dapsone (Rx)

Brand and Other Names:
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

tablet

  • 25mg
  • 100mg

Dermatitis Herpetiformis

50 mg PO qDay, titrate to 300 mg qDay or higher to achieve desired effect

Reduce dose to minimum effective dose within the range of 50-300 mg qDay as soon as possible

Leprosy

100 mg PO qDay, in combination with other antileprosy drugs

Tuberculoid or Lepromatous Disease

100 mg PO qDay with rifampin 600 mg PO qDay

Pneumocystis (Carinii) Jiroveci (Off-label)

Prophylaxis

  • 100 mg PO qDay or divided BID as monotherapy, OR
  • 50 mg qDay in combination with weekly pyrimethamine and leucovorin

Treatment

  • 100 mg PO qDay in combination with trimethoprim for 21 days

Toxoplasmosis (Orphan)

Prophylaxis in severely immunocompromised patients (CD4 count <100)

Orphan indication sponsor

  • Jacobus Pharmaceutical Company, Inc; 37 Cleveland Lane, P.O. Box 5290; Princeton, NJ 08540

Dosage Forms & Strengths

tablet

  • 25mg
  • 100mg

Leprosy

1-2 mg/kg PO qDay; not to exceed 100 mg/day in combination with other antileprosy agents  

Dosing considerations

  • Administer for 3 years (minimum) in combination with multidrug regimen (ie, rifampin)

Pneumocystis (Carinii) Jiroveci (Off-label)

Prophylaxis

  • >1 month old: 2 mg/kg PO qDay; not to exceed 100 mg/day, OR  
  • 4 mg/kg/dose PO qWeek; not to exceed 200 mg/week
  • Adolescents: 100 mg PO qDay or divided BID as monotherapy, OR 50 mg qDay in combination with weekly pyrimethamine and leucovorin

Treatment

  • >1 month old: 2 mg/kg PO qDay in combination with trimethoprim for 21 days
  • Adolescents: 100 mg PO qDay in combination with trimethoprim for 21 days
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Interactions

Interaction Checker

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            Contraindicated (0)

              Serious - Use Alternative (22)

              • abametapir

                abametapir will increase the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. For 2 weeks after abametapir application, avoid taking drugs that are CYP3A4 substrates. If not feasible, avoid use of abametapir.

              • aluminum hydroxide

                aluminum hydroxide will decrease the level or effect of dapsone by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

              • apalutamide

                apalutamide will decrease the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration of apalutamide, a strong CYP3A4 inducer, with drugs that are CYP3A4 substrates can result in lower exposure to these medications. Avoid or substitute another drug for these medications when possible. Evaluate for loss of therapeutic effect if medication must be coadministered. Adjust dose according to prescribing information if needed.

              • BCG vaccine live

                dapsone decreases effects of BCG vaccine live by pharmacodynamic antagonism. Contraindicated. Wait until Abx Tx complete to administer live bacterial vaccine.

              • calcium carbonate

                calcium carbonate will decrease the level or effect of dapsone by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

              • dapsone topical

                dapsone, dapsone topical. unspecified interaction mechanism. Avoid or Use Alternate Drug. Avoid coadministration of dapsone topical with oral dapsone or antimalarial medications because of the potential for hemolytic reactions.

              • famotidine

                famotidine will decrease the level or effect of dapsone by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

              • fexinidazole

                fexinidazole will increase the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Fexinidazole inhibits CYP3A4. Coadministration may increase risk for adverse effects of CYP3A4 substrates.

              • ibuprofen/famotidine

                ibuprofen/famotidine will decrease the level or effect of dapsone by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

              • idelalisib

                idelalisib will increase the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Idelalisib is a strong CYP3A inhibitor; avoid coadministration with sensitive CYP3A substrates

              • ivosidenib

                ivosidenib will decrease the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of sensitive CYP3A4 substrates with ivosidenib or replace with alternate therapies. If coadministration is unavoidable, monitor patients for loss of therapeutic effect of these drugs.

                ivosidenib will decrease the level or effect of dapsone by affecting hepatic enzyme CYP2C9/10 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of sensitive CYP2C9 substrates with ivosidenib or replace with alternate therapies. If coadministration is unavoidable, monitor patients for loss of therapeutic effect of these drugs.

