II. Indications

III. Contraindications

IV. Mechanism

  1. Synthetic derivative of di-amino-sulfone
  2. Antiinflammatory activity
    1. Interferes with Neutrophil adherence and chemotaxis and its oxidation damage via myeloperoxidase
  3. Antibacterial activity
    1. Analog of p-aminobenzoic acid (PABA)
    2. Inhibits dihydropteroate synthase (DHPS), and therefore Folate synthesis
    3. Reduced Folate results in reduced thymidylate needed for DNA synthesis

V. Dosing: Leprosy

  1. Combine with other agents
  2. Adult: 100 mg orally daily
  3. Child: 1 mg/kg (up to 100 mg) orally daily

VI. Dosing: Pneumocystis jiroveci (PJP, off-label)

  1. PCP Pneumonia prophylaxis
    1. Adult
      1. Dapsone 100 mg orally daily
    2. Child (age >=1 month)
      1. Dapsone 2 mg/kg (up to 100 mg) orally daily OR
      2. Dapsone 4 mg/kg/week (up to 200 mg) orally once weekly
  2. PCP Pneumonia treatment
    1. Dapsone 100 mg orally daily for 21 days
    2. Combine with other agents (e.g. trimethoprim 5 mg/kg orally three times daily)

VII. Adverse Effects

  1. Nausea or Vomiting
  2. Peripheral Neuropathy (rare)
  3. Hepatotoxicity
  4. Blood dyscrasias
    1. Hemoglobin decreased (1-2 grams)
    2. Reticulocytes increased (2-12%)
    3. Hemolysis in G6PD Deficiency
    4. Methemoglobinemia
  5. Renal effects
    1. Proteinuria or Albuminuria
    2. Nephrotic Syndrome
  6. Skin effects
    1. Photosensitivity (Sunburn risk)
    2. Erythema Nodosum leprosum in Leprosy treatment (50%)

VIII. Safety

  1. Pregnancy Category C
  2. Unknown safety in Lactation

IX. Monitoring

  1. Glucose-6-Phosphate Dehydrogenase Deficiency (G6PD)
    1. Screen for G6PD Deficiency before starting Dapsone
  2. Complete Blood Count
    1. Obtain baseline and monthly for at least 6 months (then twice yearly) while on Dapsone
  3. Liver Function Tests
    1. Obtain periodic levels

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Related Studies

Cost: Medications

dapsone (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
DAPSONE 100 MG TABLET Generic $1.02 each
DAPSONE 25 MG TABLET Generic $0.57 each
DAPSONE 5% GEL Generic $3.56 per gram
DAPSONE 7.5% GEL PUMP Generic $2.28 per gram

Ontology: Dapsone (C0010980)

Definition (CHV) a drug used to treat leprosy and skin infections
Definition (CHV) a drug used to treat leprosy and skin infections
Definition (CHV) a drug used to treat leprosy and skin infections
Definition (NCI) A synthetic derivative of diamino-sulfone with anti-inflammatory and anti-bacterial properties. As a structural analog of p-aminobenzoic acid (PABA), dapsone inhibits dihydropteroate synthase (DHPS), an enzyme important in folate synthesis, resulting in a depletion of the folate pool and a reduction in the amount of thymidylate available for DNA synthesis. Although the exact mechanism through which dapsone exerts its anti-inflammatory activity has yet to be fully elucidated, this agent interferes with the activation and oxidative damage of myeloperoxidase in neutrophils and inhibits the integrin-mediated adherence and chemotaxis of neutrophils. Dapsone's anti-inflammatory activities may contribute to the effects seen upon topical administration.
Definition (NCI_NCI-GLOSS) A drug used to treat acne. It is also used to treat other types of skin diseases and certain bacterial infections, such as leprosy. It blocks bacteria from making a substance that they need to grow. Dapsone is a type of antibacterial agent and a type of anti-inflammatory agent.
Definition (CSP) USP lists as a suppressant of dermatitis herpetiformis.
Definition (MSH) A sulfone active against a wide range of bacteria but mainly employed for its actions against MYCOBACTERIUM LEPRAE. Its mechanism of action is probably similar to that of the SULFONAMIDES which involves inhibition of folic acid synthesis in susceptible organisms. It is also used with PYRIMETHAMINE in the treatment of malaria. (From Martindale, The Extra Pharmacopoeia, 30th ed, p157-8)
Definition (PDQ) A synthetic derivative of diamino-sulfone with anti-mycobacterial and anti-malarial properties. A structural analog of p-aminobenzoic acid (PABA), dapsone inhibits dihydropteroate synthase (DHPS), an enzyme important in folate synthesis, resulting in a depletion of the folate pool and a reduction in the amount of thymidylate available for DNA synthesis. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=494629&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=494629&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C415" NCI Thesaurus)
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D003622
SnomedCT 17308007, 387096002
LNC LP17991-8, LP32038-9, MTHU024811
English 4,4'-Diaminophenyl Sulfone, DADPS, Diaminodiphenylsulfone, Diaphenylsulfone, Sulfone, 4,4'-Diaminophenyl, Sulfonyldianiline, 4,4' Diaminophenyl Sulfone, Bis(4-aminophenyl)sulfone, 4,4'-Sulfonylbisbenzeneamine, 4,4'-Sulfonyldianiline, 4,4'-Sulfonylbisbenzamine, Sulphadione, Sulfona-Mae, Croysulfone, Novophone, Dumitone, Diphenasone, dapsone, diaminodiphenylsulfone, diaminodiphenylsulfone (medication), diaminodiphenylsulfone (Dapsone), Dapsone [Chemical/Ingredient], DAPSONE, 4,4'-diaminodiphenylsulfone (DDS), Bis(4-aminophenyl) sulfone, Sulfona-MAE, 4,4'-Sulfonylbis[benzenamine], DDS, Dapsone (product), Dapsone (substance), Diaminodiphenylsulphone, Dapsone
Swedish Dapson
Czech dapson
Finnish Dapsoni
German Diaphenylsulfon, Dapson, Diaminodiphenylsulfon, Sulfonyldianilin
Russian DIAMINODIFENILSUL'FON, SUL'FONILDIANILIN, DAPSON, ДАПСОН, ДИАМИНОДИФЕНИЛСУЛЬФОН, СУЛЬФОНИЛДИАНИЛИН
Polish Dapson, Diaminodifenylosulfon
Japanese ジアフェニルスルホン, 4,4'-ジアフェニルスルホン, ジアミノジフェニルスルホン, スルホニルジアニリン, ダプソン
French 4,4'-Diaminodiphénylsulfone, Dapsone
Spanish dapsona (producto), dapsona (sustancia), dapsona, diaminodifenilsulfona, Dapsona, Diaminodifenilsulfona, Sulfonildianilina
Italian Dapsone
Portuguese Dapsona, Diaminodifenilssulfona, Sulfonildianilina