Q: The label on my prescription bottle (diabetes med) says to avoid prolonged sun exposure. Why?
A: Some drugs may cause a photosensitivity reaction (sensitivity to UVA rays of the sun or tanning devices). The result can be an exaggerated sunburn or, more rarely, an allergic reaction with itching and a blister-like eruption.
Your best defense is to wear protective clothing and apply a sunscreen that protects against both UVB and UVA rays.
Here's an alphabetized list of potentially photosensitizing drugs (by generic/brand). The list may not be complete, so check prescription labels for a photosensitivity caution.
Anti-anxiety/sleeping agents -- alprazolam (Xanax), chlordiazepoxide (Librium), eszopiclone (Lunesta), zaleplon (Sonata), zolpidem (Ambien).
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Antibiotic/antifungal/antiviral agents -- acyclovir (Zovirax), amantadine (Symmetrel), azithromycin (Zithromax), capreomycin (Capastat), cefazolin (Ancef), ceftazidime (Fortaz), ciprofloxacin Cipro), cycloserine (Seromycin), dapsone, demeclocycline (Declomycin), doxycycline (Vibramycin), ethionamide (Trecator-SC), flucytosine (Ancobon), gemifloxacin (Factive), griseofulvin (Fulvicin, Gris-PEG), isoniazid (Nydrazid), levofloxacin (Levaquin), lomefloxacin (Maxaquin), metronidazole (Flagyl), minocycline (Minocin), moxifloxacin (Avelox), nalidixic acid (NegGram), norfloxacin (Noroxin), ofloxacin (Floxin) , oxytetracycline (Terramycin), pyrazinamide, ritonavir (Norvir), saquinavir (Fortovase, Invirase), sulfamethoxazole/trimethoprim (Bactrim), sulfasalazine (Azulfidine), sulfisoxazole (Gantrisin), terconazole (Terazol), tetracycline (Achromycin) , voriconazole (VFEND), zalcitabine (Hivid).
Anti-cancer agents -- bexarotene (Targretin), capecitabine (Xeloda), dacarbazine (DTIC), epirubicin (Ellence), fluorouracil (5-FU), interferon alfa (Intron A, Alferon-N) methotrexate (Mexate), pentostatin (Nipent), procarbazine (Matulane), tretinoin oral (Vesanoid), vinblastine (Velban, Velbe).
Anticonvulsants -- carbamazepine (Tegretol), felbamate (Felbatol), gabapentin (Neurontin), lamotrigine (Lamictal), oxcarbazepine (Trileptal), topiramate (Topamax), valproic acid (Depakene).
Antidepressants -- amitriptyline (Elavil), amoxapine (Asendin), bupropion (Wellbutrin), citalopram (Celexa), clomipramine (Anafranil), desipramine (Norpramin), doxepin (Sinequan), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), imipramine (Tofranil), maprotiline (Ludiomil), mirtazapine (Remeron), nefazodone (Serzone), nortriptyline (Pamelor), paroxetine (Paxil), protriptyline (Vivactil), sertraline (Zoloft), trazodone (Desyrel), trimipramine (Surmontil), venlafaxine (Effexor).
Antidiabetic agents -- acetohexamide (Dymelor), chlorpropamide (Diabinese), glimepiride (Amaryl), glipizide (Glucotrol), glyburide (DiaBeta, Micronase), tolazamide (Tolinase), tolbutamide (Orinase).
Antihistamines -- cetirizine (Zyrtec), cyproheptadine (Periactin), diphenhydramine (Benadryl), loratadine (Claritin).
Anti-malaria agents -- chloroquine (Aralen), hydroxychloroquine (Plaquenil), pyrimethamine (Daraprim), pyrimethamine/sulfadoxine (Fansidar), quinine.
Antipsychotics -- chlorpromazine (Thorazine), clozapine (Clozaril), fluphenazine (Prolixin), haloperidol (Haldol), loxapine (Loxitane), olanzapine (Zyprexa), perphenazine (Trilafon), prochlorperazine (Compazine), quetiapine (Seroquel), risperidone (Risperdal), thioridazine (Mellaril), thiothixene (Navane), trifluoperazine (Stelazine), ziprasidone (Geodon).
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Diuretics -- bendroflumethiazide (Corzide), chlorthalidone (Thalitone), furosemide (Lasix), hydrochlorothiazide (Microzide), hydroflumethiazide (Diucardin), indapamide (Lozol), methyclothiazide (Enduron), metolazone (Zaroxolyn), polythiazide (Renese), triamterene (Dyrenium).
High blood pressure agents -- captopril (Capoten), diltiazem (Cardizem, Tiazac), enalapril (Vasotec), nifedipine (Procardia).
Hormones -- Corticosteroids (e.g., prednisone), Oral contraceptives
Lipid-lowering agents -- atorvastatin (Lipitor), fenofibrate (Tricor), fluvastatin (Lescol), gemfibrozil (Lopid), lovastatin (Mevacor), pravastatin (Pravachol), rosuvastatin (Crestor), simvastatin (Zocor).
Pain-relievers -- celecoxib (Celebrex), cyclobenzaprine (Flexeril), dantrolene (Dantrium), diclofenac (Cataflam, Voltaren), diflunisal (Dolobid), etodolac (Lodine), ibuprofen (Motrin), ketoprofen (Orudis), mefenamic acid (Ponstel), meloxicam (Mobic), nabumetone (Relafen), naproxen (Anaprox), oxaprozin (Daypro), piroxicam (Feldene), sulindac (Clinoril), sumatriptan (Imitrex).
Topical agents (applied to the skin) -- benzocaine (Americaine), benzyphenones, cinnamates, coal tar, hexachlorophene (PHisoHex), minoxidil (Rogaine), PABA, tacrolimus (Prograf, Protopic), tazarotene (Tazorac), tretinoin (Renova, Retin-A).
Other -- amiodarone (Cordarone, Pacerone), chlorhexidine (Peridex, Hibiclens), clopidogrel (Plavix), gold salts, isotretinoin (Accutane), methoxsalen (Uvadex, Oxsoralen), promethazine (Phenergan), quinidine, selegiline (Eldepryl), sotalol (Betapace), thalidomide (Thalomid).
Dietary supplements -- bitter orange, chlorella, dong quai, gossypol, gotu kola, St. John's wort, Vitamin A, Vitamin B6 (pyridoxine).
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Richard Harkness is a consultant pharmacist, natural medicines specialist and author of eight published books. Write him at 1224 King Henry Drive, Ocean Springs, MS 39564 or rharkn@aol.com .
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