis (DILACOR)

Furosemid (LASIX)Tiazidi (hidrohlortiazid - MONOZID)Triamteren (TIAREN)Bumetanid (YURINEX)

Naftidrofuril (DUSODRIL)Nicergolin (ADAVIN)

Atropin

Hlorpromazin (LARGACTIL)Promazin (PRAZINE)

www.belimantil.info

Bolesti nervnog sistema

Infekcije

Anestezija

Antidepresivi

Sedativi i hipnotici

Psihostimulansi

Antikonvulzivi

Parkinsonova bolest

Antibiotici

Uroantiseptici

Virostatici

Antimikotici

Opšti anestetici

Lokalni anestetici

Levopromazin (NOZINAN)Haloperidol (HALDOL)

Amitriptilin (AMYZOL)Meprotilin (MAPROTILIN)Klomipramin (ANAFRANIL)Imipramin (EUPRAMIN)

Bromazepam (BROMAZEPAM,LEXILLIUM)Midazolam (FLORMIDAL)Oksazepam (ADUMBRAN)Lorazepam (LORSILAN,LORAM)Hlordiazepoksid (LIBRIUM)Flunitrazepam (BENZOSAN)Hloral hidrat

Piracetam (OIKAMID)

Klonazepam (RIVOTRIL)Midazolam (FLORMIDAL)

Triheksifenidil (ARTANE,HEXIFEN)

Penicilini (Amoksicilin -SINACILIN,AMOKSICILIN, ampicilini -PENTREXYL, pivampicilin-DANCILIN, i dr.)Cefalosporini (ALFACET,PALITREX, LONGACEPH,TOLYCAR)Aminoglikozidi (GARAMYCIN,netilmicin-NETROMYCIN)Rifampicin (RIFAMOR)

Oksolinska kis. (OKSAREN)

Aciklovir (ACIKLOVIR, ZOVIRAX)

Flucitozin (ANCOTIL)

Fentanil (FENTANIL)Droperidol(DEHYDROBENZPEIDOL)EtarAzot oksidul

Tetrakain (GINGICAIN)

www.belimantil.info

Šećerna bolest

Bolesti štitne žlezde

Reumatske bolesti

Alergijske reakcije

Očne bolesti

Hormonska oboljenja

Bolesti disajnih oragana

Bolesti krvi

Miorelaksansi

Antidijabetici

Antitireotici

Antireumatici

Antihistaminici

Glaukom

Hormoni

Antitusici

Antikoagulansi

Antiagregacioni

Prokain (PROCAINIHYDROCHLORIDUM)

Sukcinilholin (MIDARINE)Pankuronjum(PAVULON, MIOLAX)Tubokurarin (TUBARINE)

Insulini

Propiltiouracil

Acetilsalicilna kis.Flurbiprofen (FLUGALIN)Indometacin (INDOMETACIN)Naproksen (NAPROXEN)Tiaprofenska kis. (TURGANIL)Diklofenak (DIKLOFEN)Ketoprofen (KETONAL)Oksifenbutazon (TANDERIL)Piroksikam (REMOXICAM)Sulindak (KLINORIL)

Difenhidramin (DIMIDRIL)Prometazin (PHENERGAN)

Acetazolamid (DIAMOX)

ACTHKortikosteroidiKateholaminiGlukagon (GLUCAGON)Tiroksin (TIVORAL, VOBENOL)

Kodein (CODEINI PHOSPHAS)

HeparinDikumarol

Aceilsalicilna kis.Dipridamol (PERSANTIN)

www.belimantil.info

DRUGI DOZVOLJNI LEKOVI KOJI NISU REGISTROVANI U NAŠOJ ZEMLJI

AlimemazinAmfotericin BrBuflomedilButakainDekshlorfeniraminEstazolamEtibenzatropinFenoperidinGlafeninGvanetidin

GvanfacinHeptaminolMekvitazinMetopimazinNefopamNifluminska kiselinaOrganonOksibuprokainParapenzolatPerheksilin

PipotiazinPropanididPropoksifenProksimetakalneNa-oksibat (hidroksibutirat)Tienilična kiselinaTraneksemična kiselinaTrinitrinTriandomicin

www.belimantil.info

LEKOVI KOJI SU KONTRAINDIKOVANI KOD OBOLELIH OD PORFIRIJE

AlkoholAlkuronium (ALLOFERIN), miorelaksansAlfadlolon-AlfeksalonAlopurinol (ALOPURINOL, ZYLORIC), gihtAlfakalneAlprazolam (XANAX), sedativAmidopirinAmineptinAmjodaron (AMIODARON, CORDARONE)AndrogeniAstemizol (ASTEMISAN, HISTAZOL), antihist.BarbituratiBasdenBepridilBromokriptin (BROMERGON, PARLODEL)Bupivakain (VEXELIT), lokalni anestetikDekstromoramidDekstropropoksifenDiazepam (BENSEDIN, APAURIN), sedativDizopiramid (KORAPEIS), antiaritmikEnfluranErgotamin i derivati (ERGOTAN, DITAMIN)Eritromicin (ERITROMICIN), antibiotikEtamsilat (DICYNONE), opšti hemostiptikEtidokainEtomidat (HYPNOMIDATE), opšti anestetikFenacetinFenazon (COSAVIL, PYRA-RECTIOLE)FenoksibenzaminFenilbutazon (PHENILBUTAZON),antireumatikFenofibrat (FENOFIBRAT, KATALIP)FloktafeninFlumekvinFlunarizinGlutetimidGrizeofulvin (GRISEOFULVIN M), antimikotikHalotan, opšti anestetikHeksapropimatHidantoiniHidralazinHidroksizin (ATARAX), sedativHloramfenikol (CHLORAMPHENICOL), antibiotikHlormezanonHlorohin (CHLOROCHIN), antimalarikHlorazepat (TRANEX), sedativInhibitori MAOIzoniazid (ISONIAZID), tuberkulostatik

