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DERMATOLOGICALS › ANTIPSORIATICS › ANTIPSORIATICS FOR SYSTEMIC USE › Psoralens for systemic use
trioxysalen
D05BA01
Adult Dosing
- Repigmentation of vitiligo: 10 mg (two 5 mg tablets) orally taken as a single dose, 2 to 4 hours before measured exposure to UVA light or sunlight
- Treatment frequency: Limit to once daily on days of sun exposure; do not repeat treatment on consecutive days
Pediatric Dosing
- Children < 12 years: Safety and efficacy have not been established; use is generally not recommended
Indications
- Idiopathic vitiligo in conjunction with controlled exposure to UVA light or sunlight to repigment depigmented patches
Mechanism of Action
- Psoralen derivative that binds covalently to pyrimidine bases in nuclear DNA upon photoactivation by UVA radiation
- Inhibits cellular DNA synthesis, suppresses mitotic activity in epidermal keratinocytes, and stimulates melanocyte tyrosinase activity to induce pigmentation
Contraindications
- Idiosyncratic reactions to psoralen compounds
- Melanoma or history of melanoma
- Invasive squamous cell carcinoma
- Diseases associated with photosensitivity (e.g., porphyrias, lupus erythematosus, xeroderma pigmentosum)
- Aphakia (due to significantly increased risk of retinal damage from UVA exposure)
- Children under 12 years of age
Adverse Reactions
- Nausea and gastrointestinal distress
- Erythema, burning, and blistering from phototoxic reactions
- Pruritus
- Dizziness, headache, and nervousness
- Long-term risks include actinic degradation, photoaging, and increased risk of non-melanoma skin cancers
Drug Interactions
- Concomitant use with other photosensitizing agents (e.g., anthralin, coal tar, griseofulvin, phenothiazines, sulfonamides, tetracyclines, thiazides) may cause severe additive phototoxicity
- Topical agents containing potent photosensitizers or irritants should be avoided during therapy
Curated Content: Needs Vetting Before Put to Clinical Use