Dapsone
ACZONE
Pronunciation: DAP-soen (AK-zoen)
What it isSulfone inhibiting dihydropteroate synthase; leprosy, dermatitis herpetiformis and PJP prophylaxis.
Why this oneIt is the treatment of choice for dermatitis herpetiformis, with a response within days.
What limits itHemolysis, severe in G6PD deficiency, and methemoglobinemia. Check G6PD before starting.
FDA-approved for
- leprosy/dermatitis herpetiformis (~1955)
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Acne vulgaris (topical) | Adults & children ≥9 yr | Pea-sized amount, thin layer to entire face QD (thin layer to other affected areas QD) | Same, QD | QD |
Renal Undefined
Hepatic Undefined
Instructions
- Topical only — not for oral, ophthalmic, or intravaginal use
- Apply to gently washed, patted-dry skin; rub in gently and completely
- Reassess if no improvement after 12 weeks
Available strengths
- gel 5, 7.5 %
- tab 25, 100 mg
Cautions
- Methemoglobinemia (avoid in congenital/idiopathic methemoglobinemia; stop if cyanosis)
- Hemolysis — G6PD deficiency; avoid with oral dapsone/antimalarials; TMP/SMX may increase risk
- Peripheral neuropathy (reported with oral dapsone)
- Skin reactions (TEN, EM, etc. — reported with oral dapsone)
Adverse reactions
- Application site dryness (1.1%)
- Application site pruritus (0.9%)
Pregnancy No human data; systemic absorption low; embryocidal in rats/rabbits only at >400× MRHD exposure.
Lactation No data for topical; oral dapsone enters milk and may cause hemolytic anemia/hyperbilirubinemia, esp. in G6PD-deficient infants.
Cost
| Strength | #/mo | generic $/unit | CostPlus | |
|---|---|---|---|---|
| 5 % | gel | per unit | not offered | |
| 7.5 % | gel | per unit | not offered |
Generic entry2016
NO BOXED WARNINGS
Principal riskHemolysis, severe in G6PD deficiency
Classes and tags
Clinical profile
Legacy pregnancy categoryUnknown / historical label unavailable
Defining liabilityGenerally tolerated at therapeutic doses; clinically important risks are agent-specific and increase with interactions or organ impairment.