Dapsone:
Class: Antibiotic.
Indications:
Treatment of leprosy (due to susceptible strains of Mycobacterium leprae) and dermatitis
herpetiformis. Prophylaxis of toxoplasmosis in severely-immunocompromised patients;
alternative agent for Pneumocystis jirovecii pneumonia (PCP) prophylaxis (monotherapy) .
Available dosage form in the hospital: 50MG TAB.
Trade Names:
Dosage:
-Leprosy: Oral: 100 mg daily, in combination with other antileprosy agents; duration of
therapy is variable
-Dermatitis herpetiformis: Oral: Start at 50 mg daily, increase to 300 mg daily, or higher to
achieve full control, reduce dosage to minimum level as soon as possible
-Aphthous ulcers, severe (unlabeled use): Oral:
-Initial: 25 mg daily for 3 days; increase dose in increments of 25 mg daily every 3 days
up to 100 mg daily for 3 days, then increase by 25 mg daily every 7 days up to 150
mg daily. Administer in 2 divided doses (75 mg dose is administered in 3 divided
doses).
-Maintenance: 100-150 mg daily in 2 divided doses with or without concomitant
colchicine (Rogers, 1982; Lynde 2009)
-Bullous systemic lupus erythematosus (unlabeled use): Oral: 100 mg once daily with or
without prednisone (Fabbri, 2003).
-Pemphigus vulgaris (unlabeled use): Oral: 25 mg daily for 7 days, then increase dose in
increments of 25 mg daily every 7 days up to 100 mg daily for 7 days (4 weeks total
therapy) with concomitant prednisone. Administer in 2 divided doses (a 75 mg dose is
administered in 3 divided doses) (Azizi, 2008). Note: If patient becomes lesion free,
taper and discontinue gradually by decreasing dose 25 mg daily over 7 days. If no new
lesions are seen, gradual taper is continued. If lesions recur, dose is increased by 25 mg
daily at 7-day intervals until the patient develops no new lesions. Taper is usually ~4
weeks total.
-Pneumocystis jirovecii pneumonia, alternative therapy (unlabeled use): Oral:
-Prophylaxis (primary or secondary): 100 mg daily once daily or in 2 divided doses as
monotherapy or 50 mg daily in combination with weekly pyrimethamine and
leucovorin or 200 mg weekly in combination with weekly pyrimethamine and
leucovorin (DHHS, 2013)
-Treatment (mild-to-moderate disease): 100 mg daily once daily in combination with
trimethoprim for 21 days (DHHS, 2013)
-Toxoplasmosis in severely-immunocompromised patients (alternative treatment)
(unlabeled use): Prophylaxis: Oral: 50 mg daily, in combination with pyrimethamine
and leucovorin or 200 mg weekly in combination with pyrimethamine and leucovorin.
(DHHS, 2013).
Renal Impairment :
No guidelines are available.
Common side effect:
Reticulocyte increase , hemolysis ,hemoglobin decrease,
methemoglobinemia , Tachycardia, Fever, headache, phototoxicity, Abdominal pain,
nausea, pancreatitis, vomiting.
Pregnancy Risk Factor: C