Kaptopril (KATOPIL, ZORKAPTIL), antihipertenzivKarbamazepin (MAZEPIN, KARBAPIN),antiepileptikKarisoprodolKetamin (RALATEK), opšti anestetikKininKlobazam (ODIPAM), sedativKlometacinKlometiazol (HEMINEVRIN), sedativKlomifen (KLOMIFEN), ovarijalni stimulatorKlonidin (CATAPRESSAN), antihipertenzivKlotiazepamLidokain (LIDOKAIN-HLORID, XYLOCAIN)LoksapinMefenaminska kiselinaMefenezinMepivakainMeprobamat (MEPROBAMAT), sedativMetildopa (ALDOMET), antihipertenzivMetilergometrin , uterostiptikMetiprilonMetronidazol (ORVAGYL, EFLORAN),Minaserin (MIANSAN), antidepresivMikonazol (DAKTARIN), antimikotikNalidiksna kiselina (BAKTOGRAM), uroantiseptNifedipin (NIFECARD, NIFELAT, CORDIPIN),tenzivNitrazepam (NITRAM), sedativNoramidopirinEstroprogestativiEstrogeniParacetamol (FEBRICET, PARACET),PargilinPentazocin (FORTRAL), opijatni analgetikPentoksifilin (TRENTAL), vazoaktivni lekPipebuzonPipemidna kiselina (PIPEM, PIPEGAL),PrilokainPrimidon (MAJSOLIN), antiepileptikProbenecidProgabidProgesteroniPropofol (DISOPRIVAN), opšti anestetikPirazinamid (PYRAZINAMID), antiepileptik,PirokainRanitidin (RANISAN, RANITAL), antiulkusikSpironolakton (ALDACTONE), diuretikSukcinamidi

www.belimantil.info

SulfonamidiSulfinpirazonSulpirid (SULPIRID), antipsihotikSulfopridTamoksifen (TAMOFEN), ovarijalni stimulator,Tetrazepam (MIOGALAN), miotonolitikTeofilin (DUROFILIN), bronhopsamolitikTinidazol (TRIAGIL), antiinfektiv

Trazodon (DEVIDON), antidepresivTriazolam (TRIASAN), sedativTrimetadionValproat Na (EFTIL, APILEPSIN, DEPAKINE),Valpromid (DIPROZIN), antiepileptikVeralipridViloksazin (VIVALAN), antidepresiv

www.belimantil.info

LEKOVI KOJI SE MOGU DAVATI BOLESNICIMA OBOLELIM OD AKUTNEINTERMITENTNE PORFIRIJE

Svi navedeni lekovi su registrovani u Jugoslaviji

BOLESTI I TEGOBE KATEGORIJALEKA

NAZIV LEKA

Akutni napad porfirije Sizbijanje napada 1. Ugljeni hidrati 400gr dnevno( glukoza 10% 4X500mlintravenski + slatki rastvoriper os)

2. Hematin arginin 250 mg uinfuziji NaCl 0,9% a 250 ml(u od svetla zaštićenomsistemu da istekne za 1/ 2 h)1X dnevno

3. Folna kiselina 45-60 mgdnevno

4. Vitamini B1, B6, B125. Nadoknada Na i Mg

Stomačne tegobe:Muka, povraćanje

Gastritis, Ulkus

ProlivZatvor

Antiemetici

Antiulkusni

AntidijaroiciLaksansi

Chlorpromazin (Largaktil)Domperidon ( Motilium)Cisaprid (Cisap)Prochlorperazin (Stemetil)Famotidin (Famosan)Omeprazol (Omeprol)Aluminijum sulfat (Alfogel)

Loperamid ( Imodium)Neostigmin (Prostigmin)Magnezium sulfatSorbitolSenna

Bol Opijatni analgetici

Analgetici

DiamorphinDroperidolMethadon (Metadon)Pethidin (Dolantin)Acetisal (Aspirin, Lazdol)Codein Phosphas (Kafetin)Paracetamol (Miralgin)

Hrana i krv Svi vitamini, Haem Arginat,Transfuzije, Albumin

www.belimantil.info

Preparati gvožđaBolesti srca Kardiotonici

Euritmici

Drugo

Diuretici

Antihipertenzivi

Antikoagulansi

Cirkulatorniporemećaji

Digoxin (Dilakor)

Procainamid (Novocamid)Quinidin

AtropinAdrenalin

Acetazolamid (Diamox)Amilorid (Hemopres)Bunetanid (Yurinex)

Atenolol (Prinorm)Dizoxid (Hyperstat)Metoprolol (Presolol)Propranolol (Inderal)Reserpin (Serpasil)

HeparinWarfarin (Farin)

Dipyridamol (Persantin)Naftidrofuryl (Dusodril)

Bolesti nervnog sistema Antikonvulzivi

Hipnotoci, SedativiPsihoanaleptici

Anabolici

Neurontin (Gabapentin)Midazolam (Flormidal)Clonazepam (Rivotril)BromidiPareldehydMagnezijum sulfat

Triazolam (Triasan)Chlorpromazin (Largactil)Promazin (Prazine)Trifluoroperazin (Perfluzin)DroperidolFluoxetin (Flunirin, Prozac)Fluvoxaminmaleat (Fevarin)Lithium carbonatPiracetam (Oikamid)

Bolesti disajnih organa Antitusici

Bronhospazmolitici

Codein phosphas (Kodein)

Ketotifen (Galitifen)Salbutamol (Ventolin)

www.belimantil.info

Kortikosteroidi Beclomethazon (Beconase)Alergijske reakcije Antihistaminici Chlorpheniramin (Lentostamin)

Reumatske bolesti Antireumatici

Specifični lekovi

Flubiprofen (Flugalin)Ibuprofen (Brufen)Ketoprofen (Ketonal)Tiaprofenska kis. (Turganil)Indomethacin (Indometacin)Dexamethazon (Deksazon)

Allopurinol (Zyloric)PenicillaminColchicin

Infekcije Antibiotici

AntituberkulotikAntimalarikAntivirotik

Antimikotik

Aminoglycosidi (Amikacin)Netilmicin (Nekomicin)Amoxycillin (Sinacilin)Amphotericin BAmpicillin (Pentrexyl)Ciprofloxacin (Ciprocinal)Clavulinska kis.(Amoksiklav)Gentamycin (Garamycin)TetracyclinDoxiciclin (Dovicin, Amracin)Norfloxacin (Uracin)Ofloxacin (Viziren)PefloxsacinPenicillinStreptomycinVancomycin (Vancogal)Fucidinska kis. (Stanicid)Etanbutol (Myambutol)QuinineAciclovir (Virolex, Zovirax)Zidovudin (Retrovir, Zidosan)Flucitozin ( Ancotil)Metronidazol (Orvagil)

