Category: DH Drugs

1. What drugs are used for the treatment of DH?
2. What's the normal drug dosage to keep the rash under control?
3. What are the side effects of dapsone?
4. I live in Canada and am having difficulty obtaining dapsone. Can you tell me how I can get hold of this drug?

1. What drugs are used for the treatment of DH?
   
   The drugs more commonly used for the treatment of DH are
   dapsone, sulphapyridine, and sulphamethoxypyridazine. All are very early antibiotics dating back to the 1930's and 1940's. However, these drugs do not work as antibiotics but the exact mechanism of action of DH is unknown.
   
   It is important that patients taking drugs for DH are carefully
   monitored with frequent blood tests at the beginning of treatment. Since side-effects tend to occur early in treatment, patients may only have to attend hospital every six months once established on drug treatment.
   
   (Source - Medical Article)
   
   
   
   
2. What's the normal drug dosage to keep the rash under
   control?
   
   Although the drugs will control the rash very quickly, ie. within
   days, the rash will recur equally quickly when drugs are discontinued. Thus, drug treatment of DH has to be considered indefinite but it is not a cure for the disease. It is important to find the smallest dose required to control the rash and this varies between patients. Thus, the dose may be increased or decreased after initial treatment.
   
   As an estimate the dapsone patient leaflet states for DH sufferers "an initial dose of 50mg daily which may be gradually increased to 300mg daily and then reduced to a usual maintenance dose of 25mg-50mg daily". It is hoped, in time on a strict gluten-free diet, that a patient can stop the medication altogether.
   
   (Source - Medical Article & Dapsone Patient Information Leaflet)
   
   
   
   
3. What are the side effects of dapsone?
   
   Like many medicines, dapsone tablets may cause side-effects in some patients, particularly when you first start taking it. These may include:
   
   a) Effects on the blood: anaemia caused by destruction of red blood cells, changes in the type and number of other blood cells (you may develop ulcers in your mouth or on your skin).
   
   b) Effects on the skin: rash which can be raised, discoloured,
   tender, destructive or itchy. Rarely skin conditions may be
   associated with fever, malaise, lung or kidney damage.
   
   c) Effects on the nervous system: headache, difficulty sleeping, nerve damage which may cause tingling in your arms or legs and some weakness.
   
   d) Effects on the gastrointestinal system: loss of appetite, feeling or being sick, inflammation of the liver.
   
   e) Other effects: fast heart beat, mental disturbances.
   
   f) Dapsone syndrome: a 'dapsone syndrome' may occur after 3-6 weeks treatment. Symptoms include rash, fever or change in blood cells. It is important to seek medical help immediately as severe skin reactions, inflammation of the liver, kidney damage and mental illness have occurred. Some deaths have been reported.
   
   If you are concerned about any side effects or notice any other
   unusual effects, tell your doctor immediately and seek advice. Most
   people taking the medicine will not experience many problems.
   
   (Source - Dapsone Patient Information Leaflet)
   
   
   
   
4. I live in Canada and am having difficulty obtaining dapsone. Can you tell me how I can get hold of this drug?
   
   You could advise your doctor about the following web page. The
   Special Access Programme (SAP) provides access to
   nonmarketed drugs for practitioners treating patients with serious or
   life-threatening conditions when conventional therapies have failed,
   are unsuitable, or unavailable. The SAP authorizes a manufacturer
   to sell a drug that cannot otherwise be sold or distributed in
   Canada.
   
   SAP: http://www.hc-sc.gc.ca/hpfb-dgpsa/tpd-dpt/index_sap_drugs_e.html
   
   (Source - Forum Contributor)