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.


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