This medication checker does 2 jobs for people with acute hepatic porphyria (AHP) and their caregivers. It screens the active AHP studies and registries for eligibility conflicts with the medicines you take, and it reminds you of the bigger question in this disease: whether a medicine is safe for you at all, since hundreds of common drugs can trigger an attack.
AHP is unusual among rare diseases in that the medicine list matters more for safety than for trial eligibility. The studies open today are observational (Alnylam's ELEVATE registry, the Porphyrias Consortium's Longitudinal Study of the Porphyrias, Mount Sinai's AIP modifier gene study, a Norwegian diet study and a Texas biomarker study), and their published criteria ask about a confirmed diagnosis, age and whether you are in another drug trial, not about your prescriptions. The safety question is answered by the drug safety database maintained by NAPOS and linked by the American Porphyria Foundation and the United Porphyrias Association, which rates each drug by its potential to trigger an attack in AIP, VP, HCP and ADP. The checker below reads the published criteria of every active AHP study and flags the ones that mention your medicine; the cards explain what each class means for you.
Attack-Triggering Drugs
Barbiturates, sulfonamide antibiotics, rifampin, several anti-seizure drugs, progestins and estrogens, many others — the classes the American Porphyria Foundation names as the worst offenders, because they push the liver's ALAS1 enzyme harder and set off the ALA and PBG build-up behind an attack. The drug safety database rates each medicine by name; check it before any new prescription, anesthesia or over-the-counter product, and ask your porphyria specialist about anything rated unsafe, probably unsafe or not classified. No trial will enroll you while an attack is being triggered, and these drugs are the most common cause.
Preventive Treatment
Givlaari (givosiran) — the monthly siRNA injection approved for adults with recurrent attacks. Observational studies take people on or off Givlaari: ELEVATE enrolls anyone aged 12 and older with a physician-documented AHP diagnosis and excludes only people in an investigational drug trial, and the Longitudinal Study of the Porphyrias enrolls anyone with biochemical or genetic proof of porphyria. If a new interventional trial opens, expect it to ask how long you have been on Givlaari and your liver and kidney results.
Attack Treatment
Panhematin (hemin for injection), IV glucose — the hospital treatments for an attack in progress. Hemin use is recorded in every registry as a measure of disease activity, and the University of Texas Medical Branch biomarker study (NCT02935400) follows adults with a documented AIP, HCP or VP diagnosis around hemin treatment. Needing hemin never excludes you from the observational studies; it is part of what they measure.
Pain and Nausea Medicines
Opioids such as morphine, anti-nausea medicines, chlorpromazine — the medicines used during attacks and, for some people, between them. NORD notes attack pain usually needs opioids, and chlorpromazine labels still carry a decades-old indication for acute intermittent porphyria. These rarely affect study eligibility, but a registry will record them and a study measuring daily pain scores may ask for a stable dose. Confirm each one in the drug safety database; a few anti-nausea and sedative drugs are rated unsafe.
Hormonal Treatments
Birth control pills, progestin-only methods, hormone replacement, GnRH analogs (leuprolide) — progesterone is a well-known attack trigger and the Panhematin label tells patients to avoid estrogens such as oral contraceptives. Some women with attacks tied to their cycle are treated with a GnRH analog to stop ovulation under specialist care. Studies do not exclude people on these medicines, but you should tell any study team and your porphyria doctor about every hormonal product, including implants and IUDs.
Seizure, Mood and Infection Medicines
Anti-seizure drugs, antidepressants, antipsychotics, antibiotics and antifungals — the classes with the widest spread of ratings in the drug safety database: some anti-seizure drugs and antibiotics are among the most dangerous triggers while others in the same class are rated safe. Seizures during an attack are often caused by low sodium, which is treated with saline, so an attack is not by itself a reason to start a long-term anti-seizure drug. When the checker flags one of these at low confidence it usually means a study excludes an unrelated condition that could confuse its results, not the drug itself.
Check every new prescription before you fill it
The American Porphyria Foundation says prevention and avoidance of unsafe medications is essential to good management, and attacks set off by an unsafe drug given to someone whose diagnosis was not known are among the most dangerous. Search the NAPOS drug safety database (drugs-porphyria.org) by brand name, keep a wallet card or emergency letter that names your diagnosis and safe drugs, and tell every prescriber, dentist and anesthesiologist that you have an acute porphyria. Report any reaction to the APF at 866-APF-3635.
On Givlaari? The registries want you, and so does the safety record
Givlaari was approved in 2019 on a 6-month trial of 94 people, so long-term data on liver enzymes, kidney function, homocysteine and pancreatitis still come largely from registries and reports. ELEVATE (NCT04883905) follows people on and off Givlaari through 2030, and the Longitudinal Study of the Porphyrias collects the same information at Consortium centers. Enrolling adds nothing to your treatment and gives the next patient better answers.
Carriers who have never had an attack can join too
Most people with an HMBS, CPOX or PPOX variant never have an attack, and researchers want to know why. Mount Sinai's modifier gene study (NCT05502133) enrolls symptomatic people with AIP and their parents and relatives out to third-degree, and the Longitudinal Study of the Porphyrias makes provision for relatives with biochemical or genetic documentation but no symptoms. If you are a carrier, these are your studies, and the drug safety rules apply to you as well.
Don't see your medication listed?
The checker covers the classes that appear most often in AHP study criteria and on the drug safety lists: attack-triggering drugs, Givlaari, hemin, pain and nausea medicines, hormonal treatments and seizure, mood and infection medicines. If yours is missing, it has not come up in current AHP criteria, but look it up in the drug safety database anyway and tell the study team about everything you take, including herbal products and supplements.
How the medication conflict checker works: This free tool helps people with acute hepatic porphyria learn whether their current medications could affect clinical study eligibility. It scans the published eligibility criteria of every active AHP study and registry and flags the ones that may exclude your treatment. Matches are sorted by confidence: high confidence means the study names your exact drug, medium confidence means it names your drug class, and low confidence means it uses broad language that may or may not apply. It does not rate whether a drug is safe for you; that is what the NAPOS and APF drug safety database is for. Always confirm eligibility with the study team and drug safety with a porphyria specialist.
Across 1,853 open rare disease treatment trials, a third exclude people over a medication they commonly take. See which medications and diseases, in our September 2026 analysis.
Sources: Eligibility details above come from ClinicalTrials.gov records NCT04883905 (ELEVATE), NCT01561157 (Longitudinal Study of the Porphyrias), NCT05502133 (Mount Sinai modifier genes), NCT06273644 (carbohydrate-rich diet) and NCT02935400 (UTMB biomarkers), read October 18, 2026; drug safety statements come from the American Porphyria Foundation's AHP Drug Safety Database page and its AIP and HCP pages, the NAPOS database (drugs-porphyria.org), NORD's AIP report and the Panhematin prescribing information.