Maligne bolesti Antineoplastičnilekovi

Imunomodulatori

Cisplatin (Belplatin, Elain)Doxorubicin (Adriablastin)Vincristin (Oncovin)Melphalan (Alceran)Cyproteron (Androcur)Buserelin (Suprefakt)Goserelin (Zoladex)Azathioprin (Imuran)

www.belimantil.info

Porodiljstvo-ginekologija Prostaglandini (Dinoprost)Oxytocin (Sytocinon)LHRHClomiphen (Klonifen citrat)

Hormonske bolesti Hormoni ACTH, FSHDetoxamethason (Dexason)GlicocorticoidiHydrocortisonPropylthiouracilLevotiroxin (Tivoral)

Šećerna bolest Antidiabetici InsulinMetformin (Tefor)

Operativni zahvati Opšti anestetici

Lokalni antestetici

Miorelaksansi

Antidoti

Fentanyl (Fentanil)Droperidol(Dehydrobensperidol)Fentanyl droperidol (Talamonal)Diethylether (Etar)Azotoxidul (Nitrogenoksid)ProcainTetracain (Gingicain)Bupivacain (Marcain)Suxametonium (Midrine)Tubocurarin (Tubarin)Flumazenil (Anxat)

Vakcine Nije dokazano štetno dejstvo

Kontrsastna sredstva Nije dokazano štetno dejstvo

Očne bolesti Acetazolamid (Daimox)Atropin sulfat (Hemotropin)Dexamethason (Deksason)Gentamycin (Gentokulin)Tetracyclini (Amracin)ZincsulfatAciclovir (Virocul)Hydrocortison (Hidrokorton)Prednisolon (Oftalmol)Timolol (Glaumol)

Kožne bolesti Zinc, Hydrocortison

www.belimantil.info

Drugs that are considered safe in the acuteporphyrias:

Categorised List

Anti-emetics Antivirals/Antifungals Analgesics (cont.) Miscellaneous (cont.)

Cyclizine Aciclovir Co-dydramol FlumazenilDomperidone Amphotericin Codeine phosphate FructoseMeclozine Famciclovir Dextromethorphan FSHProchlorperazine Flucytosine Dextromoramide GlipizidePromazine Ganciclovir Dextropropoxyphene Glucagon

Valaciclovir Diamorphine GlucoseAntihistamines Zalcitabine Diflunisal Glycopyrroni

umChlorpheniramine Dihydrocodeine GonadorelinDiphenhydramine Cardiovascular agents Fenbufen GoserelinKetotifen Amiloride Fentanyl HetastarchLoratadine Beta blockers Flurbiprofen InsulinPromethazine Bumetanide Ibuprofen IronTrimeprazine Chlorothiazide Indomethacin Ispaghula

Cyclopenthiazide Ketoprofen LactuloseAntibacterial agents Dalteparin Methadone LeuprorelinAminoglycosides Diazoxide Morphine Levothyroxin

eCo-amoxiclav Digoxin Nalbuphine LHRHEthambutol Dipyridamole Naproxen LithiumFlucloxacillin 1 Dobutamine Paracetamol LoperamidePenicillins Dopamine Pethidine LorazepamPentamidine Enalapril Sulindac Magnesium

sulphateSodium fusidate Enoxaparin Tiaprofenic acid MelphalanStreptomycin Glyceryl trinitrate MesalazineVancomycin Guanethidine Corticosteroids + other Metformin

Heparin immunosuppressants Methotrimeprazine

Lipid lowering agents Hydrochlorothiazide Beclomethasone Methylphenidate

Bezafibrate Lisinopril 4 Ciclosporin 5 MidazolamCholestyramine Naftidrofuryl Corticosteroids NaloxoneColestipol Prazosin Hydrocortisone OctreotideFenofibrate Procainamide Methylprednisolone OmeprazoleGemfibrozil Quinidine Prednisolone Oxybuprocai

neStreptokinase Oxytocin

Local Anaesthetics Tinzaparin Miscellaneous ParaldehydeAmethocaine Triamterene Acetazolamide PenicillamineBupivacaine Urokinase Acetylcysteine Phytomenadi

oneLignocaine 2 Allopurinol PrimaquinePrilocaine Anticonvulsants Alpha tocopheryl Propanthelin

eProcaine Clobazam Aluminium salts Propylthioura

cilTetracaine Clonazepam Amantadine Proxymetaca

ineGabapentin Ascorbic acid Pseudoephe

drineImmunisations Sodium valproate 3 Azathioprine PyridoxineImmunoglobulins Valproate 3 Bismuth Pyrimethami

neVaccines Vigabatrin Bromazepam Quinine

Buserelin ResorcinolAntidepressants Drugs used in anaesthesia Calcitonin SalbutamolAmitriptyline Adrenaline Calcium carbonate Senna

www.belimantil.info

Fluoxetine Atropine Carbimazole Sodium acidphos

Lofepramine Cyclopropane Chloral hydrate Sodiumbicarbonate

Mianserin Epinephrine Cisplatin SorbitolEther Clomiphene Sucralfate

Antipsychotics Isoflurane Colchicine TemazepamChlorpromazine Neostigmine Corticotrophin ThiamineFluphenazine Nitrous oxide Danthron ThyroxineHaloperidol Pancuronium Desferrioxamine Tranexamic

acidPipothiazine Phentolamine Dextran VitaminsTrifluoperazine Propofol Dextrose Warfarin

Suxamethonium Dicyclomine Zincpreparations

Malaria Prophylaxis DimercaprolChloroquine Analgesics DimethiconeMefloquine Alfentanil DiphenoxylateProguanil Aspirin Distigmine

Buprenorphine DoxorubicinCo-codamol Droperidol

1. Large intravenous doses may be associated with acute attacks (unproven as causativeagent)

2. Intravenous doses should be avoided3. Sodium valproate should only be used where other safe antiepileptics are ineffective or

inappropriate4. Safety under review, contact WMIC5. Contact WMIC for information regarding other immunosuppressants

www.belimantil.info

B. DRUGS THOUGHT TO BE SAFE FOR USE IN ACUTE PORPHYRIA (1996)

Each bracketed drug ( ) has had conflicting evidence of experimental porphyrinogenicity.Occasionally positive, but mainly negative - none of the drugs in this List have been associatedwith human porphyric attacks.

