The question concerns a pregnant woman who took Trisoralen (trioxsalen) 6 tablets 5mg daily for 5-6

Fråga: The question concerns a pregnant woman who took Trisoralen (trioxsalen) 6 tablets 5mg daily for 5-6 days during very early pregnancy (week 5-6). Is there any risk of fetal harm?

Sammanfattning: No reports of fetal damage in connection with trioxsalen treatment have been found in the literature. In general, exposure to drugs during the first three to four weeks after last menstrual period can be expected to lead to an all-or-none effect with an early miscarriage if the fetus has been harmed.

Svar: Trioxsalen is a psoralen used in combination with UV light (PUVA treatment) for the treatment of psoriasis. A similar question,asked in 1985 (1) and a follow-up literature search has not revealed any reports of a suspected connection between treatment with trioxsalen and teratogenic effects. Trioxsalen is chemically related to methoxsalen, a substance also used in psoriasis treatment in combination with UV light. The psoralens (methoxsalen and trioxsalen) are activated by radiation, bind to the DNA and prevent replication (2). A question on methoxsalen and teratogenicity concluded that effective contraception is recommended during methoxsalen treatment because of its potentially mutagenic properties. However, no reports of fetal damage in connection with methoxsalen treatment were found in the literature (3). 1 Drugline 04634 (year 1985) (bifogas) 2 Goodman and Gilman, The pharmacological basis of therapeutics. 1990; 8th ed: 1580 3 Drugline 10375 (year 1994) (bifogas)