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Sun-Sensitive Drugs (Photosensitivity to Drugs) (cont.)

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What are the symptoms of sun sensitivity (photosensitivity)?

Symptoms of phototoxic reaction

Individuals with phototoxic reactions may initially complain of a burning and stinging sensation. Then the redness typically occurs within 24 hours of the exposure to sun in the exposed areas of the body such as the forehead, nose, hands, arms, and lips. In severe cases, the sun protected areas of skin may be also be involved.

The range of skin damage may vary from mild redness to swelling to blister formation (bullae) in more severe cases. The rash from this photosensitivity reaction usually resolves with peeling and sloughing off (desquamation) of the affected skin within several days.

Symptoms of photoallergic reactions

Individuals with photoallergic reactions may initially complain of itching (pruritus). This is then followed by redness and possibly swelling and eruption of the involved area. Because this is considered an allergic reaction, there may be no symptoms for many days when the drug is taken for the first time. Subsequent exposure to the drug and the sun may cause a more rapid response in 1-2 days.

Hyperpigmentation after reaction

Hyperpigmentation (darkening) of the affected area of the skin may develop after the resolution of a phototoxicity reaction, but it is rare in a photoallergic reaction. In phototoxic reactions, high doses of the drug and long exposures to light may be required to cause the reaction.

Phototoxic drugs

Common phototoxic drugs include the following:


  • quinolonesfor, example, ciprofloxacin (Cipro, Cipro XR, Proquin XR), and levofloxacin (Levaquin)
  • tetracyclines, for example, tetracycline (Achromycin), doxycycline (Vibramycin, Oracea, Adoxa, Atridox and others
  • sulfonamides, for example, sulfamethoxazole and trimethoprim; cotrimoxazole (Bactrim, Septra), and sulfamethoxazole (Gantanol)


  • diphenhydramine (Benadryl)

Malaria medications

  • quinine (Quinerva, Quinite, QM-260)
  • chloroquine (Aralen)
  • hydroxychloroquine (Plaquenil)

Cancer chemotherapy drugs

  • 5-fluorouracil (5-FU, Efudex, Carac, Fluoroplex)
  • vinblastine (Velban, Velsar)
  • dacarbazine (DTIC-Dome)

Cardiac drugs

  • amiodarone (Cordarone)
  • nifedipine (Procardia)
  • quinidine (Quinaglute, Quinidex)
  • diltiazem (Cardizem, Dilacor, Tiazac)


  • furosemide (Lasix)
  • thiazides [hydrochlorothiazide (Hydrodiuril)

Diabetic drugs

  • sulfonylureas [chlorpropamide (Diabinese), glyburide (Micronase, DiaBeta, Glynase)]


  • Nonsteroidal anti-inflammatory drugs [naproxen (Naprosyn, Naprelan, Anaprox, Aleve), piroxicam (Feldene)

Skin medications

Acne medications

  • isotretinoin (Accutane)
  • acitretin (Soriatane)

Psychiatric drugs

  • phenothiazines [chlorpromazine (Thorazine)]
  • tricyclic antidepressants [desipramine (Norpramin), imipramine (Tofranil)
Medically Reviewed by a Doctor on 10/10/2016


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