A:

ACETAZOLAMIDE

ACETYLCHOLINE

ACTINOMYCIN D

ACYCLOVIR

ADENOSINE MONOPHOSPHATE

ADRENALINE

ALCLOFENAC

ALLOPURINOL

ALPHA TOCOPHERYL ACETATE

AMETHOCAINE

AMILORIDE

AMINOCAPROIC ACID

AMINOGLYCOSIDES

AMOXYCILLIN

AMPHOTERICIN

AMPICILLIN

ASCORBIC ACID

ASPIRIN

ATENOLOL

ATROPINE

AZATHIOPRINE

ETOPOSIDE

F:

FAMOTIDINE

FENBRUFEN(FENOFIBRATE)

FENOPROFEN

FENTANYL

FLUCYTOSINE

FLUMAZENIL

FLUOXETINE HCl

FLURBIPROFEN

FLUVOXAMINE MALEATE

FOLIC ACID

FRUCTOSE

FUSIDIC ACID

F.S.H.

G:

GENTAMICIN

GLAFENINE

GLUCAGON

GLUCOSE

OXYBUPROCAINE

(OXYPHENBUTAZONE)

OXYTOCIN

P:

(PANCURONIUM BROMIDE)

PARACETAMOL

PARALDEHYDE

PARAPENZOLATE Br

PENICILLAMINE

PENICILLIN

PENTOLINIUM

PERICYAZINE

PETHIDINE

PHENFORMIN

PHENOPERIDINE

PHENTOLAMINE MESYLATE

PIPOTHIAZINE PALMITATE

PIRACETAM

PIRBUTEROL

PIRENZEPINE

PIZOTIFEN

www.belimantil.info

B:

BECLOMETHASONE

BENZHEXOL HCl

BETA-CAROTENE

BIGUANIDES

(BROMAZEPAM)

BROMIDES

BUFLOMEDIL HCl

BUMETANIDE

BUPIVACAINE

BUPRENORPHINE

BUSERELIN

BUTACAINE SO4

C:

CANTHAXANTHIN

CARBIMAZOLE

(CARPIPRAMINE HCl)

CHLORAL HYDRATE

(CHLORMETHIAZOLE)

(CHLOROQUINE)

(CHLOROTHIAZIDE)

CHLORPHENIRAMINE

CHLORPROMAZINE

CIPROFLOXACIN

CISAPRIDE

GLYCERYL TRINITRATE

GOSERELIN

GUANETHIDINE

GUANFACINE HCl

H:

HAEM ARGINATE

(HALOPERIDOL)

HEPARIN

HEPTAMINOL HCl

HEXAMINE

(HYDROCORTISONE)

I:

IBUPROFEN

INDOMETHACIN

INSULIN

IRON

J:

JOSAMYCIN

K:

(KETAMINE)

KETOPROFEN

KETOTIFEN

L:

LABETALOL

(PRAZOSIN)

(PREDNISOLONE)

PRIMAQUINE

PROBUCOL

PROCAINAMIDE HCl

PROCAINE

PROCHLORPERAZINE

PROGUANIL HCl

PROMAZINE

PROPANTHELINE Br

PROPOFOL

PROPRANOLOL

PROPYLTHIOURACIL

(PROXYMETACAINE)

PSEUDOEPHEDRINE HCl

PYRIDOXINE

(PYRIMETHAMINE)

Q:

QUINIDINE

QUININE

R:

(RANITIDINE)

RESERPINE

RESORCINOL

S:

www.belimantil.info

CISPLATIN

CLAVULANIC ACID

CLOFIBRATE

CLOMIPHENE

CLOXACILLIN

CO-CODAMOL

CODEINE PHOSPHATE

COLCHICINE

(CORTICOSTEROIDS)

CORTICOTROPHIN (ACTH)

COUMARINS

CYCLIZINE

CYCLOPENTHIAZIDE

CYCLOPROPANE

(CYPROTERONE ACETATE)

D:

DANTHRON

DESFERRIOXAMINE

DEXAMETHASONE

(DEXTROMORAMIDE)

DEXTROSE

DIAMORPHINE

DIAZOXIDE

DICYCLOMINE HCl

DIFLUNISAL

L.H.R.H.

LIQUORICE

LITHIUM SALTS

LOFEPRAMINE

LOPERAMIDE

(LORAZEPAM)

M:

MAGNESIUM-SULPHATE

(MEBENDAZOLE)

MECAMYLAMINE

MECLOFENOXATE HCl

MECLOZINE

MEFLOQUINE HCl

(MELPHALAN)

MEPTAZINOL

MEQUITAZINE

METFORMIN

METHADONE

(METHOTRIMEPRAZINE)

METHYLPHENIDATE

METHYLURACIL

METIPROPRANOLOL

METOPIMAZINE

METOPROLOL

(METRONIDAZOLE)

SALBUTAMOL

SENNA

SODIUM BROMIDE

SODIUM Ca EDTA

SODIUM FUSIDATE

SORBITOL

STREPTOMYCIN

SULBUTIAMINE

SULINDAC

SULFADOXINE

SUXAMETHONIUM

T:

TALAMPICILLIN

TEMAZEPAM

TETRACAINE

(TETRACYCLINES)

THIOURACILS

THYROXINE

TIAPROFENIC ACID

TICARCILLIN

TIENILIC ACID

TIMOLOL MALEATE

TOLAZOLINE

TRANEXAMIC ACID

TRIACETYLOLEANDOMYCIN

www.belimantil.info

DIGOXIN

DIHYDROCODEINE

DIMERCAPROL

DIMETHICONE

DINOPROST

DIPHENOXYLATE HCl

DIPYRIDAMOLE

(DISOPYRAMIDE)

