Dapsone

• 4,4 '- diaminodiphenylsulfone (DDS)
• 4- aminophenyl
• 4,4 '- Sulfonyldianilin
• Bis- 4- aminophenyl

J04BA02

White to yellowish white crystalline powder

Antibiotic

Dihydrofolic acid inhibitor

172-175 ° C

Very poor in water ( 0.38 g · l-1 at 37 ° C)

Attention

250 mg · kg -1 ( LD50, mouse, oral)

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Dapsone is an antibiotic and anti-inflammatory effective drug. It is used for the treatment and prevention of infectious diseases such as leprosy, malaria, actinomycetes infections, and Pneumocystis jirovecii pneumonia in HIV patients. Likewise, it is used to treat chronic inflammatory autoimmune diseases in which a tissue infiltration by neutrophilic and eosinophilic inflammatory cells is observed, such as dermatitis herpetiformis, the linear IgA dermatosis, the subcorneal pustular dermatosis, erythema Elevatum diutinum and other bullous dermatoses. Is used, the D- N, N ' digalactoside.

Dapsone was first synthesized in 1908 in Germany by E. Fromm and 1934 by the IG Colors patented. It is used as chemotherapeutic agent ( against dermatosis and leprosy) of the company Riemser (trade name: dapsone Fatol ®) marketed. Since dapsone ( EU) No listed 37/2010 on pharmacologically active substances and their classification regarding maximum residue limits in foodstuffs of animal origin in Table 2 of the Regulation, its application in food-producing animals in the European Union is generally prohibited.

The antibiotic mechanism of action is explained by the inhibition of folic acid synthesis antimetabolitische of mycobacterium. Due to strong resistance development dapsone is preferably used in combination with other medicines. (eg, rifampin, or clofazimine )

To the side effects of dapsone counts a dose-dependent hemolysis and methemoglobinemia, especially for glucose-6- phosphate dehydrogenase deficiency.

Technically dapsone is used as a hardener for epoxy resins ( for heat-curing temperature resistant systems).

Dapsone hypersensitivity syndrome

In the application of dapsone occurs in 0.5 to 3.6 % of patients after 4-6 weeks after initiation of therapy to a hypersensitivity reaction, which was first described in 1949 in leprosy patients in Nigeria and 1951 first named as dapsone hypersensitivity syndrome. This is a severe idiosyncratic adverse reaction with fever, rash, and involvement of other organ systems, mainly the liver and the hematopoietic system up to their failure. The mortality rate is 9.9 %.

In a Chinese genome-wide association study could be described with the HLA -B * 13:01 allele of the human leukocyte antigen system, a genetic risk factor for the hypersensitivity syndrome, which is associated with an odds ratio of 20.53. Since this allele is found in 2-20 % in China, 1.5% in Japan, 1-12 % in India and 2-4% in Southeast Asia, but hardly in Europe or Africa, the development of genetic testing is recommended to dapsone for the HLA -B to test the affected populations prior to treatment * 13:01 allele.