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Dapsone (dapsone)


Leprostatic agent




Treatment of dermatitis herpetiformis and all forms of leprosy except for cases of proven dapsone resistance.


Dermatitis Herpetiformis

Initial: 50mg/day
Range: 50-300mg/day; may increase dose if needed

Reduce to minimum maint dose as soon as possible


100mg/day w/o interruption, in combination w/ 1 or more antileprosy drugs

Bacteriologically Negative Tuberculoid and Indeterminate Disease:
100mg/day + 6 months of 600mg/day of rifampin; daily rifampin may be replaced by 600mg/month if supervised

Continue dapsone until all signs of clinical activity are controlled, usually after an additional 6 months; then continue dapsone for additional 3 yrs for tuberculoid and indeterminate patients and for 5 yrs for borderline tuberculoid patients

Lepromatous/Borderline Lepromatous:
100mg/day + 2 yrs of 600mg/day of rifampin; daily rifampin may be replaced by 600mg/month if supervised

Continue dapsone 100mg/day for 3-10 yrs until all signs of clinical activity are controlled w/ skin scrapings and biopsies negative for 1 yr; then continue dapsone for an additional 10 yrs for borderline patients and for life for lepromatous patients


General Dosing

Same schedule as adults but w/ correspondingly smaller doses


Other Important Considerations
Dermatitis Herpetiformis:
High Acetylation Rates/Receiving Treatment Affecting Acetylation: Adjust dose


Oral route


Tab: 25mg*, 100mg* *scored


Deaths have been reported from agranulocytosis, aplastic anemia, and other blood dyscrasias. D/C if a significant reduction in leukocytes, platelets, or hemopoiesis occurs. Treat severe anemia prior to therapy and monitor Hgb. Serious dermatologic reactions (eg, toxic epidermal necrolysis) may occur; d/c and institute appropriate therapy if a new or toxic dermatologic reaction occurs. Caution w/ G6PD deficiency, methemoglobin reductase deficiency, or hemoglobin M, and those who are exposed to other agents or conditions such as infection or diabetic ketosis capable of producing hemolysis. Suspect secondary dapsone resistance whenever a lepromatous or borderline lepromatous patient receiving dapsone relapses clinically and bacteriologically; consider resistance clinically confirmed if such cases show no response to regular and supervised dapsone therapy w/in 3-6 months or good compliance for the past 3-6 months can be assured. Toxic hepatitis and cholestatic jaundice reported. Monitor LFTs; if abnormal, d/c and establish source of abnormality. Withdraw therapy if muscle weakness appears.


Hemolysis, peripheral neuropathy, N/V, abdominal pain, pancreatitis, vertigo, blurred vision, tinnitus, insomnia, fever, headache, psychosis, phototoxicity, pulmonary eosinophilia, tachycardia.


Rifampin may lower plasma levels. Folic acid antagonists (eg, pyrimethamine) may increase likelihood of hematologic reactions; monitor patient more closely. Agranulocytosis reported during the 2nd and 3rd month of therapy, in patients on weekly combination therapy w/ pyrimethamine. Concurrent use w/ trimethoprim may raise plasma levels of both drugs.


Category C, not for use in nursing.


Leprostatic agent; mechanism not established. Suspected to be bactericidal as well as bacteriostatic against Mycobacterium leprae.


Absorption: Rapid, almost complete; Tmax=4-8 hrs. Distribution: Found in breast milk. Elimination: Urine (85%); T1/2=28 hrs.


Assess for anemia, G6PD deficiency, methemoglobin reductase deficiency, hemoglobin M, hypersensitivity to the drug, pregnancy/nursing status, and possible drug interactions. Obtain baseline LFTs and CBC w/ platelet and differential counts.


Monitor for agranulocytosis, aplastic anemia and other blood dyscrasias; dermatologic reactions; peripheral neuropathy; toxic hepatitis; cholestatic jaundice; hypersensitivity reactions; and other adverse reactions. Obtain CBCs weekly for the 1st month, monthly for 6 months, and semi-annually thereafter. Monitor LFTs.


Advise to elect a strict gluten-free diet to reduce or eliminate need for therapy. Advise about need for periodic blood tests. Instruct to report any adverse effects and to consult physician before taking any drug.


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


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