              • lansoprazole

                lansoprazole will decrease the level or effect of dapsone by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

              • lonafarnib

                lonafarnib will increase the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration with sensitive CYP3A substrates. If coadministration unavoidable, monitor for adverse reactions and reduce CYP3A substrate dose in accordance with product labeling.

              • mefloquine

                mefloquine increases toxicity of dapsone by unspecified interaction mechanism. Avoid or Use Alternate Drug. Increased risk of hemolytic reactions.

              • nefazodone

                nefazodone will increase the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

              • saquinavir

                saquinavir will increase the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

              • selinexor

                dapsone, selinexor. unspecified interaction mechanism. Avoid or Use Alternate Drug. Patients treated with selinexor may experience neurological toxicities. Avoid taking selinexor with other medications that may cause dizziness or confusion.

              • sodium bicarbonate

                sodium bicarbonate will decrease the level or effect of dapsone by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

              • sodium citrate/citric acid

                sodium citrate/citric acid will decrease the level or effect of dapsone by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

              • tucatinib

                tucatinib will increase the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid concomitant use of tucatinib with CYP3A substrates, where minimal concentration changes may lead to serious or life-threatening toxicities. If unavoidable, reduce CYP3A substrate dose according to product labeling.

              • typhoid vaccine live

                dapsone decreases effects of typhoid vaccine live by pharmacodynamic antagonism. Contraindicated. Wait until Abx Tx complete to administer live bacterial vaccine.

              • voxelotor

                voxelotor will increase the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Voxelotor increases systemic exposure of sensitive CYP3A4 substrates. Avoid coadministration with sensitive CYP3A4 substrates with a narrow therapeutic index. Consider dose reduction of the sensitive CYP3A4 substrate(s) if unable to avoid.

              Monitor Closely (51)

              • apalutamide

                apalutamide will decrease the level or effect of dapsone by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. Coadministration of apalutamide, a weak CYP2C9 inducer, with drugs that are CYP2C9 substrates can result in lower exposure to these medications. Evaluate for loss of therapeutic effect if medication must be coadministered.

              • bazedoxifene/conjugated estrogens

                dapsone will decrease the level or effect of bazedoxifene/conjugated estrogens by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.

              • belzutifan

                belzutifan will decrease the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. If unable to avoid coadministration of belzutifan with sensitive CYP3A4 substrates, consider increasing the sensitive CYP3A4 substrate dose in accordance with its prescribing information.

              • bupivacaine implant

                dapsone, bupivacaine implant. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Local anesthetics may increase the risk of developing methemoglobinemia when concurrently exposed to drugs that also cause methemoglobinemia.

              • cannabidiol

                cannabidiol will increase the level or effect of dapsone by decreasing metabolism. Modify Therapy/Monitor Closely. Cannabidiol may potentially inhibit CYP2C9 activity. Consider reducing the dose when concomitantly using CYP2C9 substrates.

              • carbamazepine

                carbamazepine will decrease the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • cenobamate

                cenobamate will decrease the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Increase dose of CYP3A4 substrate, as needed, when coadministered with cenobamate.

              • clarithromycin

                clarithromycin will increase the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • cobicistat

                cobicistat will increase the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • conjugated estrogens

                dapsone will decrease the level or effect of conjugated estrogens by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.

              • crizotinib

                crizotinib increases levels of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.

              • crofelemer

                crofelemer increases levels of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Crofelemer has the potential to inhibit CYP3A4 at concentrations expected in the gut; unlikely to inhibit systemically because minimally absorbed.

              • dabrafenib

                dabrafenib will decrease the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.

              • deferasirox

                deferasirox will decrease the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • didanosine

                didanosine increases toxicity of dapsone by unknown mechanism. Use Caution/Monitor. May increase risk of nerve damage.

              • digoxin

                dapsone will increase the level or effect of digoxin by altering intestinal flora. Applies only to oral form of both agents. Use Caution/Monitor.

              • efavirenz

                efavirenz will decrease the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • elagolix

                elagolix will decrease the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Elagolix is a weak-to-moderate CYP3A4 inducer. Monitor CYP3A substrates if coadministered. Consider increasing CYP3A substrate dose if needed.

