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LFFeb05 pgs78-118 12/29/04 4:57 PM Page 86 Sunlight and the Skin MANY , TOPICAL SOLUTIONS AND EVEN SOME FOODS CAN CAUSE THE SKIN TO BURN OR BREAK OUT IN A RASH WHEN EXPOSED TO ULTRAVIOLET LIGHT. THE CONSEQUENCES CAN RANGE FROM ITCHINESS TO AN UNCOMFORTABLE RASH AND BURNS. IT IS CRITICAL THAT EVERY SALON OWNER POST A CHART OF PHOTOSENSITIVE MEDICATIONS AND AGENTS IN A CONSPICUOUS LOCATION. IF A CLIENT IS TAKING A THAT ISN’T LISTED, HE OR SHE SHOULD CONSULT WITH A PHYSICIAN OR PHARMACIST BEFORE BEING EXPOSED TO ULTRAVIOLET LIGHT—INDOORS OR OUTDOORS.

The most common photosensitizing materials are listed on the ■ Brand names of products should be considered only as examples; following pages. This is not a list of every material that could have they do NOT represent all names under which the generic product photosensitizing effects. Before using the list, you should be aware of may be sold. the following: The following list was prepared by Jerome I. Levine, M.S., R.Ph., of the ■ NOT all individuals who use or take these medications will experience U.S. Food and Administration. The list was published under the title a photosensitive reaction. Also, an individual who experiences a “Medications That Increase Sensitivity To Light: A 1990 Listing.” The FDA photosensitive reaction on one occasion will NOT necessarily has confirmed this list to be the most recent. The mention of commercial experience it again or every time. products, their sources or their use in connection with material reported ■ A medication will NOT cause the same degree of skin reaction in herein is not to be construed as either an actual or implied endorsement of all individuals. such products by the Department of Health and Human Services.

Cromolyn Intal Antiasthmatic Reported Photosensitizing Medications Flexeril Anti-skeletal, Muscle spasms Periactin , Antiserotonergic Generic Name Brand Name Therapeutic Class Dacarbazine DTIC-Dome Anti-Hodgkin’s disease, Diamox , Antiglaucoma Danocrine Gonadotropin inhibitor + Hydrochlorothizide Moduretic Antihypertensive, diuretic Declomycin Cordarone (15%) Antiarrhythmic Norpramin () Elavil Antidepressant (tricyclic) Desipramine Pertofrane Antidepressant (tricyclic) Amitriptyline Endep Antidepressant (tricyclic) Polaramine Antihistamine Asendin (<1%) Antidepressant (tricyclic) Diclofenac Voltaren (<1%) NSAID,* Antiarthritic Astemizole Hismanal Antihistamine Diflunisal Dolobid (<1%) NSAID,* Antiarthritic Atenolol + Chlorthalidone Tenoretic Beta- blocker, Thiazide Cardizem (<1%) Antianginal, Antihypertensive, Calcium diuretic Auranofin Ridaura Antiarthritic, Gold compound Antihistamine Optimine Antihistamine Hispril Spansule Antihistamine Azatidine + Trinalin Repetabs Antihistamine, Sinequan Antidepressant (tricyclic) Naturetin Antihypertensive, Thiazide diuretic Vibramycin Antibiotic Benzthiazide Exna Antihypertensive, Thiazide diuretic Doxycycline Hyclate Doryx Antibiotic Bromodiphenhydramine Ambenyl Antihistamine Vasotec Antihypertensive Dimetane Antihistamine Enalapril + Vaseretic Antihypertensive, Thiazide diuretic Capoten Antihypertensive Ethylsuccinate + Sulfisoxazole