Dapsone

What is Dapsone?

• Dapsone, also known as 4,4'-sulfonyldianiline (SDA) or diaminodiphenyl sulfone (DDS) is an antibacterial drug for susceptible cases of leprosy.

Dapsone

What are the uses of this medicine?

Dapsone, is used in the treatment of:

• Dermatitis herpetiformis
• Leprosy

Other uses:

• Dapsone is also available as a topical gel for therapy of acne.
• Off-label uses include prophylaxis against pneumocystis jiroveci (formerly carinii) in HIV infected patients.

Dapsone 3D spacefill

How does this medicine work?

• Dapsone (dap' sone) is 4,4’ diaminodiphenylsulfone and is bacteriostatic for Mycobacterium leprae.
• Like other sulfonamides, dapsone is believed to act by inhibition of folate synthesis. Bacteria including M.leprae are acutely sensitive to this inhibition as folate is necessary for protein, DNA and RNA synthesis.
• In contrast, humans are not affected by this inhibition of folate synthesis because they rely upon dietary sources of folate.
• The mechanism of action in Dermatitis herpetiformis has not been established.

Dapsone3d

Who Should Not Use this medicine ?

This medicine cannot be used in patients with:

• Hypersensitivity to Dapsone and/or its derivatives.

What drug interactions can this medicine cause?

• Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

Be sure to mention any of the following:

• aminobenzoate potassium (Potaba), aminobenzoic acid, clofazimine (Lamprene), didanosine (Videx), probenecid (Benemid), pyrimethamine (Daraprim), rifampin (Rifadin), trimethoprim (Bactrim, Cotrim, Septra), or vitamins.

Is this medicine FDA approved?

• Dapsone was approved for use in the United States in 1979.

How should this medicine be used?

Recommended dosage: For Dermatitis herpetiformis:

• The dosage should be individually titrated starting in adults with 50 mg daily and correspondingly smaller doses in children.
• If full control is not achieved within the range of 50-300 mg daily, higher doses may be tried.
• Dosage should be reduced to a minimum maintenance level as soon as possible.
• A strict gluten free diet is an option for the patient to elect, permitting many to reduce or eliminate the need for Dapsone; the average time for dosage reduction is 8 months with a range of 4 months to 2 1/2 years and for dosage elimination 29 months with a range of 6 months to 9 years.

For Leprosy:

• Dapsone is usually started at a low dose in the range of 50 mg daily and titrated upward to a total daily dose of 100 to 300 mg.
• In the therapy of leprosy, the combination of dapsone with clofazimine and rifampin is recommended for 6 or 12 months followed by monotherapy with dapsone until all signs of clinical activity are controlled and biopsies are negative for at least a year.
• Up-to-date and reliable information on the management of leprosy is available from the National Hansen's Disease (Leprosy) Clinical Center, Baton Rouge, LA.

Administration:

• Dapsone comes as a tablet to take by mouth.
• Dapsone usually is taken either once a day or three times a week.
• Take dapsone exactly as directed.
• Do not take more or less of it or take it more often than prescribed by your doctor.

What are the dosage forms and brand names of this medicine?

This medicine is available in fallowing doasage form:

• As tablets of 25 and 100 mg for oral use.

This medicine is available in fallowing brand namesː

• Dapsone

What side effects can this medication cause?

The most common side effects of this medicine include:

• hemolysis and anemia, nausea, abdominal pain, tinnitus, vertigo, blurred vision, headache, insomnia, and rash.

Less common, but serious side effects may include:

• peripheral neuropathy, acute psychosis, nephrotic syndrome, acute liver injury, hemolysis, agranulocytosis, aplastic anemia, hypersensitivity reactions and a lupus-like syndrome.

• In addition to the warnings and adverse effects reported above, additional adverse reactions include: nausea, vomiting, abdominal pains, pancreatitis, vertigo, blurred vision, tinnitus, insomnia, fever, headache, psychosis, phototoxicity, pulmonary eosinophilia, tachycardia, albuminuria, the nephrotic syndrome, hypoalbuminemia without proteinuria, renal papillary necrosis, male infertility, drug-induced Lupus erythematosus and an infectious mononucleosis-like syndrome.

What special precautions should I follow?

• Hemolysis and Heinz body formation may be exaggerated in individuals with a glucose-6-phosphate dehydrogenase (G6PD) deficiency, or methemoglobin reductase deficiency, or hemoglobin M. This reaction is frequently dose-related. Dapsone should be given with caution to these patients or if the patient is exposed to other agents or conditions such as infection or diabetic ketosis capable of producing hemolysis.
• Toxic hepatitis and cholestatic jaundice have been reported early in therapy. When feasible, baseline and subsequent monitoring of liver function is recommended; if abnormal, Dapsone should be discontinued until the source of the abnormality is established.
• The patient should be warned to respond to the presence of clinical signs such as sore throat, fever, pallor, purpura or jaundice.
• Complete blood counts should be done frequently in patients receiving Dapsone. If a significant reduction in leucocytes, platelets or hemopoiesis is noted, Dapsone should be discontinued and the patient followed intensively. if a significant reduction in leucocytes, platelets or hemopoiesis is noted, Dapsone should be discontinued and the patient followed intensively.
• Folic acid antagonists have similar effects and may increase the incidence of hematologic reactions; if co-administered with Dapsone the patient should be monitored more frequently.
• Patients on weekly pyrimethamine and Dapsone have developed agranulocytosis during the second and third month of therapy.
• Severe anemia should be treated prior to initiation of therapy and hemoglobin monitored.
• Plan to avoid unnecessary or prolonged exposure to sunlight and to wear protective clothing, sunglasses, and sunscreen. Dapsone may make your skin sensitive to sunlight.
• Dapsone has been linked with rare cases of idiosyncratic liver injury, similar to that seen with the sulfonamides.
• Dapsone is excreted in breast milk in substantial amounts. Hemolytic reactions can occur in neonates.

What to do in case of emergency/overdose?

Symptoms of overdose may include:

• Nausea, vomiting, hyperexcitability.

Management of overdosage:

• In case of overdose, call the poison control helpline of your country. In the United States, call 1-800-222-1222.

• Overdose related information is also available online at poisonhelp.org/help.
• In the event that the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services. In the United States, call 911.
• Methemoglobin induced depression, convulsions or severe cyanosis requires prompt treatment. In normal and methemoglobin reductase deficient patients, methylene blue, 1-2 mg/kg of body weight, given slowly intravenously, is the treatment of choice.
• For non-emergencies, if treatment is needed, methylene blue may be given orally in doses of 3-5 mg/kg every 4-6 hours.
• Methylene blue reduction depends on G6PD and should not be given to fully expressed G6PD deficient patients.

Can this medicine be used in pregnancy?

• Pregnancy Category C.
• Because of the lack of animal studies or controlled human experience, Dapsone should be given to a pregnant woman only if clearly needed.

Can this medicine be used in children?

• Pediatric patients are treated on the same schedule as adults but with correspondingly smaller doses.

What are the active and inactive ingredients in this medicine?

Active ingredient:

• dapsone

Inactive ingredients:

• silicon dioxide
• magnesium stearate
• cellulose, microcrystalline
• starch, corn

Who manufactures and distributes this medicine?

• jacobus pharmaceutical co., inc.
• Princeton, NJ

What should I know about storage and disposal of this medication?

• Store at 20°- 25° C (68°- 77°F).
• Protect from light.

• Dailymed label info on Dapsone
• FDA Dapsone

Dapsone Resources
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