Great care must be taken when prescribing for patients with acute porphyria, since certain drugs can induce acute porphyric crises.
Treatment of serious or life-threatening conditions should not be withheld from patients with acute porphyria. When there is no safe alternative, treatment should be started and urinary porphobilinogen excretion should be measured regularly; if it increases or symptoms occur, the drug can be withdrawn and the acute attack treated.
The BNF lists drugs that are UNSAFE in porphyria. The BNF links below contain references to drugs on the UK market that have been classified as ‘unsafe’ in porphyria because they have been shown to be porphyrinogenic in animals or in vitro, or have been associated with acute attacks in patients. Absence of a drug from these lists does not necessarily imply that the drug is safe.
BNF Unsafe drug list - check first
BNF Unsafe drug list - check second
The UK Porphyria Information Service lists drugs that are SAFE in prophyria
UK Porphyria Information Service Safe List
For many drugs no information about porphyria is available. If a specific drug is not included then contact Medicines Information: CGH 3030 or GRH 6108; Out of hours contact the on-call Pharmacist via switchboard.
Last reviewed: 27/02/2017