Migraine Medications and the Risk of Sun Sensitivity: A List
Many of the drugs and supplements we take as Migraineurs can increase our body’s sensitivity to sunlight, called Photosensitivity. Drugs that cause photo reactions are called sun-sensitizing drugs.
If you have a comorbid condition for which you are also taking medicines or supplements, the risk that you are taking one of these medicines goes up. With each medicine you take that increases your sensitivity, the more likely you will have a reaction, and the more severe the reaction may be.
There are two types of reactions that can increase our sensitivity to the sun. One is called Photoallergic. The other is called a Phototoxic reaction. Both require the combination of medicines and sunlight to occur.
Phototoxic reaction happens when the drug is activated by the sun’s rays and the skin is damaged. This often looks like a sunburn . Thankfully, withdrawing the drug usually ends the reaction.
Common phototoxic drugs include:
- Antibiotics — quinolone class, tetracycline class, sulfonamides
- Antihistamines — diphenhydramine (Benadryl)
- Anti-malarials (often taken for spasms and autoimmune disease) — quinine, chloroquine, Plaquenil
- Chemotherapy drugs (also often taken for autoimmune disease) — 5-fluorourocil, vinblastine, dacarbazine
- Cholesterol preparations - statins
- Heart medications (also sometimes used as Migraine preventives) — amiodarone, nifedipine, quinidine, diltiazem
- Diuretics — Lasix, thiazides
- Diabetic drugs — sulfonylureas, glyburide
- Oral contraceptives
- Acne medicines — Acutane, acitretin
- Psychiatric and neuroleptic meds (also used as Migraine meds and preventives) - chlorpromazine, flufenazine, perphenazine, thioridizine, thiothixene, tricyclic anti-depressants,
- Promethazine (anti-nauseant)
- NSAIDs (for pain, inflammation)
Photoallergic reactions happen when the sun changes the molecular construction of the medicine and the body identifies it as foreign, causing an allergic reaction. Withdrawing the drug will often end the reaction, but it may recur when the drug is re-introduced into the system at another time. It may also appear in areas that are not exposed to the sun, and may take days after exposure to the sun to appear.
Medicines that might trigger a photoallergic reaction include:
- Sunscreens — PABA, oxybenzone, cyclohexanol, benzophenones, salicylates, cinnamate
- Anti-microbials — chlorhexidine, hexachlorophene, dapsone
- Chemotherapy drugs (also used for autoimmunity and other conditions) 5-fluorourocil
OTC’s, supplements and herbal preparations can also cause sun sensitivity, and include:
- St. John’s Wort
- Benzoyl peroxide
- Vitamin B2 (Riboflavin)
Exfoliating skin care products may also exacerbate sun sensitivity issues.
Certain medical conditions can also result in increased sun sensitivity which may be greatly compounded by use of sun-sensitizing drugs. These conditions include:
Additionally, eating certain foods can also create sun-sensitivity. Foods you may want to avoid when taking medicines that create sun-sensitivity or before sun exposure include:
Adding foods rich in beta carotene may help prevent sun sensitivity however.
These lists are by no means comprehensive, and as new medicines are discovered and used for longer periods of time, more will be added to this category. The best way to know for sure if a medicine you are taking might cause a problem is to talk to your physician and your pharmacist, then look the medicine up yourself to be sure nothing was left out.
When it comes to planning vacations or other events where travel is required, how much does migraine factor into your decision-making?