Systemic Therapy |
Standard WHO regimen for leprosyb |
Rifampicin | Part of regular WHO-MDTa,b | Antibiotic, RNA polymerase inhibitor | >14 y: 600 mg once a month, 10-14 y: 450 mg once a month, <10 y: 10 mg/kg once a month. PB-6 mo, MB-12 mo | Orange-red discoloration of body fluids, nausea, vomiting, diarrhea, malaise, flu-like syndrome | Baseline CBC, LFT, RFT, periodic monitoring in patients with baseline derangement (3 mo) | IA1 |
Dapsone | Part of regular WHO-MDTa,b | Antibiotic, inhibits folic acid metabolism | >14 y: 100 mg once daily, 10-14 y: 50 mg once daily, <10 y: 2 mg/kg/d. PB-6 mo, MB-12 mo | Dapsone hypersensitivity syndrome, methemoglobinemia, and agranulocytosis | Baseline CBC, LFT, RFT, G6PD; periodic CBC, LFT (3-6 mo) | IA1 |
Clofazimine | Part of regular WHO-MDTa,b | Iminophenazine dye, inhibits mitochondrial respiratory chain | >14 y: 300 mg once a month, 50 mg once daily, 10-14 y: 150 mg once a month, 50 mg every other day, <10 y: 100 mg once a month, 50 mg twice a week; PB-6 mo, MB-12 mo | Pigmentation of skin, mucosae, body fluids/secretions and xerosis. Prolongation of QT interval | Gastrointestinal symptoms, skin and mucosae for discoloration at every visit; ECG at baseline, 2 wk, and then every 3 mo and after the addition of any new medication that is known to prolong QT interval | IA1 |
WHO regimen for drug-resistant leprosyc |
Ofloxacin | Drug-resistant leprosyc | Antibiotic, DNA gyrase inhibitor | 400 mg once a day for 18 mo | Nausea, vomiting, diarrhea, headache, tendon rupture. Contraindicated in children below 18 y of age | Baseline CBC, LFT, RFT, and coagulation profile, periodic CBC, LFT, RFT (3 mo) | IV2 |
Clarithromycin | Drug-resistant leprosyc | Antibiotic, attaches to bacterial 50 S ribosomal subunit preventing protein synthesis | 500 mg once a day for 18 mo | Metallic taste, fixed drug eruption, leukocytoclastic vasculitis and hypersensitivity reactions | RFT, LFT, audiogram with prolonged use, ECG for QTC prolongation | IV2 |
Minocycline | Drug-resistant leprosyc | Antibiotic, attaches to bacterial 30 S ribosomal subunit preventing protein synthesis | 100 mg once a day for 18 mo | Acute vestibular adverse effects, hyperpigmentation, ... |