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Dapsone is a sulfone antibiotic that inhibits dihydropteroate synthase in the folate pathway, reducing bacterial growth. It is primarily used to treat leprosy and dermatitis herpetiformis.

What Dapsone is

Dapsone belongs to the sulfone class and acts by blocking bacterial folate synthesis. This action helps slow the progression of certain infections and inflammatory skin conditions when used under medical supervision.

What it is used for

Its main role is in multidrug regimens for leprosy, including tuberculoid and multibacillary forms. It also treats dermatitis herpetiformis, often in combination with other therapies. In some patients, it is used for Pneumocystis jirovecii pneumonia prevention and for select dermatologic conditions.

Contraindications and precautions

Contraindications include hypersensitivity to dapsone or other sulfonamides and known G6PD deficiency with risk of hemolytic anemia. Severe anemia or other significant hematologic disorders warrant caution or avoidance. Use in pregnancy or breastfeeding requires careful risk–benefit assessment.

Before starting, clinicians typically obtain a baseline CBC, reticulocyte count, and liver function tests. Ongoing monitoring is advised for long-term use. Watch for signs of methemoglobinemia—shortness of breath, fatigue, or bluish lips or skin. A rare but serious hypersensitivity reaction, called dapsone hypersensitivity syndrome, can occur and may require immediate discontinuation and medical care.

Side effects and interactions

Common side effects include headache, nausea, loss of appetite, dizziness, and rash. Photosensitivity is possible. Hemolysis or methemoglobinemia may develop in susceptible individuals, particularly with G6PD deficiency. Rarely, neutropenia or liver injury can occur.

Interactions: avoid drugs that also raise methemoglobinemia risk (certain nitrates, nitrites, benzocaine, and other topical anesthetics). Dapsone is often used with rifampin and clofazimine in leprosy regimens; monitor liver function and blood counts during combination therapy. Concomitant sulfonamides or agents that suppress bone marrow heighten hematologic risk. Enzyme inducers such as St. John’s wort may lower dapsone levels. Alcohol should be limited due to liver strain. Breastfeeding while on dapsone is generally discouraged; discuss infant exposure with a clinician.