Editing Porphyria (section)

====Heme analogs====
[[Hematin]] (trade name Panhematin) and [[heme arginate]] (trade name NormoSang) are the drugs of choice in acute porphyria in the United States and the United Kingdom respectively. These drugs need to be given very early in an attack to be effective; effectiveness varies amongst individuals. They are not curative drugs but can shorten attacks and reduce the intensity of an attack. Side effects are rare but can be serious. These heme-like substances theoretically inhibit ALA synthase and hence the accumulation of toxic precursors. In the United Kingdom, supplies of NormoSang are kept at two national centers; emergency supply is available from [[St Thomas's Hospital]], London.<ref>{{Cite book|title=British National Formulary (BNF 57) |date=March 2009 |publisher=[[BMJ Group]] and RPS Publishing |location=United Kingdom |isbn=978-0-85369-845-6 |page=549 |chapter=9.8.2: Acute porphyrias |author=[[British Medical Association]], [[Royal Pharmaceutical Society of Great Britain]]}}</ref> In the United States, [[Lundbeck]] manufactures and supplies Panhematin for infusion.<ref>{{Cite web |url=http://www.porphyriafoundation.com/testing-and-treatment/medications-for-porphyria/panhematin |title=Panhematin for Acute Porphyria |year=2010 |author=American Porphyria Foundation |access-date=5 August 2010 |url-status=dead |archive-url=https://web.archive.org/web/20100825015445/http://www.porphyriafoundation.com/testing-and-treatment/medications-for-porphyria/panhematin |archive-date=25 August 2010 |df=dmy-all }}</ref>

Heme arginate (NormoSang) is used during crises but also in preventive treatment to avoid crises, one treatment every 10 days.{{citation needed|date=December 2014}}

Any sign of low blood sodium ([[hyponatremia]]) or weakness should be treated with the addition of hematin, heme arginate, or even [[tin mesoporphyrin]], as these are signs of impending syndrome of inappropriate antidiuretic hormone (SIADH) or peripheral nervous system involvement that may be localized or severe, progressing to [[bulbar palsy|bulbar paresis]] and respiratory paralysis.{{Citation needed|date=February 2007}}