Related | Perioperative Medication Management Appendix (Aminolevulinic acid and Phototoxicity)
Appendix D: Aminolevulinic acid and Phototoxicity
From: Perioperative Medication Management – Adult/Pediatric – Inpatient/Ambulatory Clinical Practice
Guideline
Last Reviewed 2/2020; Last Updated 6/2019
Contact information: Philip Trapskin, PharmD, Phone Number: 608-263-1328; PTrapskin@uwhealth.org
Summary
Use of aminolevulinic acid is associated with photosensitivity. Patients exposed to photosensitizing
agents may experience phototoxic skin reactions (e.g. severe sunburn). Due to the increased risk of
phototoxic reactions, administration of other phototoxic medications should be avoided whenever possible
for 24 hours before and after systemic aminolevulinic acid administration.
Medications associated with inducing phototoxicity are listed in the table below. Coordinate a
management plan for these medications with the surgeon and prescribing physician.
Generic name Therapeutic class
Acitretinoin Retinoid
Adapalene Retinoid
Afatinib Antineoplastic; tyrosine kinase inhibitor
Alitretinoin Retinoid
Alprazolam Anxiolytic
Aminolevulinic acid topical Photosensitizing agent
Amiodarone Anti-arrhythmic
Amlodipine Calcium channel blocker
Aripiprazole Antipsychotic
Atorvastatin HMG Co-A reductase inhibitor
Atovaquone/proguanil Anti-malarial
Bendroflumethiazide Diuretic
Besif loxacin Antimicrobial; fluoroquinolone
Bexarotene Retinoid
Bicalutamide Antineoplastic; antiandrogen
Cabazitaxel Antineoplastic; antimitotic agent
Calcitriol Vitamin D analog
Candesartan Angiotensin II receptor blocker
Capecitabine Antineoplastic; anti-metabolite
Carbamazepine Anticonvulsant
Cefotaxime Beta-lactam antimicrobial
Cef tazidime Beta-lactam antimicrobial
Celecoxib Non-steroidal anti-inflammatory
Chlordiazepoxide Anxiolytic
Chloroquine Anti-malarial
Chlorothiazide Diuretic
Chlorpromazine Antipsychotic
Chlorthalidone Diuretic
Ciprofloxacin Antimicrobial; fluoroquinolone
Citalopram Antidepressant
Clomipramine Antidepressant
Clopidogrel Antiplatelet
Effective 6/11/2020. Contact CCKM@uwhealth.org for previous versions.
Copyright © 2020 University of Wisconsin Hospitals and Clinics Authority. All Rights Reserved. Printed with Permission.
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 07/2020CCKM@uwhealth.org
Generic name Therapeutic class
Clozapine Antipsychotic
Cobimetinib Antineoplastic; MEK inhibitor
Crizotinib Antineoplastic; tyrosine kinase inhibitor
Dacarbazine Antineoplastic; anti-metabolite
Dapsone Antimicrobial
Delaf loxacin Antimicrobial; fluoroquinolone
Demeclocycline Tetracycline
Diclofenac Non-steroidal anti-inflammatory
Dif lunisal Non-steroidal anti-inflammatory
Diltiazem Calcium channel blocker
Diphenhydramine Antihistamine
Docetaxel Antineoplastic; antimitotic agent
Doxorubicin Antineoplastic; antimitotic agent
Doxycycline Tetracycline
Dronedarone Anti-arrhythmic
Eculizumab Monoclonal antibody
Efavirenz Antiretroviral
Enalapril Angiotensin II converting enzyme inhibitor
Epirubicin Antineoplastic; antimitotic agent
Eravacycline Tetracycline
Erlotinib Antineoplastic; tyrosine kinase inhibitor
Escitalopram Antidepressant
Esomeprazole Proton pump inhibitor
Ethinyl estradiol Contraceptive hormone
Etodolac Non-steroidal anti-inflammatory
Fenof ibrate Fibrate
Fenoprofen Non-steroidal anti-inflammatory
Fluorouracil Antineoplastic; anti-metabolite
Fluoxetine Antidepressant
Flupentixol Antipsychotic
Fluphenazine Antipsychotic
Flurbiprofen Non-steroidal anti-inflammatory
Flutamide Antineoplastic; antiandrogen
Fluvoxamine Antidepressant
Furosemide Diuretic
Gatif loxacin Antimicrobial; fluoroquinolone
Gemif loxacin Antimicrobial; fluoroquinolone
Glimepiride Anti-diabetic
Glipizide Anti-diabetic
Glyburide Anti-diabetic
Griseofulvin Antifungal
Haloperidol Antipsychotic
Hydrochlorothiazide Diuretic
Hydroxychloroquine Anti-malarial
Hydroxyurea Antineoplastic
Ibuprofen Non-steroidal anti-inflammatory
Imatinib Antineoplastic; tyrosine kinase inhibitor
Effective 6/11/2020. Contact CCKM@uwhealth.org for previous versions.