Pediazole Antibiotic Captopril + Hydrochlorothiazide Capozide Antihypertensive, Thiazide diuretic Estrogens Contraceptive, oral Female sex Tegretol , Anticonvulsant Estrogens Estrogens Female Chlordiazepoxide + Amitriptyline Limbitrol Antidepressant (tricyclic), Tranquilizer Ethionamide Trecator-SC Anti-infective, Antituberculosis Diuril Antihypertensive, Thiazide diuretic Etretinate Tegison Antipsoriatic Chlorpheniramine Chlorpheniramine Antihistamine Floxuridine FUDR Injectable Antimetabolite, Antineoplastic Chlorpheniramin + D-Pseudoephedrine Deconamine Antihistamine, Decongestant Flucytosine Ancobon Chlorpheniramine + Ru-Tuss II Antihistamine, Decongestant Fluorouracil Adrucil Antineoplastic Thorazine , Tranquilizer Fluorouracil Efudex Antineoplastic Diabinese Antidiabetic (oral), Sulfonylurea Fluorouracil Fluorouracil Antineoplastic Taractan Antiemetic, Tranquilizer Prolixin , Tranquilizer Chlorthalidone Hygroton Antihypertensive, Thiazide diuretic Fluphenazine Permitil Antipsychotic, Tranquilizer Chlorthalidone Thalitone Antihypertensive, Thiazide diuretic Ansaid NSAID,* Antiarthritic Chlorthalidone + Demi-Regroton Antihypertensive, Thiazide diuretic Eulexin Antimetastatic (prostatic carcinoma) Chlorthalidone + Reserpine Regroton Antihypertensive, Thiazide diuretic Lasix Antihypertensive, Diuretic Cipro (<1%) Anti-infective Gentamicin Garamycin Antibiotic Tavist Antihistamine Glucotrol Antidiabetic (oral),Sulfonylurea Clofazime Lamprene (<1%) Antibacterial, Antileprosy agent Glyburide Diabeta Antidiabetic (oral),Sulfonylurea Chlorthalidone + Combipres Antihypertensive, Thiazide diuretic Glyburide Micronase Antidiabetic (oral), Sulfonylurea Estar Gel Antipsoriatic, Eczema Gold Salts (compounds) Solganal Antiarthritic, Gold compound Coal Tar Balnetar Antipsoriatic, Eczema Gold Thiomalate Myochrysine Antiarthritic, Gold compound Contraceptive, oral Birth control pill, Female sex hormone Griseofulvin Fulvicin U/F Antibiotic, Antifungal

*Non-Steroidal Anti-Inflammatory Drug 86 LOOKING FIT, February 2005 LFFeb05 pgs78-118 12/29/04 4:58 PM Page 88

Generic Name Brand Name Therapeutic Class Sulfadoxine + Pyrimethamine Fansidar Antimalarial, Griseofulvin Ultramicrosize Grisactin Ultra Antibiotic, Antifungal + Phenazopyridine Thiosulfil-A Urinary analgesic, Antibiotic + Hydrochlorothiazide Esimil Antihypertensive, Thiazide diuretic Sulfamethoxazole Gantanol Antibiotic Haldol Antipsychotic, Tranquilizer Sulfamethoxazole + Phenazopyridine Azo Gantanol Antibiotic, Urinary analgesic Phisohex Antibacterial Sulfapyridine (Generic only) Dermatitis herpetiformis suppressant + Hydrochlorothiazide Apresazide Antihypertensive, Thiazide diuretic Sulfasalazine Azulfidine Bowel anti-inflammatory Hydralazine Apresoline-Esidrix Antihypertensive, Thiazide diuretic Sulfinpyrazone Anturane Antigout agent, Antihyperuricemic Hydrochlorothiazide Esidrix Antihypertensive, Thiazide diuretic Sulfasoxazole Gantrisin Antibiotic Hydrochlorothiazide Hydrodiuril Antihypertensive, Thiazide diuretic Sulfasoxazole + Phenazopyridine Azo Gantrisin Antibiotic, Urinary analgesic Hydrochlorothiazide Oretic Antihypertensive, Thiazide diuretic Sulfone Dapsone