Category:

• Miscellaneous

Description:

• Antiprotazoal

Indications:

• All forms of leprosy (Hansen’s disease), except for cases of proven dapsone resistance

• Dermatitis herpetiformis

Precautions:

• Pregnancy category C; excreted in breast milk, may cause reaction in infants

• Renal disease, G-6-PD deficiency

• Anemia, severe cardiopulmonary disease, methemoglobin reductase deficiency

Adverse Reactions (Side Effects):

• CNS: headache, insomnia, paresthesia, peripheral neuropathy, psychosis, vertigo

• EENT: blurred vision, optic neuritis, photophobia, tinnitus

• GI: abdominal pain, anorexia, nausea, vomiting

• GU: nephrotic syndrome, proteinuria, renal papillary necrosis

• HEME: agranulocytosis, aplastic anemia, hemolytic anemia

• SKIN: drug-induced systemic lupus erythematosis, photosensitivity

Dosage:

Administered orally

• Adult:            

  • Leprosy: PO 50-100mg daily for 3-10 years (addition of rifampin 600mg daily for 1^st 6 months is recommended)

  • Dermatitis herpetiformis: PO 50mg initially; increase to 300mg daily or higher to achieve full control; reduce dosage to minimum level as soon as possible

• Child:            

  • Leprosy: PO 1-2 mg/kg/day; max 100mg daily

Special considerations:

• Use in conjunction with rifampin or clofazimine to prevent development of drug resistance and reduce infectiousness of patient with leprosy more quickly

• Full therapeutic effects on leprosy may not occur for several months; compliance with dosage schedule, duration is important