Dapsone is indicated in Primary and secondary prophylaxis of Pneumocystis (carinii) jirovecii pneumonia, Multibacillary leprosy, Paucibacillary leprosy, Dermatitis herpetiformis, Acne.
Dapsone has both anti-infammatory and antimicrobial properties. A combination of these activities may account for its efcacy in acne. Anti-infammatory efects include inhibition of neutrophil myeloperoxidase and eosinophil peroxidase activity, suppression of hypochlorous acid production, scavenging of reactive oxygen species, suppression of neutrophil activity, and inhibition of chemoattractant-induced signal transduction. Antimicrobial activity, similar to that of sulfones and sulfonamides, is by inhibition of bacterial dihydropteroate synthase in the folic acid metabolic pathway. This mechanism is efective against microorganisms synthesizing their own folic acid. In vitro susceptibility testing has demonstrated some activity for Dapsone against Propionibacterium species, including Propionibacterium acnes (P. acnes).
Primary and secondary prophylaxis of Pneumocystis (carinii) jirovecii pneumonia: Adult: 50 mg daily, with pyrimethamine 50 mg once wkly. Alternatively, 100 mg with pyrimethamine 50 mg twice wkly. Child: 1 mth-18 yr: 2 mg/kg daily (max: 100 mg daily) or 4 mg/kg wkly (max: 200 mg wkly). Multibacillary leprosy: Adult: 100 mg daily with clofazimine 50 mg daily, together with rifampicin 600 mg and clofazimine 300 mg once a mth for 12 mth. Child: and child 10-14 yr old: daily doses of dapsone 50 mg, or 1 to 2 mg/kg if their body-weight is low Paucibacillary leprosy: Adult: 100 mg daily with 600 mg rifampicin once a mth, both given for 6 mth. Child: Reduce dose as for multibacillary leprosy. Dermatitis herpetiformis: Adult: Initially, 50 mg daily increased gradually to 300 mg daily if required.
Trimethoprim/ sulfamethoxazole (TMP/ SMX) increases the systemic level of Dapsone and its metabolites. Topical benzoyl peroxide used at the same time as Dapsone may result in temporary local yellow or orange skin discoloration.
Hypersensitivity. Severe anaemia, porphyria. G6PD deficiency, methaemoglobin or Hb M. Perform regular blood counts and monitor liver function regularly. Pregnancy and lactation.
Anaemia, peripheral neuropathy, haemolysis and methaemoglobinaemia (dose-related), nephrotic syndrome, psychological changes, hepatitis. Others: Nausea, vomiting, anorexia, headache, maculopapular rash, toxic epidermal necrolysis, Stevens-Johnson syndrome. Topical: Dryness, redness, oiliness and peeling at application site.
Pregnancy Category C. Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.
Store at or below 30°C temperature. Keep away from light and wet place. Keep out of reach of children.
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