Which medication can cause paresthesia, characterized by sharp pins and needles sensation, when exposed to heat or sun?

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From the Guidelines

Diclofenac 1% topical gel can cause sharp pins and needle sensations when exposed to heat or sun. This medication belongs to the nonsteroidal anti-inflammatory drug (NSAID) class and is known to cause photosensitivity reactions in some patients 1. When applied to the skin and then exposed to sunlight or heat, diclofenac can increase skin sensitivity, leading to these uncomfortable sensations along with potential redness, burning, or rash.

Some key points to consider when using diclofenac 1% topical gel include:

  • Applying the gel to affected areas only
  • Washing hands thoroughly after application
  • Avoiding sun exposure for at least two hours after applying the medication
  • Covering treated areas with clothing when going outdoors If you experience these symptoms, you should contact your healthcare provider and consider using the medication at times when sun exposure can be minimized 1.

It's also worth noting that other medications, such as amlodipine, can also cause photosensitivity reactions, although the evidence for this specific reaction is not as strong as it is for diclofenac 1. However, based on the most recent and highest quality study, diclofenac 1% topical gel is the most likely medication to cause sharp pins and needle sensations when exposed to heat or sun.

From the Research

Medications Causing Sharp Pins and Needles When Exposed to Heat/Sun

  • The medications listed are:
    • amLODIPine 5 mg tablet
    • Calcium 600 + D(3) 600 mg-10 mcg (400 unit) tablet
    • diclofenac 1 % topical gel
    • estradioL 0.01% (0.1 mg/gram) vaginal cream
    • ezetimibe 10 mg tablet
    • fenofibrate micronized 67 mg capsule
    • gabapentin 300 mg capsule
    • meclizine 25 mg tablet
    • naproxen 500 mg tablet
    • tamoxifen 20 mg tablet
  • Based on the provided studies, the following medications can cause photosensitivity reactions:
    • diclofenac: studies 2, 3, 4 show that diclofenac can cause phototoxic effects and photoallergic contact dermatitis
    • naproxen: studies 2, 5 show that naproxen can cause systemic photosensitivity and photodistributed erythema multiforme

Specific Symptoms

  • Sharp pins and needles when exposed to heat/sun are not explicitly mentioned in the studies, but photosensitivity reactions can cause a range of symptoms, including:
    • Photodistributed erythema multiforme (naproxen) 5
    • Lichenoid photodermatitis (naproxen) 5
    • Photoallergic contact dermatitis (diclofenac) 4
    • Pruritus, paresthesia, and application-site reactions (diclofenac) 4

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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