DOMPERIDONE

DOXORUBICIN HCl

DROPERIDOL

E:

(ESTAZOLAM)

ETHACRYNIC ACID

ETHAMBUTOL

(ETHINYL OESTRADIOL)

ETHOHEPTAZINE CITRATE

(MIDAZOLAM)

MINAPRINE HCl

MINAXOLONE

MORPHINE

N:

NADOLOL

NAFTIDROFURYL OXALATE

(NAPROXEN SODIUM)

NATAMYCIN

NEFOPAM HCl

NEOSTIGMINE

NETILMICIN

NIFLUMIC ACID

NITROUS OXIDE

NORFLOXACIN

O:

OFLOXACIN

OXOLINIC ACID

TRIAMTERENE

TRIAZOLAM

(TRICHLORMETHIAZIDE)

TRIFLUOPERAZINE

TRIMEPRAZINE TARTRATE

TRIMETAZIDINE HCl

TRIPELENNAMINE

TUBOCURARINE

V:

VANCOMYCIN

(VINCRISTINE)

VITAMINS

W:

WARFARIN SODIUM

Z:

ZIDOVUDINE

ZINC PREPARATIONS (TOPICAL)

www.belimantil.info

List of drugs which can precipitate porphyriaDrugs that should be avoided at all cost (*), as they are known to precipitate acute porphyria, ordrugs that should be used with extreme caution, are:

Cardiovascular drugsAmiodorone*

Bretilium*

Flecainade*

Mexitilene*

Propafenone*

Clonidine*

Dihydrylazine*

Hydralazine

Metyldopa*

Minoxidil

Indapamide

Metolazone

Torisamide*

Pirentanide

Amlodipine

Nifidipine

Nimodipine

Felodipine

Isradipine

Losartan*

Fenofibrate

Fluvastatin

Pravastatin

SimvastatinRespiratory drugs

Aminophylline*

Theophylline

Etofylline*

Montelukast*

Carbocisteine*

Clobutinol*

Fedrilate*

Acrivastine*

Azatadine*

Cyproheptadine*

Ebastine*

Fexofenadine*

Oxatomide*

TerfenadineDrugs Active in alimentary tract and metabolism

www.belimantil.info

Lansoprazole

Misoprostol

Omeprazole

Belladonna*

Cisapride*

Hyoscine butylbromide*

Mebeverine

Betahistine

Buclizine*

Cinnarizine

Doxylamine*

Granisitron*

Hyoscine

Tropisetron*

Sulfasalazine*

Amfepramone

Phendimetrazine

Phentermine

Acarbose*

Chlorpropamide

Glibenclamide

Glicazide

Glimepiride*

Tolbutamide*Genitourinary system and sex hormones (Including oral contraceptives)

Bromocriptine

Carbergoline*

Dinoprost

Dinoprostone

Ergotamine*

Metergoline

Desogestrel

Dydrogesterone

Estradiol

Estriol

Medroxyprogesterone

Mesterolone

Mestranol

Methyltestosterone

Norgestimate*

Oral Contraceptives

Testosterone

Tibolone

Cinoxacin

Finasteride

www.belimantil.info

Estrone

Ethinylestradiol

Etynodiol

Fluoxymesterone*

Gestondene

Gestrinone*

Levonorgestrel

Medrogestondene

Flavoxate*

Nalidixic acid*

Nitrofurantoin

Nitroxoline*

Phenazopyridine*

Pipemidic acid

Neurological medicationDantrolene

Desflurane*

Etomidate*

Oxethazaine*

Thiopental sodium*

Pentazocine*

Tilidine

Clonidine*

Dihydroergotamine*

Ergotamine*

Flunarizine*

Methysergide*

Pizotifen*

Carbamazipine*

Oxcarbazepine*

Phenobarbitol*

Phenotoin*

Primidone*

Topiramide*

Valproic acid*

Benzerazide*

Biperiden*

Bromocriptine

Carbidopa*

Orphenadrine*

Pergolide*

Selegiline

Buspiroon*

www.belimantil.info

Ethosuximide

Lamotrigine*

Flupentixol

Fluzepam

Hydroxyzine

Meprobamate

Pimozide*

Risperidone*

Sulpiride

Zopiclone*

Zolpidem*

Amitriptyline

Amphetamines

Dothiepin

Fluvoxamine

Chlordiazepoxide

Clotiapine*

ImipramineLofepramine

Mirtazapine*

Moclobemide*

Nefazodone

Nortriptyline

Pemoline

Phenelzine

Sertraline*

Tranylcypromine

Trazodone

Trimipramine

Venlafaxine

BethaecolHaematological agents

Ticlopidine AprotininMusculoskeletal and rheumatological agents

Auranofin

Aurothiomalate

Diclofenac

Dipyrone

Ketorolac

Baclofen

Benzbromarone

Nabumetone

Phenylbutazone

ProbenecidAntimicrobials and antiparasitic products

Azithromycin Itroconazole

www.belimantil.info

Chloramphenicol*

Ciprofloxacin

Clindamycin*

Co-trimoxazole*

Doxycycline*

Enoxacin

Erythromycin*

Fosfomycin*

Imipenem*

Lincomycin

Lomefloxacin

Lorcarbef

Lymecycline

Minocycline

Norfloxacin

Ofloxacin

Oxytetracycline

Pivampicillin

Roxythromycin

Sparfloxacin

Sulphonamides*

Tazobactam*

Tetracycline

Ketokonazole*

Miconazole*

Clofazimine

Dapsone*

Ethionamide*

Isoniazid

Pyrazinamide*

Rifabutin

Rifampicin

Terizidone*

Didanosine*

Foscarnet*

Indinavir

Lamivudine

Ritonivir

Saquinavir*

Zidovudine (AZT)

