Patients with frequent attacks should be advised to delay pregnancy until the disease is more stable. Attacks in pregnancy should be treated in the usual manner. Treatment of acute attacks Patients in acute attacks should have regular monitoring of pulse, blood pressure and respiratory rate. Haem arginate Intravenous haem precursors, administered as haem arginate, reduce the overproduction of porphyrins and precursors by a negative feedback inhibition of ALA synthase. It is given intravenously by slow-running infusion.
Biochemical response is more significant than a less dramatic clinical response.
Haem arginate has been used prophylactically to prevent the acute attack by administration during the early prodromal phase of an acute attack. Nutrition Steps should be taken to ensure the patient has adequate nutrition. Pain Severe pain should be controlled with opiate analgesics. Mild pain can be adequately controlled with aspirin, paracetamol or dihydrocodeine. There is the danger of opiate addiction in patients experiencing frequent attacks.