              • elvitegravir/cobicistat/emtricitabine/tenofovir DF

                elvitegravir/cobicistat/emtricitabine/tenofovir DF increases levels of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Cobicistat is a CYP3A4 inhibitor; contraindicated with CYP3A4 substrates for which elevated plasma concentrations are associated with serious and/or life-threatening events.

                elvitegravir/cobicistat/emtricitabine/tenofovir DF decreases levels of dapsone by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. Elvitegravir is a moderate CYP2C9 inducer.

              • encorafenib

                encorafenib, dapsone. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Encorafenib both inhibits and induces CYP3A4 at clinically relevant plasma concentrations. Coadministration of encorafenib with sensitive CYP3A4 substrates may result in increased toxicity or decreased efficacy of these agents.

              • enzalutamide

                enzalutamide will decrease the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • erythromycin base

                erythromycin base will increase the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • erythromycin ethylsuccinate

                erythromycin ethylsuccinate will increase the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • erythromycin lactobionate

                erythromycin lactobionate will increase the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • erythromycin stearate

                erythromycin stearate will increase the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • estradiol

                dapsone will decrease the level or effect of estradiol by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.

              • estrogens conjugated synthetic

                dapsone will decrease the level or effect of estrogens conjugated synthetic by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.

              • estropipate

                dapsone will decrease the level or effect of estropipate by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.

              • fedratinib

                fedratinib will increase the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Adjust dose of drugs that are CYP3A4 substrates as necessary.

              • iloperidone

                iloperidone increases levels of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Iloperidone is a time-dependent CYP3A inhibitor and may lead to increased plasma levels of drugs predominantly eliminated by CYP3A4.

              • isoniazid

                isoniazid will increase the level or effect of dapsone by affecting hepatic enzyme CYP2E1 metabolism. Use Caution/Monitor.

                isoniazid will increase the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • istradefylline

                istradefylline will increase the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Istradefylline 40 mg/day increased peak levels and AUC of CYP3A4 substrates in clinical trials. This effect was not observed with istradefylline 20 mg/day. Consider dose reduction of sensitive CYP3A4 substrates.

              • ketoconazole

                ketoconazole will increase the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • letermovir

                letermovir increases levels of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • lorlatinib

                lorlatinib will decrease the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • lumacaftor/ivacaftor

                lumacaftor/ivacaftor, dapsone. affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. In vitro studies suggest that lumacaftor may induce and ivacaftor may inhibit CYP2C9 substrates. .

              • mestranol

                dapsone will decrease the level or effect of mestranol by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.

              • methotrexate

                dapsone, methotrexate. Other (see comment). Use Caution/Monitor. Comment: Combination may increase risk of hematologic toxicity.

              • mifepristone

                mifepristone will increase the level or effect of dapsone by Other (see comment). Use Caution/Monitor. Inhibits CYP2C8/2C9; use smallest recommended doses for substrates and monitor

              • mitotane

                mitotane decreases levels of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Mitotane is a strong inducer of cytochrome P-4503A4; monitor when coadministered with CYP3A4 substrates for possible dosage adjustments.

              • nitisinone

                nitisinone will increase the level or effect of dapsone by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. Nitisinone inhibits CYP2C9. Caution if CYP2C9 substrate coadministered, particularly those with a narrow therapeutic index.

              • peginterferon alfa 2b

                peginterferon alfa 2b decreases levels of dapsone by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. When patients are administered peginterferon alpha-2b with CYP2C9 substrates, the therapeutic effect of these drugs may be altered.

              • rifabutin

                rifabutin will decrease the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • rifampin

                rifampin will decrease the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • sodium picosulfate/magnesium oxide/anhydrous citric acid

                dapsone decreases effects of sodium picosulfate/magnesium oxide/anhydrous citric acid by altering metabolism. Use Caution/Monitor. Coadministration with antibiotics decreases efficacy by altering colonic bacterial flora needed to convert sodium picosulfate to active drug.

              • St John's Wort

                St John's Wort will decrease the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • stiripentol

                stiripentol, dapsone. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Stiripentol is a CYP3A4 inhibitor and inducer. Monitor CYP3A4 substrates coadministered with stiripentol for increased or decreased effects. CYP3A4 substrates may require dosage adjustment.