Atovaquone*

Halofantrene*

Melarsoprol*

Metronidazole

Sulfadoxime*

Suramin

www.belimantil.info

Trimethoprim

Fluconazole

Niclosamide

Piperazine*

Tinidazole

Ivermectin*

Praziquantel

Pyrantil*Dermatologicals

Griseofulvin

Terbinafine

Acitretin

Methoxsalen

Isoretinoin

Anticancer and immuno-modulating agentsBleomycin*

Busulfan

Carboplatin

Cytarabine*

Dacarbazine*

Docetaxel

Estramustine*

Etoposide*

Gemcitabine*

Hydroxyurea

Idarubicin

Ifosfamide

Lomustine*

Mercaptopurine

Mitomycin

Mitoxantrone

Paclitaxel*

Procarbazine

Teniposide*

Troguanine

Vinblastine

Vindesine

Cilcosporin

Aminoglutethemide*

Flutamide

Formestane

Medroxyprogesterone

TamoxifenOther drugs

alcium carbimide* pecacuanha*

www.belimantil.info

isulfiram* Obidoxime*

www.belimantil.info

TABLE 1:A. DRUGS UNSAFE FOR USE IN ACUTE PORPHYRIA (1996)

These drugs have been classified as 'unsafe' because all have been shown to be porphyrinogenicin animals or in vitro systems, or to have been associated with acute attacks in humans.

( ) Bracketed drugs are those in which there is conflicting experimental evidence ofporphyrinogenicity - some positive, - some negative

* Those marked with an asterisk have been associated with acute attacks of porphyria.

While very great care has been taken in the compilation of lists and the drug information is givenin the belief that it is correct at the time of publication, all information contained herein andopinions expressed must be taken as information and opinions given for general guidance only.Drug names given herein are approved names not trade or common names. The authors herebydisclaim for themselves , the Porphyria Services, The National Health and Medical ResearchCouncil, The University of Queensland, Griffith University, Queensland Health and thePorphyria Charitable Trust, all responsibility for any misstatement or for the consequences to anyperson of any person acting in reliance on any statement or opinion contained herein. Medicalpractitioners and patients must make their own decisions in the circumstances of the particularcase about therapy appropriate in any case of acute porphyria.

A:

ALCURONIUM

*ALPHAXALONE: ALPHADOLONE

ALPRAZOLAM

ALUMINIUM PREPARATIONS

AMIDOPYRINE

AMINOGLUTETHIMIDE

AMINOPHYLLINE

AMIODARONE

*AMITRIPTYLINE

(AMPHETAMINES)

*AMYLOBARBITONE

ANTIPYRINE

*ETHOTOIN

ETIDOCAINE

ETOMIDATE F: FENFLURAMINE

*FLUCLOXACILLIN

*FLUFENAMIC ACID

FLUNITRAZEPAM

FLUPENTHIXOL

FLURAZEPAM

*FRUSEMIDE

G:

*GLIBENCLAMIDE

*GLUTETHIMIDE

*GLIPIZIDE

OXANAMIDE

(OXAZEPAM)

OXYBUTYNIN HCl

OXYCODONE

*OXYMETAZOLINE

*OXYPHENBUTAZONE

OXYTETRACYCLINE

P:

PARAMETHADIONE

PARGYLINE

*PENTAZOCINE

PERHEXILINE

PHENACETIN

www.belimantil.info

*AURANOFIN

*AUROTHIOMALATE

AZAPROPAZONE

B:

BACLOFEN

*BARBITURATES

*BEMEGRIDE

BENDROFLUAZIDE

BENOXAPROFEN

BENZBROMARONE

(BENZYLTHIOURACIL)

(BEPRIDIL)

BROMOCRIPTINE

BUSULPHAN

*BUTYLSCOPOLAMINE

C:

CAPTOPRIL

*CARBAMAZEPINE

*CARBROMAL

*CARISOPRODOL

(CEFUROXIME)

(CEPHALEXIN)

(CEPHALOSPORINS)

(CEPHRADINE)

(CHLORAMBUCIL)

GRAMICIDIN

*GRISEOFULVIN

H:

(HALOPERIDOL)

*HALOTHANE

*HYDANTOINS

*HYDRALAZINE

*HYDROCHLOROTHIAZIDE

*HYDROXYZINE

HYOSCINE

I:

*IMIPRAMINE

IPRONIAZID

ISOMETHEPTENE MUCATE

(ISONIAZID)

K:

KEBUZONE

KETOCONAZOLE

L:

*LEVONORGESTROL

LIGNOCAINE

*LISINOPRIL

LOPRAZOLAM

LOXAPINE

PHENELZINE

*PHENOBARBITONE

PHENOXYBENZAMINE

*PHENSUXIMIDE

*PHENYLBUTAZONE

PHENYLHYDRAZINE

*PHENYTOIN

PIPEBUZONE

PIPEMIDIC ACID

PIRITRAMIDE

*PIROXICAM

*PIVAMPICILLIN

*PIVMECILLINAM

PRAZEPAM

PRENYLAMINE

*PRILOCAINE

*PRIMIDONE

(PROBENECID)

*PROGESTERONE

PROGABIDE

PROMETHAZINE

(PROPANIDID)

*PYRAZINAMIDE

PYRROCAINE

Q:

QUINALBARBITONE

www.belimantil.info

*CHLORAMPHENICOL

*CHLORDIAZEPOXIDE

*CHLORMEZANONE

CHLOROFORM

*CHLORPROPAMIDE

CIMETIDINE

CINNARIZINE

CLEMASTINE

(CLOBAZAM)

(CLOMIPRAMINE HCl)

(CLONAZEPAM)

CLONIDINE HCL

*CLORAZEPATE

COCAINE

(COLISTIN)

CO-TRIMOXAZOLE

CYCLOPHOSPHAMIDE

CYCLOSERINE

CYCLOSPORIN

D:

DANAZOL

*DAPSONE

DEXFENFLURAMINE

DEXTROPROPOXYPHENE

DIAZEPAM

*LYNESTRENOL

LYSURIDE MALEATE

M:

MAPROTILINE HCl

MEBEVERINE HCl

*MECILLINAM

*MEDROXYPROGESTERONE

(MEFENAMIC ACID)

MEGESTROL ACETATE

*MEPHENYTOIN

MEPIVACAINE

*MEPROBAMATE

MERCAPTOPURINE

MERCURY COMPOUNDS

MESTRANOL

(METAPRAMINE HCl)

