Dapsone
ACZONE
What it isSulfone inhibiting dihydropteroate synthase; leprosy, dermatitis herpetiformis and PJP prophylaxis.
Why this oneIt is the treatment of choice for dermatitis herpetiformis, with a response within days.
What limits itHemolysis, severe in G6PD deficiency, and methemoglobinemia. Check G6PD before starting.
FDA-approved for
- leprosy/dermatitis herpetiformis (~1955)
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Dermatitis herpetiformis | Adults | 50 mg QD | 50-300 mg QD | >300 mg QD if uncontrolled |
| Leprosy (multidrug therapy) | Adults | 100 mg QD | 100 mg QD | 100 mg QD |
Renal Undefined
Hepatic Undefined
Instructions
- Individually titrate to minimum effective maintenance dose.
- In dermatitis herpetiformis a strict gluten-free diet may permit dose reduction/elimination.
- Combine with one or more anti-leprosy drugs to reduce resistance.
Cautions
- Dose-related hemolysis (with or without G6PD deficiency); greater in G6PD deficiency
- Methemoglobinemia
- Peripheral neuropathy (predominantly motor) — withdraw if muscle weakness
- Falsely reduced HbA1c
Adverse reactions
- Hemolysis / hemolytic anemia
- Methemoglobinemia
- Peripheral neuropathy
Pregnancy May be given in pregnancy only if clearly needed (no controlled human data; uncontrolled experience has not shown increased fetal risk).
Lactation Undefined
NO BOXED WARNINGS
Principal riskHemolysis, severe in G6PD deficiency
Cost, est. cash$10–$300/month
Generic entry2016
Classes and tags
Clinical profile
Legacy pregnancy categoryUnknown / historical label unavailable
Defining liabilityGenerally tolerated at therapeutic doses; clinically important risks are agent-specific and increase with interactions or organ impairment.
Mechanism of action: Dapsone ballicule