              • tazemetostat

                tazemetostat will decrease the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • tecovirimat

                tecovirimat will decrease the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Tecovirimat is a weak CYP3A4 inducer. Monitor sensitive CYP3A4 substrates for effectiveness if coadministered.

              • teriflunomide

                teriflunomide increases levels of dapsone by Other (see comment). Use Caution/Monitor. Comment: Teriflunomide inhibits CYP2C8; caution when coadministered with CYP2C8 substrates.

              • tetracaine

                tetracaine, dapsone. Other (see comment). Use Caution/Monitor. Comment: Monitor for signs of methemoglobinemia when methemoglobin-inducing drugs are coadministered.

              Minor (73)

              • alpelisib

                alpelisib will decrease the level or effect of dapsone by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.

              • amobarbital

                amobarbital will decrease the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • aprepitant

                aprepitant will increase the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • armodafinil

                armodafinil will decrease the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • artemether/lumefantrine

                artemether/lumefantrine will decrease the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • atazanavir

                atazanavir will increase the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • balsalazide

                dapsone will decrease the level or effect of balsalazide by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.

              • biotin

                dapsone will decrease the level or effect of biotin by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.

              • bosentan

                bosentan will decrease the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • budesonide

                budesonide will decrease the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • butabarbital

                butabarbital will decrease the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • butalbital

                butalbital will decrease the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • conivaptan

                conivaptan will increase the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • cortisone

                cortisone will decrease the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • cyclosporine

                cyclosporine will increase the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • darifenacin

                darifenacin will increase the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • darunavir

                darunavir will increase the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • dasatinib

                dasatinib will increase the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • dexamethasone

                dexamethasone will decrease the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • DHEA, herbal

                DHEA, herbal will increase the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • disulfiram

                disulfiram will increase the level or effect of dapsone by affecting hepatic enzyme CYP2E1 metabolism. Minor/Significance Unknown.

              • dronedarone

                dronedarone will increase the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • eslicarbazepine acetate

                eslicarbazepine acetate will decrease the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • ethanol

                ethanol will decrease the level or effect of dapsone by affecting hepatic enzyme CYP2E1 metabolism. Minor/Significance Unknown.

              • etravirine

                etravirine will decrease the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • fluconazole

                fluconazole will increase the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • fludrocortisone

                fludrocortisone will decrease the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • fosamprenavir

                fosamprenavir will increase the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • fosphenytoin

                fosphenytoin will decrease the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • ganciclovir

                ganciclovir increases toxicity of dapsone by pharmacodynamic synergism. Minor/Significance Unknown.

              • grapefruit

                grapefruit will increase the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • griseofulvin

                griseofulvin will decrease the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • hydrocortisone

                hydrocortisone will decrease the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • indinavir

                indinavir will increase the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • lapatinib

                lapatinib will increase the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • lumefantrine

                lumefantrine will decrease the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • marijuana

                marijuana will increase the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • methylprednisolone

                methylprednisolone will decrease the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • metronidazole

                metronidazole will increase the level or effect of dapsone by affecting hepatic enzyme CYP2E1 metabolism. Minor/Significance Unknown.

                metronidazole will increase the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • miconazole vaginal

                miconazole vaginal will increase the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • modafinil

                modafinil will decrease the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • nelfinavir

                nelfinavir will increase the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • nevirapine

                nevirapine will decrease the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • nifedipine

                nifedipine will increase the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • nilotinib

                nilotinib will increase the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • oxcarbazepine

                oxcarbazepine will decrease the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • pantothenic acid

                dapsone will decrease the level or effect of pantothenic acid by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.

              • pentobarbital

                pentobarbital will decrease the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • phenobarbital

                phenobarbital will decrease the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • phenytoin

                phenytoin will decrease the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • posaconazole

                posaconazole will increase the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • prednisone

                prednisone will decrease the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • primaquine

                primaquine, dapsone. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of hemolysis in G6PD deficient pts.

              • primidone

                primidone will decrease the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • probenecid

                probenecid increases levels of dapsone by decreasing elimination. Minor/Significance Unknown.

              • pyridoxine

                dapsone will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.

              • pyridoxine (Antidote)

                dapsone will decrease the level or effect of pyridoxine (Antidote) by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.

              • pyrimethamine

                dapsone, pyrimethamine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Increased bone marrow toxicity.

