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DERMATOLOGICALS › ANTIPSORIATICS › ANTIPSORIATICS FOR SYSTEMIC USE › Psoralens for systemic use
bergapten
D05BA03
Forms & Strengths
- Oral capsules: 10 mg
- Topical lotion: 0.1%
Adult Dosing
- Oral PUVA: 0.6 to 1.2 mg/kg administered 1.5 to 2 hours before UVA exposure
- Topical: Apply thinly to affected lesions 30 to 60 minutes before UVA exposure
Pediatric Dosing
- Safety and efficacy not established in pediatric patients under 12 years of age
- Use in adolescents generally restricted to severe cases of psoriasis or vitiligo under specialist supervision
Indications
- Severe recalcitrant plaque psoriasis
- Vitiligo (for repigmentation therapy)
Mechanism of Action
- Intercalates into DNA upon photoactivation by long-wave ultraviolet A (UVA) radiation
- Forms covalent monofunctional and bifunctional adducts with pyrimidine bases (thymine and cytosine)
- Inhibits cellular DNA synthesis and suppresses epidermal hyperproliferation and immune cell activation
Contraindications
- Idiopathic or history of melanoma
- History of invasive squamous cell carcinoma of the skin
- Aphakia (increased risk of retinal damage due to absence of lens)
- Systemic lupus erythematosus or porphyria
- Concomitant use with strong hepatotoxic drugs or other photosensitizing agents
Adverse Reactions
- Acute phototoxic reactions (severe erythema, blistering, burning)
- Nausea and gastric upset following oral administration
- Pruritus and dry skin
- Long-term risks include premature skin aging, actinic keratosis, and non-melanoma skin cancers
Drug Interactions
- Concomitant use with other photosensitizers (e.g., tetracyclines, sulfonamides, thiazides, phenothiazines) increases risk of severe phototoxicity
- Hepatotoxic agents may increase risk of cumulative liver injury
- Topical preparations containing tar or anthralin may cause severe skin irritation when combined with photochemotherapy
Curated Content: Needs Vetting Before Put to Clinical Use