Not metabolised. Some clinical experience as well as two references point to non-porphyrinogenicity. Risk for gastrointestinal adverse events in the form of diarrhoea and vomiting motivates vigilance against insufficient intake of food, especially of carbohydrate.

(To be edited, initial data ST OCT 04) ACE-inhibitor. Excreted in unchanged form in urine. Thunell, patient reports (n=4): tolerated. Andersson, patient reports (n=7): tolerated. Used in Swedish porphyria ward. French list: safe. South African list: use with care.

Common side effects that can be potentially porphyrinogenic through reduction in carbohydrate intake and that also can be confused with an acute porphyria attack are diarrhoea and vomiting.

Uneventful use reported in 26 patients with acute porphyria.