Antileprosy, Antimalarial Hydrochlorothiazide Oreticyl Antihypertensive, Thiazide diuretic Sunlindac Clinoril (<1%) NSAID,* Antiarthritic Hydrochlorothiazide + Dyazide Antihypertensive, Thiazide diuretic Seldane Antihistamine Hydrochlorothiazide Maxzide Antihypertensive, Thiazide diuretic Achromycin Antibiotic Diucardin Antihypertensive, Thiazide diuretic “ ” Sumycin Antibiotic Hydroflumethiazide Saluron Antihypertensive, Thiazide diuretic Mellaril Antipsychotic, Tranquilizer Hydroflumethiazide + Reserpine Salutensin/ Thiothixene Navane Antipsychotic, Tranquilizer Salutensin-Demi Antihypertensive, Thiazide diuretic + Hydrochlorothiazide Timolide Beta-adrenergic blocker, Advil (<1%) NSAID,* Antiarthritic Thiazide diuretic Ibuprofen Motrin (<1%) NSAID,* Antiarthritic Tolazamide Tolinase Antidiabetic (oral), Sulfonylurea Tofranil Antidepressant (tricyclic) Orinase Antidiabetic (oral), Sulfonylurea Lozol Antihypertensive, Diuretic Tretinoin Retin-A Antiacne (topical) Interferon ALFA-2B Intron A (<1%) Antiviral agent Triamterene Dyrenium Antihypertensive Diuretic Marplan Antidepressant, MAO inhibitor Stelazine Antipsychotic, Tranquilizer Isotretinoin Accutane Antiacne Vesprin Antiemetic, Antipsychotic Ketoprofen Orudis (<1%) NSAID,* Antiarthritic Trimeprazine Temaril Antipsychotic, Tranquilizer Normodyne Antihypertensive, Beta- and Trimethoprim Trimpex Antibiotic -adrenergic blocker Trimethoprim + Sulfamethoxazole Bactrim Antibiotic Labetalol + Hydrochlorothiazide Normozide Beta- and alpha-adrenergic “ ” Septra Antibiotic blocker, Thiazide diuretic Surmontil Antidepressant (tricyclic) “ ” Trandate HCT Beta- and alpha-adrenergic blocker, PBZ Antihistamine Thiazide diuretic Actidil Antihistamine + Hydrochlorothiazide Prinzide Antihypertensive, Thiazide diuretic Triprolidine + Pseudoephedrine Actifed Antihistamine, Decongestant “ ” Zestoretic Antihypertensive, Thiazide diuretic Visblastine Velban Antieoplastic Lovastatin Mevacor Anticholesterol *Non-Steroidal Anti-Inflammatory Drug Ludiomil Antidepressant Meperidine + Promethiazine Mepergan Narcotic analgesic Serentil Antipsychotic, Tranquilizer Methacycline Rondomycin Antibiotic Neptazane Antiglaucoma Other Photosensitizing Agents Tacaryl Antihistamine, Methotrexate Folex Antimetabolite, Antipsoriatic Classification Or Use Agent “ ” Methotrexate Antimetabolite, Antipsoriatic Fentichlor, Jadit, Multifungin “ ” Mexate & Mexate-AQ Antimetabolite, Antipsoriatic , , , Hexachlorophene Aquatensen Antihypertensive, Thiazide diuretic “ ” Enduron Antihypertensive, Thiazide diuretic Artificial sweeteners cyclamate, Cyclamates, Sodium cyclohexyl-sulfamate Methyclothiazide + Enduronyl Antihypertensive, Thiazide diuretic Methyclothiazide + Reserpine Diutensen-R Antihypertensive, Thiazide diuretic Coal tar and coal tar derivatives for , Many phenolic agents, Naphthalene, + Hydrochlorothiazide Aldoril Antihypertensive, Thiazide diuretic and chronic eczema and in hair shampoos Phenanthrene, Pitch, Thiophene Methyldopa + Chlorothiazide Aldoclor Antihypertensive, Thiazide diuretic Cosmetics and , Eosine, Erythrocine, , Diulo Antihypertensive, Thiazide diuretic , , Orange red, “ ” Mykrox Antihypertensive, Thiazide