Acute Porphyria Drug Database

C03AA03 - Hydrochlorothiazide
Propably not porphyrinogenic
PNP

Rationale
CAVE: Under revision. Clinical experience of non-porphyrinogenicity. Conflicting references, but several references refer to hydrochlorothiazide as safe in acute porphyrias. Hydrochlorothiazide is a sulfonamide congener, but apart from this there are no indications of porphyrinogenicity. Hydrochlorothiazide is not metabolised in the liver and has probably no CYP450 affinity.
Chemical description
Sulfonamide congener.
Therapeutic characteristics
Thiazide diuretic.
Metabolism and pharmacokinetics
Probably no CYP-affinity. Eliminated mainly unchanged in the urine. Seemingly not appreciably metabolized.
Preclinical data
AWAITING (Anderson 1981)
Personal communication
Thunell, patient report (n=1): tolerated. Andersson, patient reports (n=10): tolerated. Peters: On basis of clinical experience probably not porphyrinogenic.
IPNet drug reports
Uneventful use reported in 9 patients with acute porphyria.

References

  1. Scientific articles
  2. Anderson KE. Kappas A. Induction of hepatic delta-aminolevulinate synthase and cytochrome P-450 by a thiazide diuretic. [Journal] Hepatology. Vol. 1(5)(pp 1A), 1981. #1246

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