              • quinupristin/dalfopristin

                quinupristin/dalfopristin will increase the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • ribociclib

                ribociclib will increase the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • rifapentine

                rifapentine will decrease the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • ritonavir

                ritonavir will increase the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • rufinamide

                rufinamide will decrease the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • secobarbital

                secobarbital will decrease the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • sulfamethoxazole

                sulfamethoxazole, dapsone. Either increases levels of the other by decreasing elimination. Minor/Significance Unknown.

              • thiamine

                dapsone will decrease the level or effect of thiamine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.

              • topiramate

                topiramate will decrease the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • trimethoprim

                trimethoprim, dapsone. Either increases levels of the other by decreasing elimination. Minor/Significance Unknown.

              • valganciclovir

                valganciclovir increases toxicity of dapsone by pharmacodynamic synergism. Minor/Significance Unknown.

              • verapamil

                verapamil will increase the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • voriconazole

                voriconazole will increase the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • zafirlukast

                zafirlukast will increase the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • zidovudine

                zidovudine, dapsone. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Increased bone marrow toxicity.

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              Adverse Effects

              1-10%

              Hemolysis

              Methemoglobinemia

              <1%

              Reactional states (ie, abrupt changes in clinical activity occurring during any leprosy treatment; classified as reversal of erythema nodosum leprosum reactions)

              Insomnia

              Headache

              Exfoliative dermatitis

              Photosensitivity

              Nausea

              Vomiting

              Anemia

              Leukopenia

              Agranulocytosis

              Hepatitis

              Cholestatic jaundice

              Peripheral neuropathy (usually in nonleprosy patients)

              Blurred vision

              Tinnitus

              SLE

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              Warnings

              Contraindications

              Hypersensitivity to drug or component

              Cautions

              May cause blood dyscrasias (eg, agranulocytosis); monitor closely

              Peripheral neuropathy may occur

              Toxic epidermal necrolysis and other dermatologic reactions may occur

              Use caution when treating patients with hypersensitivity to sulfonamides

              Bacterial and fungal superinfections may occur from prolonged treatments

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              Pregnancy & Lactation

              Pregnancy category: C

              Lactation: Enters breast milk; not recommended (AAP Committee states "compatible with nursing")

              Pregnancy Categories

              A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

              B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

              C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

              D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

              X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

              NA: Information not available.

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              Pharmacology

              Mechanism of Action

              Sulfone; prevents normal bacterial utilization of para-aminobenzoic acid (PABA) for the synthesis of folic acid by acting as a competitive antagonist of PABA; it is bactericidal and bacteriostatic against Mycobacterium leprae

              Absorption

              Well absorbed

              Peak plasma time: 4-8 hr (after ingestion)

              Distribution

              Protein bound: 70-90% (dapsone); 99% (metabolite)

              Vd: 1.5 L/kg; throughout total body water and present in all tissues, especially liver and kidney

              Metabolism

              Hepatic P450 enzymes CYP2E1, CYP3A4

              Elimination

              Half-life: 28 hr

              Excretion: Urine (85%) as metabolites

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              Images

              BRAND FORM. UNIT PRICE PILL IMAGE
              dapsone oral
              -
              25 mg tablet
              dapsone oral
              -
              100 mg tablet
              dapsone oral
              -
              100 mg tablet
              dapsone oral
              -
              25 mg tablet
              dapsone oral
              -
              100 mg tablet
              dapsone oral
              -
              100 mg tablet
              dapsone oral
              -
              100 mg tablet
              dapsone oral
              -
              25 mg tablet
              dapsone oral
              -
              25 mg tablet
              dapsone topical
              -
              5 % gel
              dapsone topical
              -
              5 % gel
              dapsone topical
              -
              7.5 % gel
              dapsone topical
              -
              7.5 % gel
              Aczone topical
              -
              5 % gel
              Aczone topical
              -
              7.5 % gel
              Aczone topical
              -
              7.5 % gel
              Aczone topical
              -
              7.5 % gel
              Aczone topical
              -
              5 % gel

              Copyright © 2010 First DataBank, Inc.

