WHO and others recommend rifampin-based multiple-drug regimens for treatment of all forms of leprosy, including multibacillary leprosy (>5 skin lesions) and paucibacillary leprosy (2–5 lesions).
Because rifampin is bactericidal against Mycobacterium leprae, it is the principal component of multiple-drug leprosy regimens; other drugs are included in the regimens to prevent emergence of rifampin-resistant M. leprae.
For treatment of multibacillary leprosy, WHO and others recommend a multiple-drug regimen that includes rifampin, dapsone, and clofazimine. If severe adverse effects related to dapsone occur, dapsone may be discontinued, and rifampin and clofazimine continued at usually recommended dosages.
For treatment of paucibacillary leprosy, WHO and others recommend a multiple-drug regimen that includes rifampin and dapsone. If severe adverse effects related to dapsone occur, dapsone may be discontinued and substituted with clofazimine (no longer commercially available in the US; available by contacting the National Hansen's Disease Program at 800-642-2477).
Treatment of leprosy is complicated and should be undertaken in consultation with a specialist familiar with the disease (e.g., clinicians from the National Hansen's Disease Program at 800-642-2477 or http://www.hrsa.gov/hansens/clinicalcenter.htm).
Used to control dermatologic symptoms of the disease; may decrease pruritus and improve skin lesions, but has no effect on the GI component of disease or on cutaneous IgA and complement deposition. Rapid exacerbation of lesions and severe pruritus usually occur when dapsone discontinued.
Treatment or prevention of Pneumocystis jiroveci (formerly Pneumocystis carinii) pneumonia† (PCP) alone or in conjunction with other anti-infectives. Designated an orphan drug by FDA for treatment or prevention of PCP pneumonia.
Co-trimoxazole is initial drug of choice for treatment of PCP in most adults, adolescents, and children, including HIV-infected individuals. Dapsone used in conjunction with trimethoprim is one of several alternatives for treatment of mild to moderate PCP in adults or adolescents when co-trimoxazole cannot be used; not studied for treatment of PCP in children.
Dapsone monotherapy or dapsone used in conjunction with pyrimethamine and leucovorin are alternative regimens for prevention of initial episodes of PCP (primary prophylaxis of PCP)† in adults or adolescents at increased risk, including HIV-infected individuals, when co-trimoxazole (the drug of choice) cannot be used. Dapsone monotherapy also is an alternative for primary PCP prophylaxis in children, especially children <5 years of age; only limited data available on use of dapsone in conjunction with pyrimethamine for such prophylaxis in children.
Dapsone monotherapy or dapsone used in conjunction with pyrimethamine and leucovorin are alternative regimens that can be used for long-term suppressive or chronic maintenance therapy (secondary prophylaxis of PCP)† in adults or adolescents when co-trimoxazole (the drug of choice) cannot be used. Dapsone monotherapy also is an alternative for secondary PCP prophylaxis in children, especially children <5 years of age; only limited data available on use of dapsone in conjunction with pyrimethamine for such prophylaxis in children.
Dapsone monotherapy is an alternative for PCP prophylaxis in pregnant women.
Toxoplasmosis
Prevention of toxoplasmosis caused by Toxoplasma gondii in conjunction with other anti-infectives. Has been used in conjunction with pyrimethamine and leucovorin for treatment of toxoplasmosis, but not included in current CDC, NIH, and IDSA recommendations for treatment of the disease.
Dapsone used in conjunction with pyrimethamine and leucovorin is one of several recommended alternatives for prevention of T. gondiiencephalitis (primary prophylaxis)† in HIV infected adults, adolescents, and children when the drug of choice (co-trimoxazole) cannot be used.
Dapsone is not included in current CDC, NIH, and IDSA recommendations for long-term suppressive or chronic maintenance therapy (secondary prophylaxis) to prevent relapse of toxoplasmosis encephalitis† in HIV infected adults, adolescents, or children.
Media Gallery
Drug Info Tools