diuretic Paraphenylenediamine, , “ ” Zaroxolyn Antihypertensive, Thiazide diuretic blue, Trypaflavin, Trypan blue +Hydrochlorothiazide Lopressor HCT Beta-adrenergic blocker, Thiazide diuretic Deodorant and bacteriostatic agents in soaps Halogenated carbanilides, Halogenated , Minocin Antibiotic Halogenated salicylanilides Minoxidol Rogaine Hair growth stimulator Fluorescent brightening agent Blankophor Cesamet Antiemetic, Antinausea for cellulose, nylon or wool fibers + Bendroflumethiazide Corzide Antihypertensive, Beta-adrenergic blocker Melanogenics (furocoumarins) Methoxyposoralens, Petroleum products, Psoralen Nalidixic Acid NegGram Perfumes and toilet articles Ethereal oils, Musk ambrette, Oil of bergamot, Naprosyn Anaprox NSAID,* Antiarthritic (essential oils) Oil of cedar, Oil of citron, Oil of lavender, “ ” NSAID,* Antiarthritic Oil of lemon, Oil of lime, Oil of rosemary, Adalat , Antihypertensive, Oil of sandalwood blocker “ ” Procardia Antianginal, Antihypertensive, Calcium Perfumes, flavoring, spices Rutaceae (plant), Umbelliferae (plant) channel blocker Norfloxacin Noroxin Antibacterial Tattoos Cadmium Pamelor Antidepressant (tricyclic) Terramycin Antibiotic Trilafon Antipsychotic, Tranquilizer Perphenazine + Amitriptyline Etrafon Antidepressant (tricyclic), Tranquilizer “ ” Triavil Antidepressant (tricyclic), Tranquilizer Products Phenylbutazone Butazolidin NSAID,* Antiarthritic A few products also are known to make the skin more sensitive to UV light, such as halogenated salicylanilides Phenylpropanolamine + Chlorpheniramine Ornade Spansule Antihistamine, Decongestant and related compounds used as antibacterial agents in first-aid creams, preparations and deodorant soaps. Phenylpropanolamine + + Pyrilamine Triaminic TR Decongestant, Antihistamine Perfumes and colognes containing furocoumarins, compounds from natural products such as plants and fruits, Dilantin Anticonvulsant have natural oils that can sensitize the skin to sunlight. Musk ambrette is used in some aftershaves and Piroxicam Feldene NSAID,* Antiarthritic colognes and also has been found to cause skin reaction to UV light. Renese Antihypertensive, Thiazide diuretic Some makeup products contain the following dyes, which can cause a reaction under UV light, another + Polythiazide Minizide Antihypertensive, Thiazide diuretic reason to make sure skin is clean before tanning. Certain food products also contain the following dyes. Compazine Antinausea, Anti- Phenergan Antihistamine Acridine Fluorescin Toluidine Blue + Hydrochlorothiazide Inderide Beta-adrenergic blocker, Thiazide Anthracene Methylene Blue, Violet, Orange Trypaflavin diuretic Cadmium Sulfide and Red Trypan Blue Vivactil Antidepressant (tricyclic) (found in lipstick) Pyrazinamide Pyrazinamide Anti-infective, Antituberculosis Erythrosin Rose Bengal Hydromox Antihypertensive, Diuretic Gluconate Quinaglute Dura-Tabs Antiarrhythmic Quinidine Quindex Extentabs Antiarrhythmic “ ” Quinora Antiarrhythmic Quinine Quinamm Antiprotozoal Rauwolfia + Serpentina + Sunscreens With A Reported Bendroflumethiazide Rauzide Antihypertensive, Thiazide diuretic Reserpine + Chlorothiazide Diupres