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).


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


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

Restlessness, Confusion Or Psychosis​​

  • Oral: promazine, chlorpromazine or trifluoroperazine
  • Parenteral chlorpromazine


  • 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).