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DERMATOLOGICALS › ANTIPSORIATICS › ANTIPSORIATICS FOR TOPICAL USE › Psoralens for topical use
trioxysalen
D05AD01
Adult Dosing
- Psoriasis: 10 mg (2 tablets) orally as a single dose, taken 2 hours before ultraviolet A (UVA) exposure
- Vitiligo: 10 mg orally once daily, taken 2 hours before controlled UVA exposure or sunlight
Pediatric Dosing
- Children < 12 years: Safety and efficacy have not been established
- Children >= 12 years: Dosing similar to adult regimen under specialist supervision
Indications
- Repigmentation of idiopathic vitiligo
- Symptomatic control of severe, recalcitrant psoriasis in conjunction with controlled UVA photochemotherapy (PUVA)
Mechanism of Action
- Furocoumarin derivative that intercalates into DNA upon photoactivation by UVA radiation
- Forms covalent monoadducts with pyrimidine bases (thymine), inhibiting DNA replication and suppressing cellular proliferation
Contraindications
- Idiopathic or photosensitive disease states such as lupus erythematosus, porphyria, and xeroderma pigmentosum
- Melanoma or history of invasive squamous cell carcinoma
- Aphakia, due to significantly increased risk of retinal damage from UVA exposure
- Known hypersensitivity to psoralens
Adverse Reactions
- Erythema, blistering, and burning associated with UVA phototoxicity
- Pruritus and dry skin
- Nausea and gastric discomfort
- Dizziness, headache, and nervousness
- Long-term risks include actinic aging, cataracts, and increased risk of skin malignancies
Drug Interactions
- Concurrent use with other topical or systemic photosensitizing agents (e.g., anthralin, coal tar, griseofulvin, phenothiazines, sulfonamides, tetracyclines) may produce severe phototoxic reactions
- Hepatotoxic drugs may increase the risk of liver injury when used concomitantly
Curated Content: Needs Vetting Before Put to Clinical Use