What advice should be given to patients with porphyria who intend to travel?

· UKMi

  • Most travel vaccines are safe in the acute porphyrias, but there has been an unpublished report of an acute porphyria attack following yellow fever vaccination. Caution may be warranted with live vaccines.
  • The following antimalarials are suitable for use in acute porphyria: chloroquine (not suitable in active porphyria cutanea tarda, a non-acute porphyria), Malarone (atovaquone and proguanil), mefloquine and proguanil.
  • Travellers should take measures to avoid mosquito bites (e.g. use of nets, repellents, long-sleeved shirts and trousers, avoiding going out at dawn and dusk)
  • Be aware of the healthcare facilities in the destination country in case of illness. The British Embassy or Consulate closest to the destination may have relevant information.
  • Consider using a bracelet, necklace or other item which indicates that the wearer has porphyria.
  • International air travel is a risk factor for acute porphyria attacks, which may be triggered by dehydration, alcohol use, fasting, infection, stress, hormone fluctuations, e.g. premenstrual. It is advisable to avoid/minimise these factors when travelling by air or other means.
  • If medication is required for travel sickness, hyoscine hydrobromide and promethazine are safe options in acute porphyria.
  • The British Porphyria Association (0300 30 20030; helpline@porphyria.org.uk) can provide suggestions on travel insurance.
AtovaquoneChloroquineDoxycyclineHydroxychloroquineNutritional and metabolic disordersProguanilProguanil + AtovaquoneQ&ATravel Medicine

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