Acute Dapsone Intoxication: Clinical Findings and Effect of Oral Charcoal and Haemodialysis on Dapsone Elimination

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Abstract
Three patients were treated after ingestion of an overdose of dapsone [an antiinflammatory antileprotic] (1-10 g). A considerable acute cyanosis due to methemoglobinaemia was followed by a late hemolysis within 1-2 wk. Activated charcoal given orally in multiple doses (20 g .times. 4/day) shortened the half-life of dapsone to 12.7 .+-. 0.7 h, i.e., to about 1/3-1/6 of the preceding control value. The half-life of dapsone was about 10 h during each of the 3 5-h hemodialysis treatments given to 1 patient. Owing to the rebound phenomenon between hemodialyses, the half-life of dapsone from the start of the 1st to the end of the 3rd hemodialysis was 26 h. The efficacy of orally administered activated charcoal is fully comparable to that of hemodialysis in increasing the rate of elimination of dapsone and its metabolite monoacetyldapsone. Activated charcoal is cheap, it can be administered anywhere, and its administration rarely involves complications.