This list should be read in conjunction with the page Management of the acute attack.

Specific Suppressive Therapy for the Acute Attack

• Haem arginate (Normosang)
• Lyophilised haematin (Panhematin) (in the USA).

Pain​​

• Oral codeine or dihydrocodeine
• Parenteral pethidine or morphine (Note that frequent dosing is usually required).

Vomiting​​

• Oral prochlorperazine, metaclopramide or chlorpromazine
• Rectal prochlorperazine suppositories
• Parenteral prochlorperazine or metaclopramide

Restlessness, Confusion Or Psychosis​​

• Oral: promazine, chlorpromazine or trifluoroperazine
• Parenteral chlorpromazine

Convulsions​​

• Parenteral clonazepam or diazepam.
• Intravenous magnesium sulphate in difficult casesHYPERTENSION
• Beta-blockers may have some anti-porphyrinogenic effect in themselves and are thus particularly useful for the control of these autonomic manifestations.
• Intravenous labetalol and magnesium sulphate for the adrenergic crisis.

Severe Hyponatraemia​​

• Avoidance of hypotonic intravenous fluids
• Intravenous hypertonic saline for severe, symptomatic hyponatraemia (with standard protocols to avoid central pontine myelinolysis).