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Treatment of leprosy in adults

Treatment of leprosy in adults
National Hansen's Disease Program (NHDP)* World Health Organization 2018 (WHO)[1]
Regimen Dose Duration Regimen Dose Duration
Tuberculoid ("paucibacillary"): TT and BT Tuberculoid ("paucibacillary"): TT and BT
Dapsone 100 mg once daily 12 months Dapsone 100 mg once daily 6 months
Rifampin 600 mg once daily Rifampin 600 mg once monthly
      Clofazimine 300 mg once monthly, and 50 mg once daily
Lepromatous ("multibacillary"): LL, BL, BB Lepromatous ("multibacillary"): LL, BL, BB
Dapsone 100 mg once daily 24 months Dapsone 100 mg once daily 12 months
Rifampin 600 mg once daily Rifampin 600 mg once monthly
Clofazimine 50 mg once daily Clofazimine 300 mg once monthly, and 50 mg once daily

TT: tuberculoid; BT: borderline tuberculoid; LL: lepromatous; BL: borderline lepromatous; BB: mid-borderline (these refer to the Ridley-Jopling classification).

* The NHDP follows the WHO guidance issued in 1982, which favors a longer duration of therapy, administration of rifampin daily rather than monthly, and excludes clofazimine for treatment of paucibacillary disease. Additional information is available at the NHDP website: http://www.hrsa.gov/hansensdisease/diagnosis/recommendedtreatment.html.

¶ In the United States, the NHDP holds the Investigational New Drug (IND) application for clofazimine treatment of leprosy. For further information or to request investigator status to use clofazimine, contact the NHDP: 1-800-642-2477. Clofazimine should be taken either with or immediately after food or milk to facilitate absorption. If clofazimine is not tolerated, daily minocycline may be substituted.
Reference:
  1. WHO Guidelines for the Diagnosis, Treatment, and Prevention of Leprosy (2018). https://www.who.int/publications/i/item/9789290226383 (Accessed January 5, 2023).
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