Clofazimine (Oral)

Clofazimine is a leprostatic agent that may be administered alone or along with other medication to treat leprosy.

Overview

The primary objective of Clofazimine is to treat leprosy or Hansen's disease. The drug works by undermining Mycobacterium leprae (M. leprae), the bacteria responsible for leprosy. A patient may take the pill along with others as prescribed to improve leprosy symptoms/effects such as mutilating skin sores and nerve damage. The medication is not for use on an empty stomach.

Clofazimine controls inflammation too. Similarly, a patient may take it to minimize the risk or severity of erythema nodosum leprosum'a leprosy reaction that usually occurs over the course of treatment. Some clinical trials suggest a degree of success in using Clofazimine to neutralize certain tuberculosis bacteria that are defiant to numerous first-line anti-TB medical remedies. The treatment certainly helps make life easier for a patient suffering from leprosy caused by several bacteria.

Conditions treated

  • style="font-weight: 400;">Leprosy
  • Severe erythema nodosum leprosum
  • Multidrug-resistant TB
  • Multiple-bacteria leprosy

Type of Medicine

  • Leprostatic agent

Side effects

Just like with most other drugs, a patient on Clofazimine may experience specific undesired effects. Some of the side-effects are serious enough to warrant a doctor's attention, while others pose no safety risks to the patient unless they persist. As a general rule of thumb, a patient should see their physician for remedial advice when they start noticing Clofazimine side-effects whose health effects they do not know.

It is imperative that medical attention is sought when a patient discovers traces of blood in their feces, which can occur after taking Clofazimine. For example, red, black, or tarry stools are indicative of a severe underlying bleeding complication that may escalate without treatment. Similarly, the anti-leprosy drug can cause depression, stomach pain, and change of skin/eye color to yellow or orange'all of which warrant urgent medical intervention.

Ordinarily, the majority of patients using Clofazimine to treat leprosy do not experience severe adverse effects that would require sharing with their caregivers. Such patients usually go through non-threatening conditions like diarrhea, nausea/vomiting, or change of skin/eye color to brownish black. An individual may also lose appetite or have their skin develop rashes, itching, dryness, or even scales.

Most of these common side-effects are easy to manage and treat as a patient continues to take their recommended dose of Clofazimine. However, it becomes necessary to report to a healthcare practitioner any seemingly mild Clofazimine body reaction that fails to go away on its own. For instance, loss of appetite may initially seem inconsequential, but failure to eat enough compromises a patient's ability to make the most out of their anti-leprosy medication.

Still, using Clofazimine can have infrequent, persistent, but harmless outcomes on a patient. A case in point is discolored feces, sweat, urine, and tears. Typically, a patient needs not report such side-effects to their physician, even if they do not go away. There is also a very remote possibility of experiencing a strange test in the mouth, skin discomfort on exposure to sunlight, or irritating/burning eyes.

Dosage

Clofazimine is a prescription-only drug, meaning that leprosy patients cannot just source it over the counter. There are many genuine reasons as to why access to the drug is highly restricted, including the fact that its dosage requirements differ from patient to patient. As such, taking the right dosage is a question of patient safety that only a well-trained, qualified, and experienced healthcare practitioner can evaluate appropriately.

A doctor may recommend from 50 to 100 milligrams of Clofazimine per day to adults and teenagers. The dosage is usually a part of a multidrug regimen to manage and treat Hansen's disease. Typically, the practitioner first assesses the health situation of an individual patient as well as their potential allergic reactions and drug interactions. After an individualized scrutiny of the patient, the physician then determines the dosage that is effective as well as safe to administer.

It is important to note that children with leprosy may also benefit from the Clofazimine treatment. However, only a doctor can examine an affected minor and decide the strength of the anti-leprosy drug and frequency of use that is right to prescribe to them. Even the manufacturer's dosage instructions on the label are often ignored when it comes to treating a minor with leprosy.

Treating leprosy with Clofazimine requires relentless personal commitment on the part of the patient to avoid skipping a dose or giving up the medication prematurely. Some patients have to continue using the drug for the rest of their life, at least to keep symptoms in check and live more comfortably day to day. Others have to use it daily for two good years for the condition to disappear once and for all.

There is always the temptation to stop using the medication once a patient begins to feel better, but doing so often leads to the relapse of leprosy symptoms. Any return of such discomforts and pain could mean that all previous gains in recovery have gone down the drain, sometimes making it necessary for a patient to begin their dose/ treatment from square one.

A patient should always try their best (including setting up reminders and liaising closely with their caregiver) to avoid missing any dose of Clofazimine. However, they may compensate for a missed dose by taking the medication at their earliest next opportunity. When the timing is too late to make up for a missed dosage, the patient should just skip it all together and wait to take the almost due next dose.

Otherwise, the patient would be risking double dosing with potentially dangerous health ramifications.

Another reason why a patient should strictly adhere to their dosage schedule is that doing so contributes to the stability of blood volume in their system. In turn, a consistent amount of blood provides the best conditions to optimize the therapeutic actions of Clofazimine.

Important drug interactions

Any doctor treating a patient for leprosy using Clofazimine must first assess their medical history regarding any previous/co-existing health disorders along with the drugs the patient is using. Such a background check on a patient is necessary to ensure they are not on medication that is incompatible with the recommended leprosy drug. It is also essential to establish that Clofazimine will have no adverse effect on any other condition the patient may currently have besides leprosy.

