Methoxsalen (Oxsoralen Ultra): Basics, Side Effects & Reviews
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Methoxsalen (Oxsoralen Ultra)

Basics, Side Effects, Reviews & More

Warning Icon Are you looking for information on Oxsoralen (methoxsalen) lotion for skin discoloration instead?

Methoxsalen (Oxsoralen Ultra) is used to treat severe cases of a skin disease called psoriasis. It must be used in combination with special light waves, called ultraviolet (UVA) radiation, but this treatment can sometimes lead to eye damage, skin aging, and skin cancer.

COMMON BRANDS

Oxsoralen-Ultra

DRUG CLASS

Psoralen

CONTROLLED SUBSTANCE CLASSIFICATION

Not a controlled medication

GENERIC STATUS

Lower-cost generic available

AVAILABILITY

Prescription only

Reviewed by:

Shifali Patel, PharmD

Ashley Wong, PharmD

Last reviewed on:

September 29, 2021

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What is methoxsalen (Oxsoralen Ultra)?

How methoxsalen (Oxsoralen Ultra) works

Methoxsalen (Oxsoralen Ultra) is a psoralen. It works as a photosensitizer, meaning it absorbs light and makes your skin more sensitive to UVA radiation. When given in combination with UVA radiation waves, methoxsalen (Oxsoralen Ultra) damages the DNA in your skin cells, leading to inflammation. Psoriasis is a condition where your skin cells are growing too quickly. By damaging those skin cells, methoxsalen (Oxsoralen Ultra) stops those cells from multiplying (growing) and after several days to weeks, your skin cells recover with improved color and thickness.

What is methoxsalen (Oxsoralen Ultra) used for?

  • Severe psoriasis that’s not well-managed by other treatment options

Methoxsalen (Oxsoralen Ultra) dosage forms

capsule icon
capsule

Typical dosing for methoxsalen (Oxsoralen Ultra)

The dose of methoxsalen (Oxsoralen Ultra) is based on your body weight and the number of doses you’ll take per week depends on your schedule of UVA radiation therapy, but all doses must be separated by at least 2 days. Older adults will typically be started on lower doses. Take your dose 1.5 to 2 hours before your scheduled UVA radiation therapy.

Frequently asked questions about methoxsalen (Oxsoralen Ultra)





Pros and cons of methoxsalen (Oxsoralen Ultra)

Pros

Thumbs UpAvailable in a less expensive generic form

Thumbs UpTreats severe psoriasis when other therapies have failed

Thumbs UpAvailable in a newer capsule form that’s absorbed into your body better and works faster than the older form that was previously on the market

Cons

Thumbs DownMust use in combination with special light waves, called UVA radiation

Thumbs DownHas many risks such as eye damage, skin aging, and skin cancer

Thumbs DownMust protect skin from sunlight both before and after therapy

Pharmacist tips for methoxsalen (Oxsoralen Ultra)

Capsule IconBecause methoxsalen (Oxsoralen Ultra) is a strong medication, it's important to take it exactly as prescribed by your healthcare provider. Taking extra doses can cause burning or blistering of your skin when exposed to UVA light. Ask your pharmacist or healthcare provider if you have any questions about your dose.

Capsule IconIf you or anyone around you accidentally overdoses on methoxsalen (Oxsoralen Ultra), stay out of sunlight and get emergency medical help or call your local poison control center at 1-800-222-1222 right away.

Capsule IconThe most common side effect of methoxsalen (Oxsoralen Ultra) is nausea, so taking it with food or a glass of low fat milk might help. Dividing your dose into two portions and taking each portion about 30 minutes apart might also help prevent nausea.

Capsule IconMild skin redness is normal and expected 24 to 48 hours after methoxsalen (Oxsoralen Ultra) and UVA radiation therapy. If you notice areas with severe redness, swelling, and blisters within 24 hours of therapy, it might be a sign of a severe burn and those areas must be protected from sunlight until the redness goes away. Maximum skin redness will occur at 48 hours or later, so it's important to wear a hat, gloves, and sunscreen with SPF 15 or greater for added protection of your skin and lips after treatment.