METHAMPHETAMINE

METHOHEXITONE

METHOTREXATE

METHOXYFLURANE

METHSUXIMIDE

*METHYL DOPA

*METHYL SULPHONAL

*METHYPRYLONE

METHYSERGIDE

R:

RIFAMPICIN

S:

SIMVASTATIN

SODIUM AUROTHIOMALATE

SODIUM OXYBATE

(SODIUM VALPROATE)

*SPIRONOLACTONE

STANOZOLOL

SUCCINIMIDES

*SULPHACETAMIDE

*SULPHADIAZINE

*SULPHADIMIDINE

*SULPHADOXINE

*SULPHAMETHOXAZOLE

*SULPHASALAZINE

*SULPHONYLUREAS

SULPHINPYRAZONE

SULPIRIDE

SULTHIAME

SULTOPRIDE

T:

*TAMOXIFEN

*TERFENADINE

www.belimantil.info

*DICHLORALPHENAZONE

*DICLOFENAC Na

DIENOESTROL

DIETHYLPROPION

DIHYDRALAZINE

*DIHYDROERGOTAMINE

DILTIAZEM

*DIMENHYDRINATE

*DIPHENHYDRAMINE

(DOTHIEPIN HCl)

DOXYCYCLINE

*DYDROGESTERONE)

E:

*ECONAZOLE NO3

*ENALAPRIL

ENFLURANE

*ERGOT COMPOUNDS

ERGOMETRINE MALEATE

ERGOTAMINE TARTRATE

*ERYTHROMYCIN

*ESTRAMUSTINE

ETHAMSYLATE

*ETHANOL

ETHIONAMIDE

*ETHOSUXIMIDE

*METOCLOPRAMIDE

METYRAPONE

MIANSERIN HCl

MICONAZOLE

(MIFEPRISTONE)

MINOXIDIL

N:

*NADROLONE

*NALIDIXIC ACID

NATAMYCIN

*NANDROLONE

(NICERGOLINE)

*NIFEDIPINE

*NIKETHAMIDE

NITRAZEPAM

*NITROFURANTOIN

NORDAZEPAM

NORETHYNODREL

*NORETHISTERONE

(NORTRIPTYLINE)

NOVOBIOCIN

O:

*ORAL CONTRACEPTIVES

*ORPHENADRINE

TETRAZEPAM

*THEOPHYLLINE

*THIOPENTONE Na

THIORIDAZINE

TILIDATE

TINIDAZOLE

*TOLAZAMIDE

*TOLBUTAMIDE

TRANYLCYPROMINE

TRAZODONE HCl

TRIMETHOPRIM

(TRIMIPRAMINE)

TROXIDONE

V:

VALPROATE

VALPROMIDE

VERALIPRIDE

*VERAPAMIL

*VIBRAMYCIN

VILOXAZINE HCl

(VINBLASTINE)

(VINCRISTINE)

Z:

ZUCLOPENTHIXOL

www.belimantil.info

www.belimantil.info

Table 1. Drugs Thought Safe in Porphyria*

AcetazolamideacetylcholineActinomycin DAcyclovirAdenosinemonophosphateAdrenalineAlclofenacAllopurinolAlpha tocopherylAcetateAmethocaineAmilorideAminocaproic acidAminoglycosidesAmoxicillinAmphotericinAmpicillinAscorbic acidAspirinAtenololAtropineAzathioprineBeclomethasoneBenzhexol HClBeta-caroteneBiguanides[Bromazepam]BromidesBuflomedil HClBumetanideBupivacaineBuprenorphineBuserelinButacaine SO4CanthaxanthinCarbimazole[Carpipramine HCl]Chloral hydrate[Chlormethiazole][Chloroquine][Chlorothiazide]ChlorpheniramineChlorpromazine

CoumarinsCyclizineCyclopenthiazideCyclopropane[Cyproteroneacetate]DanthronDesferrioxamineDexamethasone[Dextromoramide]DextroseDiamorphineDiazoxideDicyclomine HClDiflunisalDigoxinDihydrocodeineDimercaprolDimethiconeDinoprostDiphenoxylateHClDipyridamole[Disopyramide]DomperidoneDoxorubicin HClDroperidol[Estazolam]Ethacrynic acidEthambutol[Ethinyloestradiol]EthoheptazinecitrateEtoposideFamotidineFenbufen[Fenofibrate]FenoprofenFentanylFlucytosineFlumazenilFluoxetine HClFlurbiprofen

KetoprofenKetotifenLabetalolLuteinizinghormone–releasinghormoneLiquoriceLithiumSalts lofepramineLoperamide[Lorazepam]Magnesium-sulphate[Mebendazole]MecamylamineMeclofenoxate HClMeclozineMefloquine HCl[Melphalan]MeptazinolMequitazineMetforminMethadone[Methotrimeprazine]MethylphenidateMethyluracilMetipropranololMetopimazineMetoprolol[Metronidazole][Midazolam]Minaprine HClMinaxoloneMorphineNadololNaftidrofurylOxalate[Naproxen sodium]NatamycinNefopam HClNeostigmineNetilmicinNiflumic acidNitrous oxide

PalmitatePiracetamPirbuterolPirenzepinePizotifen[Prazosin][Prednisolone]PrimaquineProbucolProcainamide HClProcaineProchlorperazineProguanil HClPromazinePropantheline BrPropofolPropranololPropylthiouracil[Proxymetacaine]Pseudoephedrine HClPyridoxine[Pyrimethamine]QuinidineQuinine[Ranitidine]ReserpineResorcinolSalbutamolSennaSodium bromideSodiumethylenediaminetetraaceticacidSodium fusidateSorbitolStreptomycinSulbutiamineSulindacSulfadoxineSuxamethoniumTalampicillinTemazepamTetracaine[Tetracyclines]

www.belimantil.info

CiprofloxacinCisaprideCisplatinClavulanic acidClofibrateClomipheneCloxacillinCo-codamolCodeine phosphateColchicine[Corticosteroids]Corticotrophin(adrenocorticotropichormone [ACTH])

