Dapsone (topical)

As a topical cream, Dapsone is commonly used to treat various skin conditions including acne and leprosy.

Overview:

Dapsone, which is also known as diaminodiphenyl sulfone, is an antibiotic which can be used within a topical cream to treat serious infectious skin conditions such as leprosy. It is also effective in treating dermatitis herpeformis, acne and pneumonia, and can be used to prevent toxoplasmosis in patients who have a low immune function.

This medicine was first studied as an antibiotic in 1937, with its use in the treatment of leprosy beginning in 1945. It is currently listed by the World Health Organization as an essential medicine, on account of its efficacy in treating some of the most serious infectious conditions for a relatively low expense.

Dapsone can be used as a standalone treatment or in combination with other medicines, such as clofazimine and rifampicin, to treat everything from skin infections to necrotic spider bites. It functions by inhibiting the bacterial synthesis of dihydrofolic acid in a similar manner to the sulphonamide group of anti-bacterial medicines, despite being structurally distinct.

This medicine also features anti-inflammatory properties, inhibiting the myeloperoxidase enzyme which is responsible for creating hypochlorous acid, one of the most potent skin-damaging inflammatory chemicals.

As a gel, Dapsone is now approved by the FDA to treat acne – a condition some doctors advised against treating with Dapsone due to the risk of anemia. The medicine, available in a 7.5% concentration which only needs to be applied once a day, is effective in reducing symptoms of acne without causing significant declines in the level of haemoglobin and is therefore considered a safe and effective treatment.

Type of medicine:

• Antibiotic cream

Conditions treated:

• Leprosy
• Acne
• Spider bites
• Dermatitis herpeformis

Side effects:

Dapsone can potentially cause some unwanted side effects along with its desired effects. The most common side effects experienced by patients undergoing treatment with this topical cream include the following: difficulty breathing, loss of appetite, pale skin, unusual weakness or tiredness, pains in the back/legs/stomach, fever, and/or skin rash.

As the patient continues to apply the cream as prescribed by a doctor, most (if not all) of the previously mentioned symptoms should lessen. If these side effects continue over a prolonged period or appear to get worse, the patient is advised to consult their physician immediately. In some instances, a doctor may be able to advise on ways to alleviate side effects which cause mild discomfort via over the counter medicines or natural remedies.

Generally, most patients will only experience minimal side effects when undergoing treatment with Dapsone. Most doctors agree that the benefits of undergoing treatment for serious skin conditions with this medicine far outweigh the risks of experiencing mild side effects.

Other side effects, which are experienced less frequently (albeit often enough to warrant mentioning), include the following: itching, redness, scaling, dryness, peeling skin, hair loss, mood or other mental changes, sore throat, numbness, tingling, burning, weakness in the hands or feet, unusual bruising or bleeding, headache, difficulty sleeping, nervousness, and/or yellow eyes and skin.

Because this drug can potentially affect the psychology or the patient, he or she should be advised that they could potentially experience mood swings, confusion, hallucinations or memory problems. Caution is advised when prescribing this medicine to patients with a history of mental health issues.

Not all side effects may have been reported. Patients who experience side effects which are not listed are advised to consult with their doctor and report their findings to the FDA.

Dosage:

Dapsone topical cream is available in 5 per cent and 7 per cent concentrations. As a topical cream, it is typically used to treat acne, as well as infectious conditions like leprosy.

As with all medicines, it is incredibly important for patients to only take Dapsone as prescribed by a qualified physician. This means that patients must avoid applying any more Dapsone topical cream than they have been advised, either in terms of dose size or frequency of use. In addition to this, patients should be willing to stop using this cream when advised to do so by their doctor, even if they still have a supply of the medicine remaining.

Before applying the cream, the patient should gently wash, and pat dry the affected area of skin. A pea-sized amount of Dapsone should then be applied in a thin layer, twice a day. Dapsone should be rubbed in gently and completely in order to be most effective, and hands should be washed directly after application to avoid the risk of contamination. If the patient shows no signs of improvement after 12 weeks of treatment with Dapsone, their doctor or healthcare professional may decide to reassess treatment. At this stage, a doctor may prescribe a higher concentration of Dapsone, combine it with another medication or switch to treatment with another drug altogether.

In the event of missing a dose, the patient is advised to take the dose as soon as they remember. If it is closer to the time for the next scheduled dose, the patient should omit the missed dose and carry on with the dosing schedule as outlined by a doctor. Patients should not apply extra medicine to make up for a missed dose.

Patients who overdose on this medication may experience vomiting, exude a pale or blue-colored appearance and/or feel restless/excited. In these instances, patients should contact their local poison control center on 1800-222-1222 or visit their local emergency room.

Interactions:

All drugs have the potential to interact with other chemicals or medicines in the body, changing the effects of each medication. This can cause a medicine to become ineffective, or can even lead to the patient experiencing potentially serious side effects. Because of this, patients are advised to keep a fully detailed list of all medicines they are currently undergoing treatment with. This applies to herbal remedies, complementary medicines, over the counter treatments and vitamin supplements as well as prescribed medications.

