Clofazimine: Difference between revisions

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==Administration==
==Administration==
*Type: Antibacterial
*Type: [[Antibiotic]]
*Dosage Forms: CAP 50mg
*Dosage Forms: CAP 50mg
*Routes of Administration: Oral
*Routes of Administration: Oral
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==Adult Dosing==
==Adult Dosing==
===Hansen disease, mutlibacillary===
===[[Hansen's disease]], multibacillary===
*50mg PO qd x 12mo in combination with [[rifampin]] and [[dapsone]]
*50mg PO qd x 12mo in combination with [[rifampin]] and [[dapsone]]
**Give 300mg PO qmo x 12mo in addition to daily dose
**Give 300mg PO qmo x 12mo in addition to daily dose
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==Pediatric Dosing==
==Pediatric Dosing==
===Hansen disease, mutlibacillary===
===[[Hansen's disease]], multibacillary===
*10-14 yo
*10-14 yo: 50mg PO qod AND 150mg PO qmo x12mo in combination with [[rifampin]] and [[dapsone]]
**50mg PO qod AND 150mg PO qmo x12mo in combination with [[rifampin]] and [[dapsone]]
*>15 yo: 50mg PO qd AND 300mg PO qmo x 12mo in combination with [[rifampin]] and [[dapsone]]
*15+ yo
**50mg PO qd AND 300mg PO qmo x 12mo in combination with [[rifampin]] and [[dapsone]]


==Special Populations==
==Special Populations==
*[[Drug pregnancy categories|Pregnancy Rating]]: Caution of use during pregnancy; obtain negative pregnancy test before starting
*[[Drug pregnancy categories|Pregnancy Rating]]: C
*Lactation risk: Caution advised
*Lactation risk: Caution advised
===Renal Dosing===
*Renal dosing: not defined
*Adult: Not defined
*Hepatic dosing: not defined
*Pediatric: Not defined
===Hepatic Dosing===
*Adult: Not defined
*Pediatric: Not defined


==Contraindications==
==Contraindications==
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*Caution:
*Caution:
**Electrolyte abnormality
**Electrolyte abnormality
**Congenital long QT syndrome
**Congenital long QT syndrome, [[QT prolongation]] or family history of long QT
**[[QT prolongation]] or family history
**[[Torsades de pointes]], ventricular arrhythmias
**[[Torsades de pointes]]
**Ventricular arrhythmias
**Bradycardia
**Bradycardia
**Recent MI
**Recent MI
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==Adverse Reactions==
==Adverse Reactions==
===Serious===
===Serious===
*Abdominal sx, severe
*Severe abdominal symptoms
*[[Hepatitis]]
*[[Hepatitis]], [[Jaundice]]
*[[Jaundice]]
*Intestinal obstruction
*Intestinal obstruction
*[[GI Bleeding]]
*[[GI Bleeding]]
*Splenic infarction
*Splenic infarction
*[[Thromboembolism]]
*[[Thromboembolism]]
*[[QT Prolongation]]
*[[QT Prolongation]], [[Torsades de pointes]]
*[[Torsades de pointes]]


===Common===
===Common===
*Skin discoloration
*Skin discoloration
*[[Nausea]]/[[Vomiting]]
*[[Nausea]]/[[Vomiting]], [[diarrhea]], abdominal/epigastric pain
*[[Diarrhea]]
*Abdominal/epigastric pain
*Ichthyosis/xeroderma
*Ichthyosis/xeroderma
*[[Pruritus]]/rash
*[[Pruritus]]/rash
*Discolored urine/feces/sputum/sweat
*Discolored urine/feces/sputum/sweat
*Ocular pigmentation
*Ocular pigmentation, ocular irritation
*Ocular irritation
*[[Hyperglycemia]]
*[[Hyperglycemia]]
*ESR elevated
*ESR elevated
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==See Also==
==See Also==
*[[Hansen's disease]]


