Therapy with certain drugs can result in pellagra.
Features of drug-induced pellagra:
(1) onset of pellagra in a patient taking the implicated drug
(2) reversal of pellagra after the implicated drug is discontinued
Implicated medications:
(1) anticonvulsants
(2) some antidepressants
(3) chloramphenicol
(4) 5-fluoruracil (5-FU)
(5) isoniazid (INH)
(6) 6-mercaptopurine
(7) morazone (an analgesic)
(8) sulfapyridine
The pellagra may occur despitetherapy with pyridoxine and vitamin B supplements.
The condition occurs when there is inhibition of an enzyme involved in the conversion of niacin to NAD.