Capsule IconIf methoxsalen (Oxsoralen Ultra) causes skin tenderness or blistering, ask your pharmacist or healthcare provider for recommendations on skin products that might help. If these side effects bother you for longer than 24 to 48 hours, tell your provider because you might need to stop using the medication.

Capsule IconProtect your eyes with special wrap-around sunglasses designed to completely block and absorb UVA light. These sunglasses are different from your regular sunglasses, and wearing them right after taking methoxsalen (Oxsoralen Ultra) and for 24 hours after UVA radiation treatment will help protect you from indirect sunlight that comes through windows and clouds. It's also important to visit your eye doctor for a routine eye exam before starting therapy, after the first year of therapy, and every 2 years after that because of the risk of eye damage and cataracts with methoxsalen (Oxsoralen Ultra).

Capsule IconTake methoxsalen (Oxsoralen Ultra) with caution if you're using other light-sensitive medications because they can make your skin more sensitive to sunlight, causing you to burn more easily. These medications include anthralin (Drithocreme or Zithranol), coal tar, griseofulvin (Gris-PEG), phenothiazines, nalidixic acid, fluoroquinolone antibiotics, antibacterial or deodorant soaps, sulfonamide antibiotics, tetracycline antibiotics, thiazide water pills, and certain dyes, such as methylene blue, toluidine blue, rose bengal, and methyl orange. If you take any of these medications, discuss with your pharmacist or healthcare provider before starting methoxsalen (Oxsoralen Ultra).

Capsule IconStore methoxsalen (Oxsoralen Ultra) capsules at room temperature in a place out of reach from children.

Prices for methoxsalen (Oxsoralen Ultra) start at just $1327.37 with a GoodRx coupon. They’re fast, easy-to-use and free!

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What are the side effects of methoxsalen (Oxsoralen Ultra)?

With any medication, there are risks and benefits. Even if the medication is working, you may experience some unwanted side effects.

Warning Small Contact your doctor immediately if you experience any of the following:

  • Allergic reaction: itchy red rash (hives), shortness of breath, chest tightness, swelling of your lips, tongue, face, or eyes

Caution Small The following side effects may get better over time as your body gets used to the medication. Let your doctor know immediately if you continue to experience these symptoms or if they worsen over time.

Common side effects

Methoxsalen (Oxsoralen Ultra) only:

  • Nausea (10%)

Combination of methoxsalen (Oxsoralen Ultra) and UVA radiation therapy:

  • Itching (10%)
  • Skin redness

Other side effects

Methoxsalen (Oxsoralen Ultra) only:

  • Nervousness
  • Difficulty sleeping (insomnia)
  • Depression

Combination of methoxsalen (Oxsoralen Ultra) and UVA radiation therapy:

  • Swelling (edema)
  • Dizziness
  • Headache
  • Weakness or discomfort
  • Depression
  • Loss of skin color
  • Skin blisters
  • Rash
  • Herpes
  • Heat rash
  • Hives
  • Inflammation of hair follicles
  • Stomach pain or discomfort
  • Leg cramps
  • Low blood pressure
  • Worsening psoriasis

Source: DailyMed

The following side effects have also been reported:

What are the risks and warnings for methoxsalen (Oxsoralen Ultra)?

Methoxsalen (Oxsoralen Ultra) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options

Physician supervision

Black Box Warning Because it can cause serious side effects, methoxsalen (Oxsoralen Ultra) with UVA radiation should only be used under the care and supervision of an experienced physician who has special training using this treatment. Your physician will discuss risks and serious side effects, such as eye damage, skin aging, and skin cancer, with you before starting treatment.

New dosage form

Black Box WarningMethoxsalen (Oxsoralen Ultra) is now available in a new dosage form as a softgel capsule. Compared to the old dosage form that was previously on the market, this new capsule form gets absorbed in your body better and works faster as well. It's important to follow the dose prescribed by your healthcare provider, and ask your pharmacist or provider if you have any questions regarding your dose.

Skin burns

  • Risk factors: Exposure to sunlight | Higher doses of methoxsalen (Oxsoralen Ultra) | Excessive exposure to UVA radiation

Serious skin burns can result if you take higher doses of methoxsalen (Oxsoralen Ultra) than prescribed or from having more exposure to UVA light than expected. Methoxsalen (Oxsoralen Ultra) with UVA radiation therapy also makes your skin more sensitive to sunlight, even sunlight coming in through windows, so your skin might burn more easily. Follow your prescribed dose and don't make any dose changes without discussing with your healthcare provider first.