==References==
*Lexicomp
*Aronoff GR, Bennett WM, Berns JS, et al, Drug Prescribing in Renal Failure: Dosing Guidelines for Adults and Children, 5th ed. Philadelphia, PA: American College of Physicians; 2007.
*FDA Safety Alert. Med Watch. Lamprene (Clofazimine). Food and Drug Administration website. Available at http://www.fda.gov/Safety/MedWatch/SafetyInformation/ucm514749.htm. Accessed November 11, 2016.
*Freerksen E, Seydel JK. Critical comments on the treatment of leprosy and other mycobacterial infections with clofazimine. Arzneimittelforschung. 1992;42(10):1243-5. Review. [PubMed 1472145]
*Health Resources and Services Administration (HRSA). National Hansen's Disease (Leprosy) Program: Recommended Treatment Regimens. http://www.hansensdisease/diagnosis/recommendedtreatment.html. Accessed on March 31, 2016.
*Holdiness MR. Clinical pharmacokinetics of clofazimine. A review. Clin Pharmacokinet. 1989;16(2):74-85. [PubMed 2656045]
*Lamprene (clofazimine) [prescribing information]. East Hanover, NJ: Novartis Pharmaceuticals; January 2019.
*Legendre DP, Muzny CA, Swiatlo E. Hansen's disease (Leprosy): current and future pharmacotherapy and treatment of disease-related immunologic reactions. Pharmacotherapy. 2012;32(1):27-37. [PubMed 22392826]
*Szeto W, Garcia-Buitrago MT, Abbo L, Rosenblatt JD, Moshiree B, Morris MI. Clofazimine enteropathy: a rare and underrecognized complication of mycobacterial therapy. Open Forum Infect Dis. 2016;3(3):ofw004. [PubMed 27800519]
*World Health Organization. Drugs Used in Leprosy. http://apps.who.int/medicinedocs/pdf/h2988e/h2988e.pdf. Accessed April 6, 2016.
*World Health Organization. WHO Expert Committee on Leprosy. World Health Organ Tech Rep Ser. 2012;(968):1-61, 1 p following 61. [PubMed 22970604]


==References==
<references/>
<references/>


[[Category:Pharmacology]]
[[Category:Pharmacology]]
[[Category:ID]]

Latest revision as of 17:40, 20 September 2019

Administration

  • Type: Antibiotic
  • Dosage Forms: CAP 50mg
  • Routes of Administration: Oral
  • Common Trade Names: Lamprene

Adult Dosing

Hansen's disease, multibacillary

  • 50mg PO qd x 12mo in combination with rifampin and dapsone
    • Give 300mg PO qmo x 12mo in addition to daily dose

Erythema nodosum leprosum

  • 100mg PO bid x12wk, then 100mg PO qd 12-24wk
    • Start 100mg PO tid x12wek

Pediatric Dosing

Hansen's disease, multibacillary

  • 10-14 yo: 50mg PO qod AND 150mg PO qmo x12mo in combination with rifampin and dapsone
  • >15 yo: 50mg PO qd AND 300mg PO qmo x 12mo in combination with rifampin and dapsone

Special Populations

  • Pregnancy Rating: C
  • Lactation risk: Caution advised
  • Renal dosing: not defined
  • Hepatic dosing: not defined

Contraindications

  • Allergy to class/drug
  • Caution:


Adverse Reactions

Serious

Common

Pharmacology

  • Half-life: 70 days
  • Metabolism: Unknown
  • Excretion: Feces primarily

Mechanism of Action

  • Bacteriostatic or bactericidal: Binds to mycobacterial DNA, inhibiting growth


Comments

See Also

References

  • Lexicomp
  • Aronoff GR, Bennett WM, Berns JS, et al, Drug Prescribing in Renal Failure: Dosing Guidelines for Adults and Children, 5th ed. Philadelphia, PA: American College of Physicians; 2007.
  • FDA Safety Alert. Med Watch. Lamprene (Clofazimine). Food and Drug Administration website. Available at http://www.fda.gov/Safety/MedWatch/SafetyInformation/ucm514749.htm. Accessed November 11, 2016.
  • Freerksen E, Seydel JK. Critical comments on the treatment of leprosy and other mycobacterial infections with clofazimine. Arzneimittelforschung. 1992;42(10):1243-5. Review. [PubMed 1472145]
  • Health Resources and Services Administration (HRSA). National Hansen's Disease (Leprosy) Program: Recommended Treatment Regimens. http://www.hansensdisease/diagnosis/recommendedtreatment.html. Accessed on March 31, 2016.
  • Holdiness MR. Clinical pharmacokinetics of clofazimine. A review. Clin Pharmacokinet. 1989;16(2):74-85. [PubMed 2656045]
  • Lamprene (clofazimine) [prescribing information]. East Hanover, NJ: Novartis Pharmaceuticals; January 2019.
  • Legendre DP, Muzny CA, Swiatlo E. Hansen's disease (Leprosy): current and future pharmacotherapy and treatment of disease-related immunologic reactions. Pharmacotherapy. 2012;32(1):27-37. [PubMed 22392826]
  • Szeto W, Garcia-Buitrago MT, Abbo L, Rosenblatt JD, Moshiree B, Morris MI. Clofazimine enteropathy: a rare and underrecognized complication of mycobacterial therapy. Open Forum Infect Dis. 2016;3(3):ofw004. [PubMed 27800519]
  • World Health Organization. Drugs Used in Leprosy. http://apps.who.int/medicinedocs/pdf/h2988e/h2988e.pdf. Accessed April 6, 2016.
  • World Health Organization. WHO Expert Committee on Leprosy. World Health Organ Tech Rep Ser. 2012;(968):1-61, 1 p following 61. [PubMed 22970604]


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