Acute Porphyria Drug Database

Monograph

N02BE05 - Propacetamol
Propably not porphyrinogenic
PNP

Rationale
The paracetamol (acetaminophen) formed is CYP 3A4 inducer, but gives rise only to a low hepatic oxidative load. Occasional patient reports of suspected porphyrinogenicity but vast and significant clinical experience of non-porphyrinogenicity.
Chemical description
Moderatly strong analgesic and antipyretic for intravenous administration. At the end of the infusion 99% of propacetamol is hydrolyzed in plasma to paracetamol and di-ethylglycine. The paracetamol metabolite is excreted in urine as sulfate and glucuronide conjugates. Less than 4% metabolized by CYPs. At low concentrations paracetamol is inducer of CYP 3A4, increasing activity and content. South African list: use. French list: avoid, known to have precipitated an acute attack.

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