There are usually two viable options in case a physician establishes the possibility of dangerous interactions between Clofazimine and another drug that their patient cannot avoid taking. One option is for the patient to have a smaller dose of one or both of the drugs. Alternatively, the frequency of the dosage for one or each of the medications may be tweaked.

Some of the medications that may bring undesirable consequences when taken along with Clofazimine include:

  • Bedaquiline
  • Aluminum Hydroxide
  • Fosphenytoin
  • Magnesium Hydroxide
  • Phenytoin

Noteworthy is the fact that any known adverse interactions between Clofazimine and another drug a patient is using do not necessarily mean that the two options are off the table as far as safe treatment is concerned. Both the patient and their doctor weigh the drug interactions in question against the promise of effective treatment before deciding what to do. In case the risks are too extreme, another anti-leprosy drug may suffice.

Clofazimine may also have interactions with certain beverages and foods. So it is essential to seek a doctor's directive regarding what works best and safest for the patient. For example, orange juice may react with the drug and cause unpleasant side-effects. Likewise, a patient who uses alcohol or tobacco should discuss with their doctor the possible implications of their lifestyle on the effectiveness and safety of Clofazimine.

Warnings

There is a chance that Clofazimine may not be working as it should in the treatment of leprosy if it has been three months since a patient started using it but no symptom improvements have come up so far. In that case, the patient should see a doctor right away. At the same time, escalation of the condition several months into taking anti-leprosy medication warrants urgent medical intervention.

Besides, there is an indirect link between Clofazimine and depression in patients using the medication. A patient is urged to speak to their physician and if necessary, a psychiatrist, if they are experiencing depression upon taking the anti-leprosy medicines. Typically, a patient may enter that desperate state of mind in response to the skin discoloration Clofazimine causes a couple of weeks after they start taking the treatment.

Depression related to the use of anti-leprosy treatment calls for immediate psychological intervention because it can get worse. In some extreme case, depressed patients have entirely lost their sense of self-worth, paving the way for suicidal thoughts.

Similarly, Clofazimine is known to compromise alertness levels. As such, the drug is not ideal for use on-the-job, especially where personal and everyone else' safety is contingent on the user's excellent capacity for attention to detail. It also causes lightheadedness and drowsiness, making it vital for a patient to avoid any dangerous activity, such as riding a motorbike, driving, or operating a machine, when on this medication.

In case some side-effects of Clofazimine make it difficult or impossible to work as would be reasonably possible, the patient should consult their healthcare provider for guidance. Probably, an adjustment of the dosage may reduce the severity of drug effects like dizziness. If these unfavorable treatment results are unbearable for a patient's day-to-day life, medical intervention may also be necessary.

Also, some patients may have to avoid exposure to sunlight after taking Clofazimine. Such patients have sensitive skin that develops discoloration, rashes, itching, or even acute sunburn. However, under no circumstances should a patient with such skin sensitivity utilize a sunlamp or tanning booth. They are also advised to find shelter/shade when the sun is hot out there, if convenient.

Equally critical, a leprosy patient who also has liver disease should let their doctor know about it before any treatment can begin. Although extremely rare, Clofazimine may trigger hepatitis and liver disease. The medication is more likely to aggravate any such pre-existing conditions in an individual with leprosy.

People with a medical record of stomach or intestinal disorders should likewise exercise caution before taking Clofazimine. While it is common for the drug to cause mild, manageable stomach upsets, it rarely leads to incidences of acute, extreme abdominal pain. In such cases, it is likely that the medication has a side-effect that both the doctor and their patient should establish soon enough.

Storage

It goes without saying that the potency and safety of any drug, including Clofazimine, is affected by the temperature conditions of its storage area. As such, room temperature storage helps preserve the quality, properties, and ultimately, efficacy of Clofazimine before its date of expiry. Exposure to household sources of heat, including burners and cookers, should be avoided. Likewise, the drug should be kept away from direct light, including sunlight, which can heat and destroy it.

Freezing temperatures are a big no for Clofazimine. The same is true for water and moisture, which are guaranteed to damage the medicine. The medication must be put away in not-so-obvious places every time after use to promote the safety of kids. Similarly, capsules should be safely discarded upon expiry or once no longer in use.

Summary

Clofazimine is a leprostatic agent that gives a new lease of life to people struggling with leprosy. After extensive clinical trials and real-life application, the medication has been shown to effectively fight the effects of Mycobacterium leprae in the patient's body. It is usually administered simultaneously with other anti-leprosy drugs. Besides leprosy, the medication may treat other complications such as multidrug-resistant TB and multiple-bacteria leprosy.

The right dosage for a patient depends on many factors, including severity of the condition, age, and any other medication they are currently using. Full recovery is only possible when the victim adheres to their prescribed dosage to the dot. A patient should always eat well or drink milk when about to take the anti-leprosy drug.

Many of Clofazimine's side-effects are manageable and usually go away with continued treatment. However, a patient should immediately report to their caregiver any adverse effects that never seem to disappear. Likewise, any noticeable drug interactions should be quickly addressed to protect the patient from further harm.

Overall, a patient should embrace dialogue with their physician to avail treatment that best suits their health complication. They should reveal their medical history, any allergies, and lifestyle habits to help their doctor devise a proper Clofazimine regimen for treating leprosy.

 

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