FluvoxamineMaleateFolic acidFructoseFusidic acidFollicle-stimulatinghormoneGentamicinGlafenineGlucagonGlucoseGlyceryl trinitrateGoserelinGuanethidineGuanfacine HClHaem arginate[Haloperidol]HeparinHeptaminol HClHexamine[Hydrocortisone]IbuprofenIndomethacinInsulinIronJosamycin[Ketamine]

NorfloxacinOfloxacinOxolinic acidOxybuprocaine[Oxyphenbutazone]Oxytocin[Pancuroniumbromide]ParacetamolParaldehydeParapenzolate BrPenicillaminePenicillinPentoliniumPericyazinePethidinePhenforminPhenoperidinePhentolaminemesylatePipotiazine

ThiouracilsThyroxineTiaprofenic acidTicarcillinTienilic acidTimolol maleateTolazolineTranexamic acidTriacetyloleandomycinTriamtereneTriazolam[Trichlormethiazide]TrifluoperazineTrimeprazineTartrateTrimetazidine HClTripelennamineTubocurarineVancomycin[Vincristine]VitaminsWarfarin sodiumZidovudineZinc Preparations

*Bracketed [ ] drugs are those in which experimental evidence of porphyringenicity is conflicting.

Table 2. Drugs Thought Unsafe in Porphyria†

Alcuronium*AlphaxaloneAlphadoloneAlprazolamAluminiumPreparationsAmidopyrineAminoglutethimideAminophyllineAmiodarone*Amitriptyline

CyclophosphamideCycloserineCyclosporinDanazol*DapsoneDexfenfluramineDextropropoxypheneDiazepam*Dichloralphenazone*Diclofenac NaDienoestrol

MaleateMaprotiline HClMebeverine HCl*Mecillinam*Medroxyprogesterone[Mefenamic acid]Megestrol acetate*MephenytoinMepivacaine*MeprobamateMercaptopurine

*Pivampicillin*PivmecillinamPrazepamPrenylamine*Prilocaine*Primidone[Probenecid]*ProgesteroneProgabidePromethazine[Propanidid]

www.belimantil.info

[Amphetamines]*AmylobarbitoneAntipyrine*Auranofin*AurothiomalateAzapropazoneBaclofen*Barbiturates*BemegrideBendrofluazideBenoxaprofenBenzbromarone[Benzylthiouracil][Bepridil]BromocriptineBusulphan*ButylscopolamineCaptopril*Carbamazepine*Carbromal*Carisoprodol[Cefuroxime][Cephalexin][Cephalosporins][Cephradine][Chlorambucil]*Chloramphenicol*Chlordiazepoxide*ChlormezanoneChloroform*ChlorpropamideCinnarizineClemastine[Clobazam][ClomipramineHCl][Clonazepam]Clonidine HCl*ClorazepateCocaine[Colistin]Co-trimoxazole

DiethylpropionDihydralazine*DihydroergotamineDiltiazem*Dimenhydrinate*Diphenhydramine[Dothiepin HCl]Doxycycline*Dydrogesterone*Econazole NO3*EnalaprilEnflurane*Ergot compoundsErgometrine maleateErgotamine tartrate*Erythromycin*EstramustineEthamsylate*EthanolEthionamide*Ethosuximide*EthotoinEtidocaineEtomidateFenfluramine*Flucloxacillin*Flufenamic acidFlunitrazepamFlupenthixolFlurazepam*Frusemide*Glibenclamide*Glutethimide*GlipizideGramicidin*Griseofulvin[Haloperidol]*Halothane*Hydantoins*Hydralazine*Hydrochlorothiazide*HydroxyzineHyoscine*ImipramineIproniazidIsometheptene

Mercury compoundsMestranol[Metapramine HCl]MethamphetamineMethohexitoneMethotrexateMethoxyfluraneMethsuximide*Methyldopa*Methylsulphonal*MethypryloneMethysergide*MetoclopramideMetyraponeMianserin HClMiconazole[Mifepristone]Minoxidil*Nandrolone*Nalidixic acidNatamycin*Nandrolone[Nicergoline]*Nifedipine*NikethamideNitrazepam*NitrofurantoinNordazepamNorethynodrel*Norethisterone[Nortriptyline]Novobiocin*Oral contraceptives*OrphenadrineOxanamide[Oxazepam]Oxybutynin HClOxycodone*Oxymetazoline*OxyphenbutazoneOxytetracyclineParamethadionePargyline*PentazocinePerhexilinePhenacetin

*PyrazinamidePyrrocaineQuinalbarbitoneRifampicinSimvastatinSodiumaurothiomalateSodium oxybate[Sodium valproate]*SpironolactoneStanozololSuccinimides*Sulfacetamide*Sulfadiazine*Sulfadimidine*Sulfadoxine*Sulfamethoxazole*Sulfasalazine*SulfonylureasSulfinpyrazoneSulpirideSulthiameSultopride*Tamoxifen*TerfenadineTetrazepam*Theophylline*Thiopentone NaThioridazineTilidateTinidazole*Tolazamide*TolbutamideTranylcypromineTrazodone HClTrimethoprim[Trimipramine]TroxidoneValproateValpromideVeralipride*Verapamil*VibramycinViloxazine HCl[Vinblastine][Vincristine]

www.belimantil.info

mucate[Isoniazid]KebuzoneKetoconazole*LevonorgestrelLignocaine*LisinoprilLoprazolamLoxapine*LynestrenolLysuride

Phenelzine*PhenobarbitonePhenoxybenzamine*Phensuximide*PhenylbutazonePhenylhydrazine*PhenytoinPipebuzonePipemidicAcidPiritramide*Piroxicam

Zuclopenthixol

*These drugs have been associated with acute attacks of porphyria.†Bracketed [ ] drugs are those in which experimental evidence ofporphyringenicity is conflicting.

www.belimantil.info

PREKURSORI METABOLITA HEMOGLOBINA U 24-ČASOVNOM URINU

( REFERENTNE VREDNOSTI)

KOPROPORFIRIN < 0,180 mikromola/l

UROPORFIRIN < 1,2 mikromola/l

PORFOBILINOGEN 4,4 - 8,84 mikromola/l

ALK(deltaaminolevulinska kiselina) < 76,3 mikromola/l

www.belimantil.info