drug prescription in the acute porphyrias Guidelines for patients with

Summary Certain drugs are well known to cause acute ... neurological crises in patients with hereditary coproporphyria, variegate porphyria and acute intermittent porphyria. Guidelines for drug therapy have been' provided in this article, particular attention being paid to the manner in which the porphyrogenicity or safety of a drug has been assessed and providing full references to the original reports to allow further research if necessary. S. Atr. med. J.. 61,656 (1982). The patient with an 'acme anack' of hereditary coproporphyria, variegate porphyria or acute interminent porphyria presents with abdominal pain, vomiting, constipation, autonomic neuropathy and an ascending polyneuropathy which may lead to death in respiratory failure. 1In most instances the crisis can be causally related to the ingestion of specific drugs and, as it is essential mat affected patients and their medical attendants have guidelines for safe therapy, several papers have appeared in recent years _classifying drugs as either safe or dangerous for porphyrics. 2 " Interpretation of such data is only possible, however, if it is realized that the porphyrogenic capacity ofdrugs can be evaluated in several different ways. Assessment of the porphyrogenicity of