Antihypertensive, Thiazide diuretic Photosensitizing Ingredient Reserpine + Hydrochlorothiazide Hydropres Antihypertensive, Thiazide diuretic “ ” Serpasil-Esidrix Antihypertensive, Thiazide diuretic 6-Acetoxy-2, 4-dimethyl-m-dioxane (Preservative in sunscreen) Reserpine + Hydralazine + Benzophenones (Aramis, Clinique and others) Hydrochlorothiazide Ser-Ap-Es Antihypertensive, Thiazide diuretic Cinnamates (Aramis, Estée Lauder and others) Eldepryl Anti-, MAO inhibitor Oxybenzone (Eclipse, PreSun and others) + Hydrochlorothiazide Aldactazide Antihypertensive, Thiazide diuretic PABA (Eclipse, Block Out, Sea & Ski and others) Sulfacytine Renoquid Antibiotic Para-aminobenzoic acid (PABA-Pabagel, Pabanol, PreSun and others)

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Health Conditions If your clients have any of the following conditions they should not tan without written consent from their physicians. (It is very unlikely that any doctor will permit tanning under these circumstances.) Albinism Lung Tuberculosis Polymorphous Light Eruption Rosacea Varix Atinie Prurigo Lupus Erythemotosum Porphria Solar Urticaria Vitiligo Dermatomysitis Melasma Related Sun Poisoning Xeroderma Pigmentosum Lichen Rubber Photoallergic Eczema

ANTIDEPRESSANTS *HYPOGLYCEMIC Ethopropazine (Anafranil) SULFONYLUREAS Cyproheptadine Fluphenazine isocarboxazid (Marplan) (Dymelor) Dexchlorpheniramine Mesoridazine maprotiline (Ludiomil) chlorpropamide (Diabinese) Methdilazine (Remeron) (Amaryl) Diphenhydramine Methotrimeprazine sertaline (Zoloft) glipzide (Glucotrol) Diphenylpyraline Perphenazine TRICYCLIC AGENTS, e.g., glyburide (DiaBeta, Micronase) Elavil, Asendin, Norpramin, (Tolinase) Prochlororperazine Sinequan, Tofranil, Aventyl, tolbutamide (Orinase) Vivactil, Surmontil, Promethazine venlafixine (Effexor) NSAIDs All non-steroidal anti-inflammatory Methdilazine , e.g., Thioridazine (Hismanal) ibuprofen (Motrin), Pheniramine Trifluoperazine (Zytec) naproxen (Anaprox, Naproxyn), Promethazine Triflupromazine cyproheptadine (Periactin) Orudis, Feldene, Voltaren, etc. Pyrilamine Trimeprazine dimenhydrinate (Dramamine) The new NSAID agents include: Terfenadine diphenhydramine (Benadryl) etodolac (Lodine), nabumetone (Relafen), Trimeprazine PSORALENS hydroxyzine (Atarax, Vistaril) oxaprozin (Daypro) Tripelennamine Methoxsalen loratadine (Claritin) Triprolidine Trioxsalen terfenadine (Seldane) SUNSCREENS *benzophenones (Arimis, Clinique) COAL TAR SULFONAMIDES ANTIMICROBIALS cinnamates (Arimis, Estée Lauder) AND DERIVATIVES (“sulfa” drugs, antimicrobials, (Zithromax) dioxbenzone (Solbar Plus) (examples by brand names) anti-infectives) griseofulvin (Fulvicin, Grisactin) oxybenzone (Eclipse, PreSun, Shade) Alphosyl Acetazolamide *nalidixic acid (NegGram) PABA (PreSun) Aquatar Sulfacytine QUINOLONES, e.g., *PABA esters Denorex Medicated Shampoo Sulfadiazine Cipro, Penetrex, Levaquin, Floxin, (Block Out, Sea & Ski, Eclipse) DHS Tar Gel Shampoo Sulfadoxine *Maxaquin, Noroxin, *Zagam DOAK Shampoo Sulfamethizole sulfasalazine (Azulfidine) MISCELLANEOUS Estar Sulfamethoxazole *SULFONAMIDES, e.g., Ionil T Plus Sulfapyridine Gantrisin, Bactrim, Septra benzoyl (Oxy 10) LAVATAR