After malaria cases in early August there were no more for the following three months. Dapsone played a major part in the achievement of this result but it was certainly not the only important factor. Decline in operational activity and its cessation in October also had a significant bearing on this outcome. Soldiers degree of exposure to malarial infection was much reduced. With the withdrawal of the last Australian units from Nui Dat in October-November 1971, Australian soldiers ceased taking Dapsone for malaria prophylaxis once and for all.
Also known as
Avlosulphone [Merck Index 1989] ; Croysulfone [Merck Index 1989] ; DADPS [Merck Index 1989] ; Diaphenylsulfone [Merck Index 1989] ; Diphenasone [Merck Index 1989] ; Diphone [Merck Index 1989] ; Disulone [Merck Index 1989] ; Dumitone [Merck Index 1989] ; Eporal [Merck Index 1989] ; Novophone [Merck Index 1989] ; Sulphadione [Merck Index 1989] ; Udolac [Merck Index 1989] ; Bis(4-aminophenyl)sulfone [Merck Index 1989] ; 4,4'-Diaminodiphenyl sulfone [Merck Index 1989] ; Acedapsone [CHEMLINE] ; Araldite HT [CHEMLINE] ; Croysulphone [Merck Index 1989] ; Metabolite C [CHEMLINE] ; Sulfanona-mae [Merck Index 1989] ; Sulfonyldianiline [CHEMLINE] ; Sumicure S [CHEMLINE] ; Dapsone USP [PDR 1993] ; DDS [Merck Index 1989] ; 4,4'-Sulfonyldianiline [Merck Index 1989] ; Sulfona [CHEMLINE] ; Diaminodiphenylsulfone [USP DI 1989] ;
Manufactured by:
Jacobus Pharmaceuticals
Dapsone is a medication that requires careful laboratory monitoring. It has some important side effects, which are more likely with higher doses. If you are on dapsone, follow your doctor's instructions carefully, and let him or her know if you start any new medications.
Contraindications
You should not take dapsone if you are allergic to it. Let your doctor know if you are allergic to sulphur antibiotics - dapsone is usually well tolerated, but it should be started cautiously.
If you have significant heart or lung disease, the dose of dapsone may have to be lower because of the drug's effect on oxygen carrying capacity of your blood cells.
Side Effects: Minor, relatively infrequent
Gastrointestinal upset including nausea or vomiting.
Headache.
Blue discolouration of lips and fingertips.
Side Effects of Greater Importance
Anaemia (low haemoglobin or blood count) is common in patients receiving dapsone; it is usually mild. Possible problems include tiredness and shortness of breath. More severe anaemia may occur if you have a rare condition known as glucose-6-phosphate dehydrogenase (G6PD) deficiency.
Allergy may cause a widespread skin rash.
Uncommonly, weakness of the foot and hand muscles can occur, particularly with long term dapsone therapy with doses greater than 100 mg per day. Once per week it is advisable to test your ability to walk on your "tip-toes" and to test your hand grip strength.
Rarely, psychosis (hallucinations or delusions) has been reported
. Rare, But Potentially Serious Side Effects
A significant decrease in the white blood count typically presents with fever, sore throat, skin infections, or other local signs of infection. Commonly a widespread red skin rash is also present. Rarely, an illness resembling glandular fever develops, causing severe fatigue, fever, sore throat, rash and prominent lymph glands.
Dapsone is the parent chemical of the sulfone drugs, and the major therapeutic agent in this group for the treatment of leprosy. It is also administered to treat dermatitis herpetiformis and malaria, and is used in combination with radiotherapy in the treatment of gynecologic neoplasms. Dapsone is also sold for use as an accelerator in epoxy resins.
A bioassay of dapsone, 4,4'-sulfonyldianiline, for possible carcinogenicity was conducted by administering the test material in feed to Fischer 344 rats and B6C3F1 mice.
Groups of 35 rats and 35 mice of each sex were administered dapsone at one of two doses, either 600 or 1,200 ppm for rats and either 500 or 1,000 ppm for mice. The rats and mice were treated for 78 weeks; the rats were then observed for 26-28 weeks, the mice for 28-30 weeks. Matched controls consisted of groups of 15 untreated rats and 14 untreated mice of each sex, pooled controls, used for statistical evaluation, consisted of the matched controls combined with 30 male and 30 female untreated rats and 29 male and 29 female untreated mice from similarly performed bioassays of two other test chemicals. All surviving rats were killed at 104-106 weeks, all surviving mice at 106-108 weeks.
Treated rats and mice had lower mean body weights than the corresponding controls; when treatment was discontinued at week 78, both species showed some increase in body weight. Survival among rats was unaffected by treatment with dapsone; adequate numbers of animals survived for meaningful statistical analyses of the incidences of tumors. Dapsone did not adversely affect the survival of mice, as shown by the test for positive dose-related trend. Suppurative bronchopneumonia was found in some mice in all matched-control and treated groups. Several control males died early in the study, while survival of the othergroups of mice was not affected until week 75.
Among rats, mesenchymal tumors of the abdominal organs or peritoneal tissues occurred in 13/35 low-dose males and 22/33 high-dose males. None occurred among control males or among control or treated females. The most commonly occurring tumors were fibroma, fibrosarcoma, or sarcoma, NOS (not otherwise specified), of the spleen and the peritoneum. In male rats, these mesenchymal tumors of the spleen occurred in a statistically significant incidence in both treated groups (low-dose 6/34, P=0.006; high-dose 14/32, P<0.001) when compared with pooled controls. In the peritoneum, the incidences of these mesenchymal tumors were significant in both treated groups (low-dose 5/35, P=0.014; high-dose 6/33, P=0.005) when compared with the pooled controls. No tumors related to treatment were found in female rats.
Among the mice, there were no tumors that could clearly be related to treatment.
It is concluded that under the conditions of this bioassay, dapsone was not carcinogenic for female Fischer 344 rats or B6C3F1 mice of either sex. Dapsone was carcinogenic (sarcomagenic) for male Fischer 344 rats, causing mesenchymal tumors in the spleen and the peritoneum.
Synonym: 4,4-sulfonyldianiline
Report Date: 1977
Related Adverse Effects
Adverse effects may include nausea, hallucinations, confusion, depression, loss of balance, isomnia, orthostatic hypotension, increased akinetic involuntary movements, agitation, arrhythmia, bradykinesia, chorea, delusion, hypertension, new or increasedangina pectoris and syncope, headache, leg pain, back pain, tinnitus, migraine, supraorbital pain, burning throat, chills , numbness in fingers and toes, taste disturbance, constipation, weight loss, anorexia, dysphagia, diarrhea, rectal bleeding,slow urination, urinary frequency, increased sweating, diaphoresis, facial hair, hair loss, hematoma, rash, and photosensitivity. [PDR 1995]