Dapsone

Background

• Diamino-diphenyl sulfone

Indications

• Second-line PJP prophylaxis (CD4 <200)
• Rifampicin and clofazimine as multidrug therapy (MDT) for the treatment of Mycobacterium leprae

Dosing

• Dermatitis herpetiformis:
  • Start at 50 mg PO daily, increase to 300 mg daily in 25 mg increments every 1 to 2 weeks, up to 2 mg/kg/dose
  • Pruritus usually improves within 72 hours, and the skin manifestations typically resolve within days
  • After 2-3 months of gluten-free diet, start tapering by 25 mg every four to six weeks
• PJP prophylaxis (primary or secondary):
  • 100 mg PO once daily or in 2 divided doses as monotherapy
  • Continue until CD4 count >200 cells/mm3 for >3 months
• PJP treatment: 100 mg PO once daily in combination with trimethoprim for 21 days

Safety

• Check CBC, liver, and G6PD deficiency before starting