Skin cancer

  • Risk factors: Higher doses of methoxsalen (Oxsoralen Ultra) | Exposure to UVA radiation | Exposure to sunlight | Fair skin that burns rather than tans | Using coal tar | UVB treatment | X-ray treatment | Arsenic therapy | Treatment with grenz rays

Taking methoxsalen (Oxsoralen Ultra) raises your risk of developing certain skin cancers, such as melanoma and cutaneous squamous cell cancer, especially at higher doses. Lower doses of methoxsalen (Oxsoralen Ultra) and less exposure to UVA radiation can greatly reduce your risk, but skin cancer can still occur even after you've stopped treatment. If you notice any unusual skin changes, such as a new growth or new mole that's odd in size, shape, or color, tell your healthcare provider right away.

Cataracts

  • Risk factors: Exposure to UVA radiation | History of cataracts | Older age

Exposing your eyes to UVA radiation waves after taking methoxsalen (Oxsoralen Ultra) can damage the lens of your eyes and cause cataracts. To prevent cataracts, it's important to protect your eyes by wearing special UVA-absorbing, wrap-around sunglasses during UVA therapy and for 24 hours after having UVA treatment. Visit your eye doctor for routine eye exams before starting treatment and yearly.

Skin aging

  • Risk factors: Excessive exposure to sunlight | Long-term use of methoxsalen (Oxsoralen Ultra) and UVA radiation treatment | People who tan poorly

Exposure to sunlight and long-term treatment with methoxsalen (Oxsoralen Ultra) and UVA radiation can cause aging of your skin. Wear a hat or gloves and apply a sunscreen with SPF 15 or greater with ingredients that protect against UVA radiation, such as benzophenone and PABA esters, to help protect your skin and lips from sunlight. Don't use sunscreen on areas of your skin affected by psoriasis until after your scheduled UVA treatment.

Basal cell cancer

  • Risk factors: History of basal cell cancer | Exposure to sunlight

Take methoxsalen (Oxsoralen Ultra) with caution if you have a history of basal cell cancer, which is a type of skin cancer. If you notice any changes in your skin, such as open sores that won't go away or itchy red patches on your face, chest, arms, or legs, let your healthcare provider know right away.

Liver problems

  • Risk factors: History of liver problems

Take methoxsalen (Oxsoralen Ultra) with caution if you're older or have liver problems, because your liver helps break down methoxsalen (Oxsoralen Ultra) so it can be cleared from your body through your urine. If you have liver problems, let your healthcare provider know, because the medication can buildup in your body and cause serious side effects.

Heart problems

  • Risk factors: History of heart problems | History of low blood pressure

Take methoxsalen (Oxsoralen Ultra) with caution, especially if you're older and have heart problems, such as blood pressure problems, because exposure to UVA radiation can cause your blood pressure to drop. If you have trouble standing for long periods of time or you can't tolerate heat, let your healthcare provider know because you might need to be treated with a different type of UVA chamber.

How much does methoxsalen (Oxsoralen Ultra) cost?

Methoxsalen (Oxsoralen Ultra) is available as a generic medication and may be significantly cheaper compared to the brand version. Unless there is a specific reason you need the brand, the generic medication will be a better value. For even more savings, use a GoodRx coupon and pay just a fraction of the retail price.

Lowest GoodRx Price
Oxsoralen-Ultra (brand)

$3930.19

Lowest GoodRx Price
methoxsalen (generic)

$1327.37

View Prices & Coupons

Pricing based on most commonly-filled versions: 50 capsules of methoxsalen 10mg

What are alternatives to methoxsalen (Oxsoralen Ultra)?

There are a number of medications that your doctor can prescribe in place of methoxsalen (Oxsoralen Ultra). Compare a few possible alternatives below.

Methoxsalen (Oxsoralen Ultra)
Drug Class:Psoralen

$1327.37

lowest GoodRx price

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Methotrexate
Drug Class:Antimetabolite

$13.99

lowest GoodRx price

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Acitretin (Soriatane)
Drug Class:Retinoid

$90.50

lowest GoodRx price

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