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Drug Interactions between aminolevulinic acid and methoxsalen

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Major

methoxsalen aminolevulinic acid

Applies to: methoxsalen and aminolevulinic acid

GENERALLY AVOID: Patients exposed to photosensitizing agents around the same time as oral aminolevulinic acid may be at an increased risk of a phototoxic skin reaction (severe sunburn). These agents have each been individually associated with photosensitivity reactions and may have additive effects when used together. Medicinal products with known phototoxic or photoallergic potential include, but are not limited to, hypericin-containing products (e.g., St. John's Wort), griseofulvin, thiazide diuretics, sulfonylureas, phenothiazines, sulfonamides, quinolones, tetracyclines, and topical aminolevulinate preparations. There is one case report of a severe sunburn lasting for 5 days in a patient who used oral aminolevulinic acid concurrently with a hypericin extract.

MANAGEMENT: Photosensitizing agents (e.g., fluoroquinolones, phenothiazines, retinoids, sulfonamides, sulfonylureas, tetracyclines, thiazide diuretics, griseofulvin, St. John's wort) and topical preparations containing aminolevulinic acid should be avoided for 24 hours before and after oral administration of aminolevulinic acid. Some authorities recommend avoiding exposure to any photosensitizing agent for up to 2 weeks after oral administration of aminolevulinic acid. Patients should also avoid exposure of the eyes and skin to sunlight and bright indoor lights (e.g., examination lamps, operating room lamps, tanning beds, lights at close proximity) for 48 hours after treatment.

References

  1. Hoffman GA, Gradl G, Schulz M, Haidinger G, Tanew A, Weber B (2020) "The frequency of photosensitizing drug dispensings in Austria and Germany: A correlation with their photosensitizing potential based on published literature." J Eur Acad Dermatol Venereol, 34, p. 589-600
  2. Blakely KM, Drucker AM, Rosen CF (2019) "Drug-induced photosensitivity—an update: Culprit drugs, prevention and management." Drug Saf, 42, p. 827-47
  3. (2023) "Product Information. Gliolan (aminolevulinic acid)." Medac UK
  4. (2022) "Product Information. Gleolan (aminolevulinic acid)." Medexus pharma Inc
  5. (2020) "Product Information. Gleolan (aminolevulinic acid)." Medexus Inc
  6. (2021) "Product Information. Gliolan (aminolevulinic acid)." Specialised Therapeutics Australia Pty Ltd
View all 6 references

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Drug and food interactions

Moderate

methoxsalen food

Applies to: methoxsalen

GENERALLY AVOID: The ingestion of foods containing photosensitizing components (e.g., limes, figs, parsley, parsnips, rue (Ruta graveolens), mustard, carrots and celery) may increase the risk of photosensitivity and severe burning during methoxsalen therapy. Two cases of photosensitivity involving rue and a soup containing celery, parsley, and parsnip have been reported in PUVA patients.

MANAGEMENT: Patients who are undergoing PUVA treatment and taking methoxsalen should be advised to avoid eating large quantities of these foods.

References

  1. the Australasian Society of Clinical and Experimental Pharmacologists and Toxicologists (ASCEPT), Royal Australian College of General Practicioners (RACGP), the Pharmaceutical Society of Australia (PSA) (2007) Australian Medicines Handbook. https://www.amh.net.au/

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Therapeutic duplication warnings

Therapeutic duplication is the use of more than one medicine from the same drug category or therapeutic class to treat the same condition. This can be intentional in cases where drugs with similar actions are used together for demonstrated therapeutic benefit. It can also be unintentional in cases where a patient has been treated by more than one doctor, or had prescriptions filled at more than one pharmacy, and can have potentially adverse consequences.

Duplication

Photochemotherapeutic agents

Therapeutic duplication

The recommended maximum number of medicines in the 'photochemotherapeutic agents' category to be taken concurrently is usually one. Your list includes two medicines belonging to the 'photochemotherapeutic agents' category:

  • aminolevulinic acid
  • methoxsalen

Note: In certain circumstances, the benefits of taking this combination of drugs may outweigh any risks. Always consult your healthcare provider before making changes to your medications or dosage.


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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.