dr samiullah khalil peshawar pakistan

2. Dr samiullah khalil
Fcps (II)
Trainee
Dermatology

3.  In the early 20th century, it is invented by the German chemist Paul
Ehrlich while working on selective toxicity .
 Dapsone (diamino-diphenyl sulfone)
is a medication most commonly used
in combination with rifampicin and
clofazimine as multidrug therapy
(MDT) for the treatment of
Mycobacterium leprae infections (leprosy).
 Official in IP,BP,USP.

4. 4,4’-diaminodiphenylsulfone

6. 1. Absorption
 It is completely absorbed after oral administration
2. Distribution
 Approximately 70% bound to plasma protein. The main
metabolite, monoacetyl dapsone, is nearly 100% protein
bound.

7.  After oral administration the drug is mainly
eliminated by kidney.20 percent is excreted
unchanged while 80 percent as derivatives.
 Only minor amount is excreted in faeces .
 Bile: 10% of an oral dose was found in the bile
 Breast-milk: Dapsone is excreted in breast milk

8.  Plasma concentration of Dapsone is reduced by Rafampicin.
 Plasma concentration of both drugs may increase when
Dapsone given with Trimethoprim.
 This medication may decrease the effectiveness of combination-
type birth control pills.
This can result in pregnancy.

9.  Mycobacterium leprae infections
(leprosy)./hansen’s disease
 Linear Ig A Bullous disease
 Acne.
 Vasculitis
 Sweet syndrome
 Mycetoma

10.  Pyoderma Gangrenosum
 Apthous ulceration
 Granuloma Annulare
 Pneumocystis pneumonia.
 Dermatitis Herpetiformis.
 Toxoplasmosis - Prophylaxis

11. DISEASE ADULT CHILDREN DAYS
Leprosy - Lepromatous 50-100 mg/day 6-10 mg/day 2-5 years
Leprosy - Tuberculoid 100 mg/day NA 6 months
Dermatitis Herpetiformis 50-300 mg/day NA Life long basis
Pneumocystis Pneumonia 100 mg/day 2 mg/kg/day 14-21 days
Pneumocystis Pneumonia 100 mg/day 2 mg/kg/day Life long basis
Prophylaxis
Toxoplasmosis - Prophylaxis 100 mg/day 2 mg/kg/day Life long basis

12. TRANSDERMAL DOSE
 Administered transdermally
 As a gel 5% topical acne medication
 available in 3-, 30-, and 60-gram tubes.
 In normal use, 0.5 grams should be administered
to the face per application twice a day.

13.  Mild haemolytic anaemia (decreases with
use of Vit C or Vit E ).
 Gastric intolerance-nausea & anorexia
 Methaemoglobinaemia (treated with Cemitidine) , headache,
paresthesias, mental symptoms & drug fever
 allergic rashes, fixed drug eruption, hypermelanosis,
phototoxicity& rarely exfoliative dermatitis, steven Jhonsen
syndrome.
 Hepatitis & agranulocytosis

14.  Uncommonly weakness of the feet and
hands muscles with dose greater then
100 mg/day
 It is tested by ability to walk on toes tip and to test
Hand grip.
 Leucopenia presents with fever ,sore throat ,skin infections
and other common infections.
 Bluish discoloration of lips and finger tips
 Dapsone reaction/sulfone syndrome

15.  Hypersensitivity
 more frequent in patients receiving multiple-drug therapy.
 The reaction involves a rash and may also include
fever, jaundice, and eosinophilia.
 Swollen lymph glands and internal organ failure (Liver
, Lungs , Heart and Kidney).
 In general, these symptoms will occur within the first six
weeks of therapy or not at all, and may be treated by
corticosteroid therapy.

16.  Allergic to sulphur containing antibiotics
 G6PD deficiency
 Heart diseases
 Lung diseases
 Breast feeding
 Pregnancy
 Porphyria

17.  FBC before the start of the therapy
 Then at 1 week
 Then once monthly