DDS

DDS dapsone; Doctor of Dental Surgery.

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DDS

abbr.

1. Doctor of Dental Science

2. Doctor of Dental Surgery

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dapsone (DDS)

[dap′sōn]

a bacteriostatic and bactericidal sulfone derivative.

indications It is prescribed in the treatment of leprosy and dermatitis herpetiformis and for prophylaxis against toxoplasmosis and Pneumocystitis carinii in immunocompromised patients.

contraindications Known hypersensitivity to this drug prohibits its use. It is not recommended for use during pregnancy or lactation.

adverse effects Among the more serious adverse reactions are hemolysis (particularly in people who have glucose-6-phosphate dehydrogenase deficiency), leprosy reactional state, methemoglobinemia, neuropathy, nausea, anorexia, toxic hepatic aplastic anemia, and skin rash. Dapsone was carcinogenic in animal models.

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dapsone (DDS)

Aczone, Avlosulfon (CA), Dapsone

Pharmacologic class: Synthetic sulfone

Therapeutic class: Antileprotic, antimalarial

Pregnancy risk category C

Action

Unknown. Bactericidal and bacteriostatic against Mycobacterium leprae. Action in dermatitis herpetiformis not established.

Availability

Tablets: 25 mg, 100 mg

Topical gel: 5%

⊘Indications and dosages

➣ Leprosy

Adults: 100 mg/day P.O. (given initially with one or more antileprotics) for 3 to 10 years, depending on disease course

Children ages 10 to 14: 50 mg daily (given with one or more antileprotics). Length of therapy is dependent on disease course.

Children younger than age 10: As appropriate

➣ Dermatitis herpetiformis

Adults: Initially, 50 mg/day P.O., increased as needed to a maximum of 300 mg/day, then reduced to minimum maintenance level as soon as possible

➣ Acne vulgaris

Adults: After the skin has been washed and patted dry, apply a pea-sized amount in a thin layer to the acne-affected areas b.i.d. Rub in gently and completely.

Off-label uses

• Inflammatory bowel disorders
• Malaria prophylaxis
• Pneumocystis jiroveci pneumonia
• Rheumatic and connective tissue disorders

Contraindications

• Hypersensitivity to drug or its derivatives

Precautions

Use cautiously in:
• renal or hepatic impairment, cardiopulmonary disease, refractory anemia, glucose-6-phosphate dehydrogenase deficiency
• pregnant or breastfeeding patients.

Administration

• Give with meals if GI upset occurs.

Route	Onset	Peak	Duration
P.O.	Unknown	4-8 hr	Unknown
Topical	Unknown	Unknown	Unknown

Adverse reactions

CNS: headache, vertigo, insomnia, paresthesia, peripheral neuropathy, psychosis

CV: tachycardia

EENT: blurred vision, retinal and optic nerve damage, tinnitus

GI: nausea, vomiting, abdominal pain, anorexia, pancreatitis

GU: albuminuria, male infertility, nephrotic syndrome, renal papillary necrosis

Hematologic: hemolytic anemia, agranulocytosis, aplastic anemia, hypoalbuminemia

Respiratory: pulmonary eosinophilia

Skin: photosensitivity, exfoliative dermatitis, lupus erythematosus

Other: fever, hypersensitivity reaction, infectious mononucleosis-like syndrome, sulfone syndrome

Interactions

Drug-drug. Activated charcoal: decreased dapsone absorption

Didanosine: therapeutic failure of dapsone

Folic acid antagonists (such as methotrexate): increased risk of adverse reactions to dapsone

Para-aminobenzoic acid: antagonistic effect

Probenecid: reduced urinary excretion of dapsone metabolites

Rifampin: increased hepatic metabolism of dapsone, causing reduced blood level

Trimethoprim: increased blood levels of both drugs

Drug-diagnostic tests. Albumin, granulocytes, hemoglobin: decreased values

Methemoglobin, reticulocytes: increased values

Drug-behaviors. Sun exposure: photosensitivity

Patient monitoring

☞ Monitor patient for sulfone syndrome, a potentially fatal reaction that causes fever, malaise, jaundice with hepatic necrosis, exfoliative dermatitis, lymphadenopathy, methemoglobinemia, and hemolytic anemia.
• Evaluate CBC weekly for first month of therapy, monthly for next 6 months, and then every 6 months. Discontinue drug if tests show decreased white blood cell or platelet count or reduction in hematopoiesis.
• Monitor liver function test results.

Patient teaching

☞ Instruct patient to immediately report persistent sore throat, fever, chills, malaise, fatigue, swollen lymph nodes, yellowing of skin or eyes, or easy bruising or bleeding.
• Caution patient to avoid driving and other hazardous activities until he knows whether drug affects vision or balance.
• Tell patient drug is intended for long-term use.
• Advise patient to minimize GI upset by eating small, frequent servings of healthy food and drinking plenty of fluids.
• Teach patient how to use topical gel, not to allow gel to get into mouth or eyes, and to wash hands thoroughly after use.
• Teach patient how to use topical gel and don't allow gel to get into mouth or eyes.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, and behaviors mentioned above.