Therefore, the urine may be discolored, especially after standing in light. Such changes in urine color may lead a doctor to suspect porphyria. Treatment and Prevention Severe attacks of acute intermittent porphyria are treated with heme, which must be given intravenously. Heme is available as hematin in the United States. Another product, heme arginate, has fewer side effects but is still investigational.
Heme is taken up in the liver, where it compensates for the reduced synthesis of heme.
Blood and urine levels of delta-aminolevulinic acid and porphobilinogen are promptly lowered and symptoms improve, usually within several days. If treatment is delayed, recovery takes longer and some nerve damage may be permanent. Glucose given intravenously or a diet high in carbohydrates can also be beneficial, but these measures are less effective than heme. Pain can be controlled with drugs until the person responds to heme or glucose. The doctor will stop the person from taking any harmful drugs and, if possible, address other factors that may have contributed to the attack.