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DRUG-INDUCED PHOTOSENSITIVITY GUIDANCE

Date: 05/01/23

Drug–Induced Photosensitivity (DIP) is a cutaneous adverse reaction due to a chemical change caused by UV radiation from sun exposure1,2. This chemical change can cause the person to be photosensitive. Two different types of photosensitivity can occur depending on time lapsed responses. If a person becomes photosensitive, there are medications can be prescribed for symptom management.

Types of Photosensitivity

Photosensitivity may include sunburn or rash that the patient would not typically experience without taking certain medications. Different types of medications can cause adverse effects including oral, topical, or injectable medications.

Phototoxicity is the most common type of photosensitive reaction. It can occur with the first dose and is a non-immunologically mediated response that can clinically present with an exaggerated sunburn, pruritis, or erythema.  

Photoallergic reactions are less common and can occur due to the sun’s radiation converting the medication into an antigen. The antigen then forms an immunogenic complex with cutaneous proteins. The reaction is delayed, typically developing 24-72 hours after exposure. The patient can clinically present with dermatitis or eczema1-4. 

See the table below for a list of common photosensitizing medications2,3 or click the here for a full list.

Cardiovascular Medications

NSAIDs

Antibiotics

Retinoids

Hydrochlorothiazide

Naproxen

Doxycycline

Acitretin

Furosemide

Ketoprofen

Tetracycline

Isotretinoin

Amiodarone

Piroxicam

Demeclocycline

 

Fenofibrate

 

Sulfonamides

 

 

 

Ciprofloxacin

 

 
AntimetaboliteSulfonylureasOthers
Methotrexate

Glyburide

Promethazine

 Glimepiride 
 Glipizide 
   
   

Management and Prevention4.

A photosensitivity reaction can present differently in patients and there are some individuals that will not experience a reaction. If it occurs, the medication may be discontinued and topical or systemic corticosteroids can be prescribed to manage symptoms. If it is not possible

to discontinue the medication, the patient and caregivers should be educated on the following: 

  1. Limit exposure to intense sunlight.
  2. Apply sunscreens that protect against UVA. 
  3. Wear sunglasses with UVA filters.
  4. Wear protective clothing such as hats or long sleeve shirts. 

References: 

  1. Drug-induced Photosensitivity. Prescriber Update. 2016; 37(4): 60-61. 
  2. Zhang AY. Drug-induced Photosensitivity https://emedicine.medscape.com/article/1049648-overview. Accessed March 26, 2023. 
  3. Hofmann GA, Weber B. Drug-induced photosensitivity: culprit drugs, potential mechanisms, and clinical consequences. J Dtsch Dermatol Ges. 2021;19(1):19-29. doi: 10.1111/ddg.14314. PMID: 33491908; PMCID: PMC7898394. 
  4. Buck ML. Drug-induced Photosensitivity. Pediatric Pharmacotherapy. 1998; 4(6): 1-3.