Leprosy Medication

Updated: Aug 24, 2018
  • Author: Darvin Scott Smith, MD, MSc, DTM&H; Chief Editor: Michael Stuart Bronze, MD  more...
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Medication

Medication Summary

The goals of pharmacotherapy are to eliminate the infection, to prevent complications, to halt its further transmission and spread, and to reduce morbidity.

The multidrug therapy (MDT) plan recommended by the WHO can be used to plan therapy based on the type of leprosy (paucibacillary or multibacillary) and whether it is supervised monthly or self-administered daily (see Medical Care).

Clofazimine is no longer commercially available in the United States. It is available only by obtaining an investigational new drug (IND) permit from the National Hansen’s Disease Program (NHDP) from the U.S. Department of Health and Human Services. For more information, visit www.hrsa.gov/hansensdisease/ or call 1-800-642-2477.

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Antibiotics, Other

Class Summary

These agents have bactericidal and bacteriostatic activity against mycobacteria.

Dapsone

Bactericidal and bacteriostatic against mycobacteria; mechanism of action is similar to that of sulfonamides, in which competitive antagonists of PABA prevent formation of folic acid, inhibiting bacterial growth. Part of a 2-drug regimen for treatment of paucibacillary leprosy; part of a 3-drug regimen for treatment of multibacillary leprosy.

Rifampin (Rifadin)

For use in combination with at least 1 other antituberculous drug; inhibits DNA-dependent bacterial but not mammalian RNA polymerase. Most bactericidal drug used against M leprae. Cross-resistance may occur.

Treat for 6-9 mo or until 6 mo have elapsed from conversion to sputum-culture negativity.

Part of 2-drug regimen for treatment of paucibacillary leprosy; part of 3-drug regimen for treatment of multibacillary leprosy.

Clofazimine (Lamprene)

Inhibits mycobacterial growth, binds preferentially to mycobacterial DNA. Has antimicrobial properties, but mechanism of action is unknown. Part of 3-drug regimen for treatment of multibacillary leprosy. No longer commercially available in the United States; available only by obtaining an investigational new drug (IND) permit from the National Hansen's Disease (Leprosy) Program (NHDP).

Minocycline (Minocin, Solodyn)

Minocycline is a semisynthetic tetracycline. Has bacteriostatic activity. Inhibits protein synthesis, and is selectively concentrated in susceptible organisms. It is used in single-lesion paucibacillary leprosy in patients who cannot tolerate clofazimine.

Ofloxacin (Floxin)

Ofloxacin is a pyridine carboxylic acid derivative with broad-spectrum bactericidal effect. It is used in single-lesion paucibacillary leprosy.

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