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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, OCPs, 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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