What medications can cause photo sensitivity?

From the Guidelines

Medications that can cause photo sensitivity include tetracyclines, fluoroquinolones, sulfonamides, antifungals, cardiovascular drugs, psychiatric medications, retinoids, and nonsteroidal anti-inflammatory drugs (NSAIDs), as reported in the most recent study 1.

Medications Linked to Photo Sensitivity

• Tetracyclines (doxycycline, minocycline) are known to cause photosensitivity, with doxycycline being more photosensitizing than minocycline 1
• Fluoroquinolones (ciprofloxacin, levofloxacin) and sulfonamides are also common photosensitizing medications
• Antifungals such as voriconazole, and cardiovascular drugs including amiodarone, diltiazem, and many diuretics like hydrochlorothiazide can cause photosensitivity
• Psychiatric medications such as phenothiazines, tricyclic antidepressants, and some SSRIs, as well as retinoids like isotretinoin, are also notable photosensitizers
• Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen can cause photosensitivity, as can diabetes medications like sulfonylureas and cancer treatments such as 5-fluorouracil and methotrexate

Protecting Against Photo Sensitivity

• If taking any of these medications, protect yourself by using broad-spectrum sunscreen (SPF 30+), wearing protective clothing, avoiding peak sun hours (10am-4pm), and discussing with your healthcare provider if you experience unusual skin reactions after sun exposure
• A review of the full list of patient medications is necessary to rule out other drug-induced causes for photosensitivity, as recommended in the management of immune-related adverse events 1
• Consider referral to a dermatologist if autoimmune skin disease is suspected, and consider skin biopsy or clinical monitoring with use of serial clinical photography if necessary 1

From the FDA Drug Label

Photosensitivity/Phototoxicity: Moderate to severe photosensitivity/phototoxicity reactions, the latter of which may manifest as exaggerated sunburn reactions (e.g., burning, erythema, exudation, vesicles, blistering, edema) involving areas exposed to light (typically the face, “V” area of the neck, extensor surfaces of the forearms, dorsa of the hands), can be associated with the use of quinolones after sun or UV light exposure. Patients should minimize or avoid exposure to natural or artificial sunlight (tanning beds or UVA/B treatment) while taking quinolones. If patients need to be outdoors while using quinolones, they should wear loose-fitting clothes that protect skin from sun exposure and discuss other sun protection measures with their physician Photosensitivity manifested by an exaggerated sunburn reaction has been observed in some individuals taking tetracyclines. This has been reported with minocycline Levofloxacin tablets can make your skin sensitive to the sun (photosensitivity) and the light from sunlamps and tanning beds. You could get severe sunburn, blisters or swelling of your skin.

Medications that can cause photo sensitivity:

• Ciprofloxacin 2: can cause moderate to severe photosensitivity/phototoxicity reactions
• Levofloxacin 3: can make skin sensitive to the sun and cause severe sunburn, blisters, or swelling
• Minocycline 4: can cause photosensitivity manifested by an exaggerated sunburn reaction

It is essential to take precautions when taking these medications, such as avoiding excessive exposure to sunlight, wearing protective clothing, and using sunscreen. If any symptoms of photosensitivity occur, patients should contact their healthcare provider immediately.

From the Research

Medications that Cause Photo Sensitivity

The following medications have been identified as potential causes of photo sensitivity:

• Nonsteroidal anti-inflammatory drugs (NSAIDs) 5, 6
• Antifungals 5
• Antimicrobials, including sulfonamides, tetracyclines, and quinolones 5, 6, 7, 8, 9
• Cardiovascular drugs, such as amiodarone 6, 8, 9
• Phenothiazines, especially chlorpromazine 6, 8
• Retinoids 6
• Targeted anticancer therapies, including BRAF kinase inhibitors (vemurafenib, dabrafenib), EGFR inhibitors, VEGFR inhibitors, MEK inhibitors, and Bcr-Abl tyrosine kinase inhibitors 6
• Tetracyclines, including doxycycline, minocycline, and demeclocycline 5, 6, 7, 8, 9
• Quinolones 5, 6, 9
• Hydrochlorothiazide 8
• Naproxen 8
• Piroxicam 8
• Thioridazine 8
• Voriconazole 8
• Nalidixic acid 8

Management and Prevention

Patients taking these medications should be warned of the possibility of photo sensitivity and advised to:

• Avoid direct exposure to sunlight
• Use adequate photoprotection, such as sunscreen and protective clothing
• Monitor their skin for signs of photo sensitivity, such as burns or rashes
• Discontinue the medication if photo sensitivity occurs, and seek medical attention if necessary 6, 8, 9