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dapsone

General Information Dapsone is an old antibiotic used in the setting of HIV to prevent or sometimes treat an unusual pneumonia called pneumocystis pneumonia (PCP.)
Specifics Dapsone is a well-respected and well-tolerated antibiotic.

Dapsone works by inhibiting the production of bacterial proteins.  Dapsone is used for a variety of purposes including but not limited to the following:

1.  Treat an opportunistic pneumonia called pneumocystis pneumonia (PCP)
2.  Prevent pneumocystis pneumonia (this is probably one of the most common uses in the setting of HIV infection)
3.  Treatment for leprosy

Dosing

The usual dose to prevent pneumocystis pneumonia is 100 mg once a day.

Dapsone is used to prevent PCP in persons who have T-cell counts less than 200 or some other AIDS-defining conditions.  Dapsone is usually continued until the immune system has improved dramatically with T-cell counts greater than 250 or so assuming the HIV viral load is suppressed.

Adherence
(this refers to your willingness, ability, and actual performance in taking your medications)

For further information and tips on adherence, go to the Adherence section of this site.

It is very important to take every dose that is prescribed unless instructed by your healthcare provider.

Do not change the dose of dapsone without speaking to your healthcare provider.

If you miss doses when dapsone is used to prevent PCP, you may get PCP which is a serious, potentially life-threatening pneumonia.  If you miss doses of dapsone when it is being used to treat PCP, the PCP may not get better or it may worsen.  PCP is possibly life-threatening.

It is strongly recommended that you consider using weekly pill boxes and arrange all of your doses a week in advance.  Buy a small pill box so that you can carry a dose or two of your medicines with you in case you are away from home.

Possible Side Effects
The package insert for most drugs including dapsone is often overwhelming and scary with perhaps an overemphasis on side effects.  We have summarized the important and more common problems here.

Most people take dapsone without any or very many side effects. 

Possible side effects include low red blood cells (anemia), low white blood cells, low platelet cells, allergic rashes, sores in your mouth, and rarely numbness, tingling, or pain in your feet and legs (peripheral neuropathy.) 

You are more susceptible to getting low red blood cells if you are born with the inability to make a certain enzyme in your blood.  This condition is called G-6-PD deficiency.  You may be more susceptible to low white blood cells or low platelet cells if you have more advanced HIV or if you are taking other drugs that cause these side effects (zidovudine, chemotherapy, etc.) or if you have underlying conditions that cause these problems (e.g., cirrhosis). 

Allergic rashes can be very minor to very serious (rarely,) but all rashes should be reported.  If you have rash that steadily gets worse or you have a rash and fever, you need to inform your healthcare provider immediately.  Some persons who are allergic to sulfa drugs like sulfamethoxazole/trimethoprim (Bactrim, Septra, etc.) are also allergic to dapsone.

Report to you healthcare provider or go to an Emergency Room if you have severe side effects, increasing side effects, shortness of breath, uncontrollable diarrhea, fever, weakness, jaundice (eyes and skin turn yellow,) muscle pain, nausea and vomiting (so that you cannot hold down your food and liquids) or rash.
You can download this handout in PDF format by clicking HERE.

8.27.2004