Sulfasalazine , e.g., carbamazepine (Tegretol) Medotar Sulfinpyrazone *Declomycin, Vibramycin, Minocin, chlordiazepoxide (Librium) T\Derm Tar Emollient Sulfisoxazole Terramycin coal tar, e.g., Tegrin, Zetar) Tegrin Shampoo CONTRACEPTIVES, oral T\Gel Therapeutic Shampoo SULFONYLUREAS (ProSom) Zetar Shampoo (oral anti-diabetics, hypoglycemics) *bithionol (Bitin) *etretinate (Tegison) Acetohexamide (Aralen) (Felbatol) CONTRACEPTIVES, Chlorpropamide (Lariam) (Neurontin) ORAL & ESTROGENS Glipizide pyrvinium parnoate (Povan, Vanquin) quinine gold salts (Myochrysine, Ridaura, Solganal) (birth control pills, Glyburide hexachlorophene (pHisoHex) female sex ) Tolazamide hypericum (St. John’s Wort) Tolbutamide chlorprothixene (Taractan, Tarasan) interferon beta-1b (Betaseron) ESTROGENS haloperidol (Haldol) *isetretinoln (Accutane) THIAZIDE *, e.g., masoprocol (Actinex) (“ pills”) Compazine, Mellaril, Stelazine, Phenergan, olsalazine (Dipentum) Bendroflumethiazide Thorazine *PERFUME OILS, e.g., Estrogens, conjugated Benzthiazide (Risperdal) bergamot, citron, lavender, sandalwood, Estrogens, esterfied Chlorothiazide thiothixene (Navane) cedar, musk Chlorthalidone CANCER *PSORALENS *dacarbazine (DTIC) selegiline (deprenyl, Eldepryl) PROGESTOGENS Hydrochlorothiazide fluororacil (5-FU) *tretinoin (Retin-A, A Acid) Ethinyl estradiol Hydroflumethiazide methotrexate (Mexate) (Ambien) Medroxyprogesterone Methyclothiazide (Matulane, Natulan) Megestrol Polythiazide vinblastine (Velban, Belbe) Note: Items with an asterisk (*) are more likely Norethindrone to cause photosensitivity reactions. Overall, the CARDIOVASCULARS drugs listed above cause reactions in less than TETRACYCLINES (see also Diuretics) 1% of patients. Tell clients who get an unusual (, anti-infectives) ACE INHIBITORS, e.g., “” or allergic or eczematous reaction in NSAIDs: NON-STEROIDAL Capoten, Vasotec, Monapril, Accupril, Altace, skin areas exposed to light to let their physician Demeclocycline or pharmacist know about the problem and ANTI-INFLAMMATORY DRUGS Univasc (antiarthritics) Doxycycline *amiodarone (Cordarone) to discontinue exposure to UV radiation. Methacycline Photosensitivity data from Pharmacist’s Letter. Diclofenac diltiazem (Cardizem) Diflunisal Oxytetracycline (Norpace) Tetracycline (Hyzaar) Flurbiprofen lovastatin (Mevacor) Primary Class Ibuprofen TRICYCLIC nifedipine (Procardia) Of Medications Responsible Indomethacin pravastin (Pravachol) Ketoprofen Amitriptyline quinidine (Quinaglute) For Photosensitizing Meclofenamate Amoxapine simvastatin (Zocor) Naproxen Clomipramine (Betapace) Reactions Phenylbutazone Desipramine (examples by generic name) Piroxicam Doxepin DIURETICS Sulindac Imipramine (see also Cardiovasculars) Suprofen Isocarboxazid acetazolamide (Diamox) ANTIHISTAMINES Tolmetin Astemizole Maprotiline amiloride (Midamor) Mirtazapine furosemide (Lasix) Azatadine Brompheniramine PHENOTHIAZINES Nortriptylin metolazone (Diulo, Zaroxolyn) (major tranquilizers, anti-emetics) Protriptyline *, e.g., HydroDiuril, Naturetin Sertaline Cetirizine Trimipramine Chlorpheniramine Carphenazine Clemastine Chlorpromazine

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