Adult Dosing
Dermatitis herpetiformis
- Start dose: 50 mg PO daily, may titrate up to 300 mg daily
- Reduce dose to minimum maintenance level as soon as possible
Leprosy
- 100 mg PO daily in combination with one or more anti leprosy drugs for 3 to 10 years
Pneumocystis carinii Pneumonia associated with HIV [Not FDA Approved]
Treatment
- 100 mg PO daily x 21 days, in combination with trimethoprim
Primary Prophylaxis
- 100 mg PO daily or 50 mg PO twice daily; Alt: dapsone 50 mg PO daily in combination with pyrimethamine and leucovorin
Secondary Prophylaxis
- 100 mg PO daily or 50 mg PO twice daily; Alt: dapsone 50 mg PO daily in combination with pyrimethamine and leucovorin or dapsone 200 mg PO weekly in combination with pyrimethamine and leucovorin
Prevention of Toxoplasmosis associated with HIV [Not FDA Approved]
- 50 mg PO daily, in combination with pyrimethamine and oral leucovorin
- 200 mg PO qwk, in combination with pyrimethamine and oral leucovorin
Pediatric Dosing
Dermatitis herpetiformis
- Correspondingly smaller doses of dapsone should be considered
Leprosy
Tuberculoid and indeterminate disease
- Child >14 yrs: 100 mg PO daily x 6 months, in combination with Rifampin 600 mg/month as per WHO
- Child 10-14 yrs: 50 mg PO daily x 6 months, in combination with Rifampin 450 mg/month as per WHO
- Child <10 yrs: 25 mg PO daily x 6 months, in combination with Rifampin 300 mg/month as per WHO
Lepromatous and borderline lepromatous patients
- Child >14 yrs: 100 mg PO daily x 12 months, in combination with Rifampin 600 mg/month and Clofazamine 50-100 mg PO qd as per WHO
- Child 10-14 yrs: 50 mg PO daily x 12 months, in combination with Rifampin 450 mg/month and Clofazamine 50 mg qod and 150 mg/month as per WHO
- Child <10 yrs: 25 mg PO daily x 12 months, in combination with Rifampin 300 mg/month and Clofazamine 50 mg x2 qwk and 100 mg/month as per WHO
Pneumocystis carinii Pneumonia [Not FDA Approved]
Treatment
- 2 mg/kg PO daily x 21 days, in combination with trimethoprim
Prophylaxis
- 2 mg/kg PO daily or 4 mg/kg qwk, in combination with pyrimethamine and oral leucovorin
Prevention of Toxoplasmosis [Not FDA Approved]
- 2 mg/kg or 15 mg/m2 PO daily, in combination with pyrimethamine and oral leucovorin
[Outline]
- Deaths from agranulocytosis, aplastic anemia and other blood dyscrasias have been reported with the administration of dapsone. Monitor the patients for the clinical sign such as sore throat, fever, pallor, purpura or jaundice and evaluate CBC weekly for the first month, monthly for six months and semi-annually thereafter. Discontinue the drug if reduction in leucocytes, platelets or hemopoiesis is noted
- Coadministration of folic acid antagonists increases the incidence of hematologic reactions, monitor hematological parameters more frequently in these patients. Dapsone and weekly pyrimethamine causes agranulocytosis during the second and third month of therapy
- Treat severe anemia prior to initiation of therapy and monitor hemoglobin
- Severe cutaneous reactions especially bullous, including toxic erythema, erythema multiforme, toxic epidermal necrolysis, morbilliform and scarlatiniform reactions, urticaria and erythema nodosum have been reported with sulfone therapy. Discontinue the drug if such reactions occurs and institute appropriate therapy
- Use cautiously in patients with a glucose-6-phosphate dehydrogenase (G6PD) deficiency, or methemoglobin reductase deficiency, or hemoglobin M, as hemolysis and Heinz body formation is exaggerated in these individuals and also if the patient is exposed to other agents or conditions such as infection or diabetic ketosis capable of producing hemolysis
- Dapsone causes toxic hepatitis and cholestatic jaundice early in therapy, particularly in G6PD deficient patients. Monitor liver function test at base line and periodically thereafter, if abnormal discontinue dapsone until the source of the abnormality is established
Cautions: Use cautiously in
- Hepatic impairment
- G6PD deficiency
- Cardiopulmonary diseases
Pregnancy Category:C
Breastfeeding: Dapsone can be used during breastfeeding; however, hemolytic anemia might occur, especially in newborn infants and those with G-6-PD deficiency. One source states that use of dapsone in the treatment of leprosy is advantageous because it kills the organisms in breastmilk. Monitor the infant for signs of hemolysis, especially in newborn or premature breastfed infants. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 3 March 2011). As per manufacturer data dapsone can cause hemolytic reactions in neonates and because dapsone shows potential for tumorgenicity in animal studies, a decision should be made whether to discontinue nursing or discontinue the drug taking into account the importance of drug to the mother.
Drug Name: Dapsone 100 MG Oral Tablet
Ingredient(s): Dapsone
Imprint: JACOBUS;100;101
Color(s): White
Shape: Round
Size (mm): 8.00
Score: 2
Inactive Ingredient(s): silicon dioxide / magnesium stearate / cellulose, microcrystalline / starch, corn
Drug Label Author:
Jacobus Pharmaceutical Company, Inc.
DEA Schedule:
Non-Scheduled
Drug Name: Dapsone 25 MG Oral Tablet
Ingredient(s): Dapsone
Imprint: JACOBUS;25;102
Color(s): White
Shape: Round
Size (mm): 6.00
Score: 2
Inactive Ingredient(s): silicon dioxide / magnesium stearate / cellulose, microcrystalline / starch, corn
Drug Label Author:
Jacobus Pharmaceutical Company, Inc.
DEA Schedule:
Non-Scheduled
