Leprosy-Medicines For Treatment,Dosages,Side Effects
Leprosy is an infectious disease which is being caused by a bacteria called mycobacterium leprae. When treating leprosy, it is important to know which of the two main types of leprosy the person has.
If there are light-colored skin patches with loss of sensation but no lumps or thickened skin, then the person probably has tuberculoid leprosy and only two medicines are required.
If there are lumps, then the person probably has lepromatous leprosy and it is best to use 3 medicines. If possible, medicines for leprosy should be taken with the guidance of an experienced health worker or doctor according to the national plan.
This mildly infectious disease is also known as Hansen’s disease, it develops slowly, often over many years. It can only spread from persons who haven’t treated the disease to persons who have low resistance to the disease.
This disease can cause a variety of skin problems like loss of feeling and paralysis of the hands and feet.
The first symptom of this disease is often a slowly growing patch on the skin that does not itch or hurt. At first, feeling inside the patch may be normal. Keep watching it.
If feeling in the patch becomes reduced or absent, it is probably leprosy.
- Pale patch without clear border.
- Patches with different color surrounding the skin but never completely white or scaly.
- Ringworm-like patch with or without raised border.
There are different symptoms according to the person’s natural resistance to the disease. They can be the following :
- Tingling, numbness or loss of feeling in hands or feet. Or deformities or loss of feeling in skin patches.
- Slight weakness or deformities in the hands and feet (clawed toes and drop foot).
- Swollen nerves that form thick cords under the skin. Nerves may or may not be painful when you press them.
- Burns and scars where feeling has been lost.
- Loss of eyebrows.
- Nose sometimes deformed.
- Ear lobe thick and lumpy.
- Painless sores on hands or feet.
- Paralysis and deformity of the hands and feet.
PREVENTION OF DAMAGE TO HANDS, FEET AND EYES.
The large open sores often seen on the hands and feet of the person are not caused by the disease itself and can be prevented. They are as a result of loss of feeling and not being able to protect oneself from injury.
For instance, when a person with normal feeling walks a long distance or way and gets a blister, it hurts, so the person stops walking or limps.
- Protect hands and feet from things that can cut, bruise, blister or burn them. Do not go barefoot especially where there are sharp stones or thorns. Wear shoes or sandals. Put soft padding inside shoes and under straps that may rub. Do not smoke and make sure you wear gloves when cooking to avoid burning.
- At the end of each day, examine your hands and feet very carefully or have someone else examine them. Look for cut, bruises or thorns. Also look for spots or areas on the hands and feet that are red, hot, swollen or show the beginning of blisters. If you find any of these, rest the hands or feet until the skin is completely normal again.
- If you have an open sore, keep the part with the sore very clean and at rest until it has completely healed.
- Protect your eyes. Much eye damage comes from not blinking enough, because of weakness or loss of feeling. Blink your eyes often to keep them wet and clean. If you cannot blink well, close your eyes tightly often during the day, especially when dust blows. Wear sun glasses with side shades and may be a sun hat. Make sure you keep eyes clean and flies away.
This disease is curable but medicine must usually be taken for years. If there is a ‘lepra reaction’ like fever, a rash, pain and perhaps swelling of hands and feet or eye damage occurs or gets worse while taking the medicine, keep taking it but get medical help. A course of prednisolone may be needed.
Treatment of leprosy must usually continue for at least 6 months and sometimes for life. To prevent the bacteria (bacilli) that cause leprosy from becoming resistant, it is important to keep taking the medicines regularly without interruption.
Be sure to get more medicine before your supply runs out.
For tuberculoid leprosy, take both of these for at least 6 months
- Dapsone daily
- Rifampin each month
For lepromatous leprosy, take all of these for 2 to 5 years
- Dapsone daily
- Clofazimine daily and a larger dose each month
- Rifampin each month
NOTE : Although curing leprosy is quicker using dapsone together with other medicines. Sometimes only dapsone is available. When taken alone, it often gives good results but more slowly. So treatment must continue for at least 2 years and sometimes for life for lepromatous leprosy.
Occasionally, a person may develop a serious problem called lepra reaction while taking leprosy medicines. There may be lumpy and inflamed spots, fever, swollen and tender nerves. It may also cause joint pains, tender lymph nodes and testicles, swollen of the hands and feet, red and painful eyes which may lead to loss of vision.
In case of a severe lepra reaction (pain along the nerves, numbness or weakness, eye irritation or painful testicles), it is usually best to keep taking the leprosy treatment but to also take a full course of the anti-inflammatory medicine prednisolone. Seek experienced medical advice about this because the cortico-steroid can also cause serious problems.
MEDICINES FOR LEPROSY
DAPSONE (diaminodiphenylsufone, DDS)
This medicine comes in tablets of 50 and 100 mg. It sometimes can cause anemia or skin rashes which can be severe. If severe skin peeling occurs, stop taking the medicine.
WARNING : DDS is a dangerous drug. Keep it where children cannot reach it.
DOSAGE FOR DDS
2 mg/kg/day- using tablets of 100 mg. Take once a day.
- Adults : (100 mg (one 100 mg tablet)
- Children between 13 to 18 years old : 50 mg (half of a 100 mg tablet)
- Children between 6 to 12 years old : 25 mg (a quarter of 100 mg tablet)
- Children between 2 to 5 years old : 25 mg (a quarter of a 100 mg tablet) 3 times a week only
This medicine often comes in tablets or capsules of 150 and 300 mg. Rifampin is a very expensive medicine but only a small amount is needed to treat leprosy, so the total cost is not much.
For side effects and risks. Take rifampin only with the advice of an experienced health worker or doctor.
DOSAGE OF RIFAMPIN
10 to 20 mg/kg- using tablets of 300 mg. For leprosy, give rifampin once a month. It should be taken either 1 hour before or 2 hours after eating. In each month dose, give :
- Adults : 600 mg (two 300 mg tablets)
- Children between 8 to 12 years old : 450 mg (one and a half 300 mg tablet)
- Children between 3 to 7 years old : 300 mg (one 300 mg tablet)
- Children under 3 years old : 150 mg (half a 300 mg tablet)
This medicine comes in capsules of 50 and 100 mg. Clofazimine is also an expensive medicine. Although it is less effective in killing leprosy bacteria than rifampin, it has the advantage of controlling lepra reaction to some extent, particularly in persons with lepromatous leprosy
Side effects : It causes the skin to become a red purple color. This is only temporary and will disappear 1 to 2 years after stopping the medicine. It may also cause stomach or digestive problems. It is not recommended for pregnant women.
DOSAGE FOR CLOFAZIMINE
1 mg/kg/day – using capsules of 50 mg. Give one dose of clofazimine each day and a second, larger dose once a month. In each daily dose, give :
- Adults : 50 mg (one 50 mg capsule)
- Children between 8 to 12 years old : 37 mg (3/4 of a 50 mg capsule)
- Children between 3 to 7 years old : 25 mg (½ of a 50 mg capsule)
- Children under 3 years old :12 mg (¼ of a 50 mg capsule)
In each monthly dose, give :
- Adults : 300 mg (six 50 mg capsules)
- Children between 8 to 12 years old : 225 mg (four and a half 50 mg capsules)
- Children between 3 to 7 years old : 150 mg (three 50 mg capsules)
- Children under 3 years old : 75 mg (one and a half 50 mg capsules)