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Clofazimine
See also Antituberculosis drugs
General information
Clofazimine is weakly bactericidal against Mycobacterium leprae . It is active in chronic skin ulcers (Buruli ulcer) and partly against Mycobacterium avium intracellulare. The usual adult dosage is 50–100 mg/day. At higher doses, its anti-inflammatory effect seems to prevent the development of acute reactions, such as erythema nodosum leprosum.
Clofazimine is a strongly lipophilic dye and accumulates in tissues, especially fat, bile, macrophages, the reticuloendothelial system, and skin. This is the basis of adverse reactions, including skin discoloration [ ]. Lymphedema [ ], diminished sweating, and reduced tearing have been observed [ ].
Drug studies
Observational studies
In 84 patients with leprosy who took clofazimine, the most common adverse effect was a dark red skin pigmentation of varying intensity, which appeared within 10 weeks of the start of therapy [ ]. The intensity of the color was proportional to the density of the infiltration. There was ichthyosis in 56 patients. Adverse reactions such as anorexia, diarrhea, lymph gland enlargement, liver enlargement, corneal drying, and loss of weight were self-correcting, but nine patients had severe gastrointestinal reactions (severe abdominal pain, vomiting, and diarrhea).
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