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              Patient Handout

              Select a drug:
              Patient Education
              dapsone oral

              DAPSONE - ORAL

              (DAP-sone)

              COMMON BRAND NAME(S): Avlosulfon

              USES: This medication is used to treat a certain type of skin disorder (dermatitis herpetiformis). It is also used with other drugs to treat Hansen's disease. Dapsone belongs to a class of drugs known as sulfones. It works by decreasing swelling (inflammation) and stopping the growth of bacteria.This medication will not work for viral infections (e.g., common cold, flu). Unnecessary use or misuse of any antibiotic can lead to its decreased effectiveness.

              HOW TO USE: Take this medication by mouth with or without food, usually once daily or as directed by your doctor.Medications for heartburn/reducing stomach acid (e.g., large amounts of antacids, ranitidine, famotidine), or didanosine may prevent full absorption of dapsone into your bloodstream, possibly reducing its effectiveness. Separate your dose of dapsone from your doses of any of these products by at least 2 hours. Ask your doctor or pharmacist for more details.If you are taking dapsone for a skin disorder, your doctor may start you on a low dose of dapsone and gradually adjust your dose to control your disease. If you are taking this medication to treat Hansen's disease or to prevent infections due to HIV, the drug is usually taken for years or for life.Dosage is based on your medical condition and response to treatment. In children, the dosage is also based on age and weight.For the best effect, take this antibiotic at evenly spaced times. To help you remember, take this medication at the same time(s) every day.Tell your doctor if your condition worsens.

              SIDE EFFECTS: Nausea, vomiting, loss of appetite, dizziness, or blurred vision may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: unusually fast heartbeat, unusually fast breathing, bluish lips/skin, chest pain, mental/mood changes, muscle weakness, difficulty urinating.This drug may rarely cause very serious low blood counts (bone marrow suppression) or liver disease. Seek immediate medical attention if you develop signs of an infection (e.g., fever, chills, persistent sore throat), easy bruising/bleeding, unusual tiredness, pale skin, yellowing eyes/skin, dark urine, stomach/abdominal pain.Dapsone can commonly cause a rash that is usually not serious. However, you may not be able to tell it apart from a rare rash that could be a sign of a severe reaction. Seek immediate medical attention if you develop any rash.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

              PRECAUTIONS: Before taking dapsone, tell your doctor or pharmacist if you are allergic to it; or to similar drugs such as sulfoxone; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: certain blood disorders (e.g., anemia, G6PD deficiency, methemoglobin reductase deficiency), liver disease, heart disease, lung disease, serious infection, very high blood sugar (diabetic ketosis).If using this drug to treat Hansen's disease, note that as your immune system helps fight the infection, you may notice skin sores worsening, and numbness/pain/tingling or muscle weakness. This may require special treatment, so tell your doctor right away if these symptoms occur.This drug may make you dizzy. Alcohol or marijuana (cannabis) can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.This medication passes into breast milk and may have undesirable effects on a nursing infant. Consult your doctor before breast-feeding.

              DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug are: folic acid antagonists (such as pyrimethamine), nitrofurantoin, primaquine.Other medications can affect the removal of dapsone from your body, which may affect how dapsone works. An example is saquinavir, among others.

              OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: seizures, bluish skin (cyanosis), sudden vision changes, sudden loss of vision.

              NOTES: Do not share this medication with others.Laboratory and/or medical tests (e.g., complete blood counts/platelets, liver function tests) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.Iron, folic acid, and vitamin C might reduce the risk of developing a certain serious side effect (anemia). Ask your doctor for more details.If you are using dapsone for dermatitis herpetiformis, a gluten-free diet may improve the condition. Consult your doctor for more information.

              MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

              STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

              Information last revised August 2021. Copyright(c) 2021 First Databank, Inc.

              IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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              Formulary

              FormularyPatient Discounts

              Adding plans allows you to compare formulary status to other drugs in the same class.

              To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

              Adding plans allows you to:

              • View the formulary and any restrictions for each plan.
              • Manage and view all your plans together – even plans in different states.
              • Compare formulary status to other drugs in the same class.
              • Access your plan list on any device – mobile or desktop.

              The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

              Tier Description
              1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
              2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
              3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
              4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              NC NOT COVERED – Drugs that are not covered by the plan.
              Code Definition
              PA Prior Authorization
              Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
              QL Quantity Limits
              Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
              ST Step Therapy
              Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
              OR Other Restrictions
              Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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              Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.