Below is a list of medicines known to interact negatively with Dapsone. Patients who are already taking one or more of these drugs should inform their doctor prior to beginning treatment with Dapsone topical cream:

• Amyl Nitrite/Sodium Nitrite/Sodium Thiosulfate
• Epinephrine/Prilocaine
• Lidocaine/Prilocaine Topical
• Prilocaine
• Sodium Nitrite
• Sodium Nitrite/Sodium Thiosulfate
• Acetaminophen
• Acetaminophen/Aluminum Hydroxide/Aspirin/Caffeine/Magnesium Hydroxide
• Acetaminophen/Aspirin
• Acetaminophen/Aspirin/Caffeine
• Acetaminophen/Aspirin/Caffeine/Salicylamide
• Acetaminophen/Aspirin/Diphenhydramine
• Acetaminophen/Aspirin/Phenylpropanolamine
• Acetaminophen/Brompheniramine
• Acetaminophen/Brompheniramine/Dextromethorphan/Pseudoephedrine
• Acetaminophen/Brompheniramine/Phenylpropanolamine
• Acetaminophen/Brompheniramine/Pseudoephedrine
• Acetaminophen/Butalbital
• Acetaminophen/Butalbital/Caffeine
• Acetaminophen/Butalbital/Caffeine/Codeine
• Acetaminophen/Caffeine
• Acetaminophen/Caffeine/Chlorpheniramine/Hydrocodone/Phenylephrine
• Acetaminophen/Caffeine/Chlorpheniramine/Phenylpropanolamine
• Acetaminophen/Caffeine/Dihydrocodeine
• Acetaminophen/Caffeine/Guaifenesin/Phenylephrine
• Acetaminophen/Caffeine/Isometheptene Mucate
• Acetaminophen/Caffeine/Magnesium Salicylate
• Acetaminophen/Caffeine/Magnesium Salicylate/Phenyltoloxamine
• Acetaminophen/Caffeine/Phenylpropanolamine/Salicylamide
• Acetaminophen/Caffeine/Phenyltoloxamine
• Acetaminophen/Caffeine/Phenyltoloxamine/Salicylamide
• Acetaminophen/Caffeine/Pyrilamine
• Acetaminophen/Chlophedianol/Pyrilamine
• Acetaminophen/Chlorpheniramine
• Acetaminophen/Chlorpheniramine/Codeine
• Acetaminophen/Dexbrompheniramine/Pseudoephedrine
• Acetaminophen/Tramadol
• Amyl Nitrite
• Chloroquine
• Erythromycin/Sulfisoxazole
• Hydralazine/Isosorbide Dinitrate
• Isosorbide Dinitrate
• Isosorbide Mononitrate
• Nitrofurantoin
• Nitroglycerin
• Nitroprusside
• Oxytetracycline/Phenazopyridine/Sulfamethizole
• Phenazopyridine/Sulfisoxazole
• Primaquine
• Pyrimethamine/Sulfadoxine
• Quinine
• Sulfadiazine
• Sulfadoxine
• Sulfamethizole
• Sulfisoxazole

Warnings:

Patients are advised to tell their healthcare providers about any medical conditions or allergies they suffer from. This is because Dapsone cream could contain active or inactive ingredients known to cause allergic reactions in some patients. Those who are allergic to Dapsone or any of its ingredients are advised to avoid using it.

Dapsone may not be safe for certain patients. Those who have one or more of the following conditions should inform their doctor:

• Liver disease
• Lung disease
• Heart disease
• A genetic enzyme deficiency known as G6PD
• Methemglobin reductase deficiency

Dapsone is a pregnancy category C drug. This means that it is unknown whether it can cause harm to an unborn baby. Patients are advised to tell their doctor if they are pregnant or intending to become pregnant soon. In some instances, a doctor will advise against using this medicine while pregnant, unless the benefits vastly outweigh the risks.

This medication can be excreted into breastmilk and could potentially cause harm to nursing babies. Breastfeeding mothers are advised to discontinue breastfeeding for the duration of use of this medicine. Alternatively, the patient can continue to breastfeed but seek another treatment for their skin condition.

Storage:

Dapsone topical cream should be stored in the packaging it was shipped in, away from moisture, heat and light. It is therefore unsuitable for storage in a bathroom, and should instead be kept in a dedicated medicine cabinet, out of the reach of children and pets.

For advice on how to dispose of unwanted or unused Dapsone cream, patients are advised to contact their local pharmacy. Many pharmacies offer medication “take back” schemes, where they will dispose of or recycle expired or otherwise unwanted medicines, including Dapsone.

Summary:

Dapsone topical cream is incredibly beneficial at treating skin conditions, although it can also pose a risk to patients who fail to communicate properly with their healthcare providers. It alleviates symptoms of acne and can also be used for more serious bacterial infections such as leprosy, but it can also create feelings of mental confusion along with other adverse reactions.

When taken correctly, Dapsone helps to treat unsightly and painful skin conditions, allowing the patient to enjoy a more fulfilling, pain-free life. In order to achieve this, patient and doctor are advised to work together to find out the most appropriate dose schedule and best frequency of use.