Acute Porphyria Drug Database

N02BE01 - Paracetamol
Propably not porphyrinogenic
PNP

Rationale
Low extent of oxidative metabolism. Inducer of CYP 3A4. Three references consider it safe. Occasional patient reports of suspected porphyrinogenicity, but vast and significant clinical experience of non-porphyrinogenicity.
Chemical description
Anilide (acetaminophen) derivative metabolized by conjugation with glucuronic acid and sulfate. A small part (<4%) is oxidatively metabolized by CYPs and excreted as cysteine and mercapto conjugates. At low concentrations inducer of CYP 3A4, increasing activity and content. Australian list: safe. South African list: use French list: avoid, known to have precipitated an acute attack Thunell; patient inquiry: tolerated (n=28), possibly not tolerated (n=2 C. Andersson; patient inquiry: used without illeffecs (n=18). Used in Swedish porphyria ward . See e.g. Feierman et al. The paradoxical effect of acetaminophe on CYP3A4 activity and content in transfected HepG2 cells. Arch Biochem Biophys 2002 398: 109-17.
IPNet drug reports
Uneventful use reported in 430 patients with acute porphyria.

Similar drugs
Explore alternative drugs in similar therapeutic classes N02B / N02BE or go back.

 
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