Dapsone

Dosing

Leprosy in combination with anti-leprosy medications 100 mg PO once daily in combination with 1 or more anti-leprosy drugs

Dermatitis herpetiformis Initial: 50 mg PO; maintenance 50-300 mg PO once daily

HIV infection - Pneumocystis pneumonia 100 mg PO once dialy in combination with Trimethoprim 15 mg/kg/d PO in 3 divided doses x21d

HIV infection - Pneumocystis pneumonia; Prophylaxis 200 mg PO once weekly + Pyrimethamine 75 mg + Leucovorin 25 mg PO once weekly

HIV infection - Toxoplasmosis; Prophylaxis 50 mg PO once daily + Pyrimethamine 50 mg PO + Leucovorin 25 mg PO once weekly

Acne

  • 5% gel: apply pea-sized amount to skin twice daily

  • 7.5% gel: apply pea-sized amount to skin once daily

Leprosy in combination with anti-leprosy medications 1-2 mg/kg PO once daily (max 100 mg/d)

Dermatitis herpetiformis Refer to adult dose

HIV infection - Pneumocystis pneumonia; Prophylaxis Age ≥1m: 2 mg/kg PO once daily (max 100 mg/d) OR 4 mg/kg PO once weekly

HIV infection - Toxoplasmosis; Prophylaxis Age ≥1m: 2 mg/kg or 15 mg/m(2) (max 25 mg) PO daily + Pyrimethamine 1 mg/kg (max 25 mg) PO daily + Leucovorin 5 mg PO every 3d

  • Continue Leucovorin for 1 week after Pyrimethamine is stopped

HDAdjust dose 50 mg twice daily (give at least 1 dose after dialysis)

General Information

  • Dermatitis herpetiformis

  • Leprosy in combination with other anti-leprosy medications

  • Acne

Monitor CBC weekly for first month then monthly for 6 months.

Monitor liver function at baseline, then periodically throughout therapy.

In HIV patients, monitor CBC platelets and reticulocyte counts, every 2-3 days during first 2-3 weeks, then monthly for the first 3 months, and then every 6 months.

Common

  • Dry skin

  • Peeling of skin

  • Erythema

Serious

  • Bullous dermatosis

  • Erythema multiforme

  • Erythema nodosum

  • Erythema scarlatiniforme

  • Erythroderma

  • Toxic epidermal necrolysis

  • Toxic erythema

  • Acquired Heinz body anemia

  • Agranulocytosis

  • Aplastic anemia

  • Hemolysis

  • Hemolytic anemia

  • Methemoglobinemia

  • Cholestatic jaundice syndrome

  • Toxic hepatitis

  • Peripheral motor neuropathy

  • Infectious mononucleosis

  • Warfarin- may result in increased INR

  • Zidovudine- may result in hematologic toxicity

Antimicrobial class: Sulfone

Pregnancy category: C

Average serum half life: 10-50 hours (average 28 hours)

Precautions: Dose-related hemolytic anemia, hemolysis and hepatotoxic reactions have been reported with oral treatment, especially in individuals with G6PD deficiency; discontinue if signs and symptoms occur.

Discontinue if new or toxic skin reactions occur.

Monitoring recommended and discontinue if significant reduction in leukocytes, platelets, or hemopoiesis occurs.

Treat severe anemia prior to oral dapsone initiation; monitoring recommended.

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