Copyright © 2020 University of Wisconsin Hospitals and Clinics Authority. All Rights Reserved. Printed with Permission.
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
07/2020CCKM@uwhealth.org
Generic name Therapeutic class
Imipramine Antidepressant
Indapamide Diuretic
Indomethacin Non-steroidal anti-inflammatory
Irbesartan Angiotensin II receptor blocker
Isoniazid Anti-tuberculosis
Isotretinoin Retinoid
Itraconazole Antifungal
Ketoconazole Antifungal
Ketoprofen Non-steroidal anti-inflammatory
Ketorolac Non-steroidal anti-inflammatory
Lef lunomide Anti-inf lammatory
Levof loxacin Antimicrobial; fluoroquinolone
Losartan Angiotensin II receptor blocker
Meclofenamate Non-steroidal anti-inflammatory
Meclofenamide sodium Non-steroidal anti-inflammatory
Mefenamic acid Non-steroidal anti-inflammatory
Meloxicam Non-steroidal anti-inflammatory
Mesalamine Anti-inf lammatory
MESNA Chemoprotective agent
Metformin Anti-diabetic
Methyldopa Antihypertensive; centrally acting agent
Methylene blue Antidote; Phenothiazine
Metolazone Diuretic
Minocycline Tetracycline
Moxifloxacin Antimicrobial; fluoroquinolone
Nabumetone Non-steroidal anti-inflammatory
Naproxen Non-steroidal anti-inflammatory
Nifedipine Calcium channel blocker
Of loxacin Antimicrobial; fluoroquinolone
Olanzapine Antipsychotic
Olmesartan Angiotensin II receptor blocker
Omadacycline Tetracycline
Oxaprozin Non-steroidal anti-inflammatory
Paclitaxel Antineoplastic; antimitotic agent
Panitumumab Antineoplastic; monoclonal antibody
Pantoprazole Proton pump inhibitor
Paroxetine Antidepressant
Perphenazine Antipsychotic
Phenelzine Antidepressant
Pirfenidone Anti-inf lammatory
Piroxicam Non-steroidal anti-inflammatory
Porf imer Antineoplastic
Pravastatin HMG Co-A reductase inhibitor
Prochlorperazine Antipsychotic
Promethazine Antihistamine
Pyrazinamide Anti-tuberculosis
Quinapril Angiotensin II converting enzyme inhibitor
Effective 6/11/2020. Contact CCKM@uwhealth.org for previous versions.
Copyright © 2020 University of Wisconsin Hospitals and Clinics Authority. All Rights Reserved. Printed with Permission.
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
07/2020CCKM@uwhealth.org
Generic name Therapeutic class
Quinidine Anti-malarial
Quinine Anti-malarial
Ramipril Angiotensin II converting enzyme inhibitor
Ranitidine Antihistamine
Risperidone Antipsychotic
Sarecycline Tetracycline
Sertraline Antidepressant
Simvastatin HMG Co-A reductase inhibitor
Sitagliptin Anti-diabetic
St. John’s Wort Herbal
Sulfacetamide Antimicrobial; sulfonamide derivative
Sulfadiazine Antimicrobial; sulfonamide derivative
Sulfamethoxazole Antimicrobial; sulfonamide derivative (in combo w/
trimethoprim)
Sulindac Non-steroidal anti-inflammatory
Tegafur Antineoplastic; anti-metabolite
Telmisartan Angiotensin II receptor blocker
Tenofovir Antiretroviral
Terbinaf ine Antifungal
Tetracycline Tetracycline
Thioridazine Antipsychotic
Tocilizumab Monoclonal antibody
Tolbutamide Anti-diabetic
Tolmetin Non-steroidal anti-inflammatory
Tretinoin Retinoid
Triamterene Diuretic
Trif luoperazine Antipsychotic
Trimethoprim Antimicrobial
Trimethoprim/sulfamethoxazole Antimicrobial; sulfonamide derivative
Valsartan Angiotensin II receptor blocker
Vandetanib Antineoplastic; tyrosine kinase inhibitor
Vemurafenib Antineoplastic; BRAF kinase inhibitor
Venlafaxine Antidepressant
Verteporfin Ophthalmic agent
Vinblastine Antimitotic agent
Voriconazole Antifungal
References:
1. Blakely KM, Drucker AM, Rosen CF. Drug-induced phototoxicity- an update: culprit drugs, prevention, and management.
Drug Saf. 2019;42:827-847.
2. Lexicomp Online, Hudson, Ohio: Wolters Kluwer Clinical Drug Information, Inc.; accessed March 4, 2020.
3. Monteiro M, Rato M, Martins, C. Drug induced photosensitivity: photoallergic and phototoxic reactions. Clin Dermatol.
2016;34:571-581.
Effective 6/11/2020. Contact CCKM@uwhealth.org for previous versions.
Copyright © 2020 University of Wisconsin Hospitals and Clinics Authority. All Rights Reserved. Printed with Permission.
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
07/2020CCKM@uwhealth.org