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Reporting a Medication Error

Hot, Hot, Hot! Medicine-related Sunburn

e1e1ad60f07c4aa3ccbcb2973e9d7007 MA 34-year-old woman with severe redness, pain, and peeling of her face, shoulders, and arms visited an emergency department. She had spent several hours at an outdoor flea market and developed the worst case of sunburn she had ever suffered.


Three weeks earlier, she had started taking Rheumatrex (methotrexate), a medicine used to treat rheumatoid arthritis. Rheumatrex causes an abnormal skin reaction to sunlight. Other medicines that can cause you to be very sensitive to the sun are listed below. The reaction can be even more severe when these medicines are taken in higher doses and if you are exposed to the sun for a long time. Some of these reactions happen quickly and can worsen during the next 12-24 hours, even without further exposure to the sun.

Here's what you can do: Ask your pharmacist if any medicines you are taking can cause a skin reaction when exposed to the sun. Many times, your pharmacist will apply a special warning label on your prescription bottle to let you know about avoiding the sun. If you are taking a medicine that causes a skin reaction to the sun, avoid tanning beds/ booths and direct sunlight, especially between 10 a.m. and 3 p.m. When you go outdoors, use a UV-A and UV-B combination sunscreen with at least a sun protection factor (SPF) of 15. Wear protective clothing, a hat, and sunglasses whenever possible. If a mild reaction occurs, apply an over-the-counter hydrocortisone cream or place cool wet bandages or clean cloths over the area to help reduce pain and itching that usually accompanies sunburn. Call your doctor for more severe or worsening cases. Your doctor also might be able to switch you to a different medicine that does not cause sun-sensitivity.

Table 1.Examples of medicines known to cause sun-sensitivity

Depression/mental health medicines

  • amitriptyline (Elavil)
  • haloperidol (Haldol)

Heart/blood pressure medicines

 

  • amiodarone (Cordarone, Pacerone)
  • fosinopril (Monopril)
  • captopril (Capoten, Lopril)
  • lisinopril (Lisodur, Novatec, Prinivil, Zestril)
  • enalapril (Vasotec, Renitec)
  • benazepril (Lotensin)
  • hydrochlorothiazide (Microzide)
  • quinidine
  • spironolactone (Aldactone)

Seizure medicines

  • phenobarbital
  • carbamazepine (Carbatrol, Tegretol)

Antibiotics (to fight infections)

  • ciprofloxacin (Cipro, Proquin)
  • levofloxacin (Levaquin)
  • norfloxacin (Noroxin)
  • ofloxacin (Floxin)
  • sulfamethoxazole and trimethoprim (Bactrim, Septra, Sulfatrim)
  • tetracyclines

Acne medicine

  • isotretinoin (Accutane)

Herbal medicines (condition)

  • St. John's wort (depression)
  • Dong quai (menstral problems)
  • Pyridoxine (vitamin B6 replacement)

 

 

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