Dapsone (Aczone®)

Dapsone is available as a prescription topical treatment. It is available in gel form.

• Available forms:
  
  
  • Topical treatment: 
    
    
    • Gel:
      Available as prescription
      • Brand names (US):
        • Aczone®
          Generic available (US)

• Available in these doses:
  
  
  • Gel (generic): 5%
  • Aczone®: 5%, 7.5% 

• Who is it for? 
  
  
  • Gender:
    • Males and females
  • Severity of acne:
    • Moderate-to-severe
  • Age:
    • Children of 12 years and older, adolescents, and adults. 

How to use it:

Dapsone is a topical treatment and is available as a gel.

Your physician will specify how much of the medication you need to apply and how often. Do not apply more dapsone or apply dapsone more frequently because this will not improve the results but may cause skin irritation.  

Improvement of acne may take up to 12 weeks of treatment. If your symptoms get worse or do not improve after 12 weeks, contact your physician. 

The dosing for children of 12 years and older and adolescents is the same as the dosing for adults. Dapsone is not recommended in children younger than 12 years. 

Do not get dapsone in your eyes, nose, or mouth. If it does get into your eyes, wash your eyes with a generous amount of water and seek medical attention if there is any irritation. 

Follow the instructions on your prescription carefully and use dapsone exactly as prescribed by your physician. Do not change the dose or the frequency of your medication. If you have any questions about the medication or the prescription, ask your physician or pharmacist. 

• Gel application:
  
  
  • Before applying dapsone, wash the acne-affected skin with water and a mild cleanser. Pat the skin dry with a soft towel. You can ask your physician to recommend a gentle cleanser.
  • Apply a pea-sized amount of gel on acne-affected areas and allow it to absorb it into the skin. You may notice a gritty feel to the gel or see particulates.
  • Dapsone gel 7.5% is applied once a day and dapsone gel 5% is applied twice a day. 
  • After application of the gel, close the tube tightly. 
  • Once you have applied the gel, immediately wash your hands.

Be aware of: 

• Before using dapsone, let your physician or pharmacist know if you are allergic to dapsone, ‘sulfa drugs’ (medication derived from sulfonamide) or to any of the other ingredients in the gel. 
• Before using dapsone, inform you physician about the prescription and non-prescription medications, vitamins, nutritional supplements, and herbal products (especially St. John’s wort) you are using/taking. You will find a complete list of drug interactions below.
• Before using dapsone, inform your physician if you have or have ever suffered from hemolytic anemia (low number of red blood cells), glucose-6-phosphate dehydrogenase (G-6PD) deficiency (an inherited blood disorder), or methemoglobinemia (a condition with defective red blood cells that cannot transport oxygen).
• Dapsone use may rarely lead to hemolytic anemia so consult your physician right away if you have back, leg, or stomach pain, bleeding gums, chills, dark urine, nosebleeds, nausea or vomiting, or yellow eyes or skin.
• Be sure to consult your physician right away if you have bluish-colored lips, fingernails, or palms, dark urine, trouble breathing, dizziness or lightheadedness, a headache, pale skin, unusual bleeding or bruising, or unusual tiredness or weakness. These symptoms may be caused by a serious blood disorder.
• If you are using dapsone and are pregnant or are planning to become pregnant, talk to your physician about using dapsone during pregnancy.
• If you are using dapsone and are breastfeeding, talk to your physician about using dapsone during this period.
• Before having surgery (which also includes dental surgery), tell your physician or dentist that you use dapsone.
• Before using dapsone, inform you physician if you use topical products containing benzoyl peroxide. The use of dapsone and benzoyl peroxide may temporarily cause your skin or facial hair to become yellow or orange. 
• If dapsone was prescribed for acne, you can continue your regular diet unless your physician advises otherwise.
• Do not use other medication unless you have consulted your physician first, including prescription, non-prescription medications, vitamins, nutritional supplements, and herbal products. 
• Do not use dapsone for a skin condition that it was not prescribed for, without consulting your physician first. 
• Do not share your medication with anyone else. 
• Keep your regular appointments with your physician to track your response to dapsone.

Drug interactions: 

Inform your physician or pharmacist about all the prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take before starting dapsone. Also inform your physician or pharmacist of the skin products you use including soaps, cleansers, moisturizers, and cosmetics. 

Full list of drug interactions (From PubMed and Medline Plus):

• Acetaminophen
• Benzoyl peroxide
• Chloroquine (Aralen)
• Dapsone (by mouth)
• Nitrofurantoin (Furadantin)
• Nitroglycerin (Minitran, Nitro-Dur, Nitromist, others) 
• Phenobarbital
• Phenytoin (Dilantin, Phenytek)
• Primaquine
• Pyrimethamine (Daraprim)
• Quinine (Qualaquin)
• Rifampin (Rifadin, Rimactane; in Rifamate, in Rifater)
• Sulfonamide-containing medications including co-trimoxazole (Bactrim, Septra)

Do not swallow

If dapsone is swallowed, contact an emergency facility or call the American Association of Poison Control Centers at 1 (800) 222-1222 (available 24/7).

If immediate assistance is necessary because the victim has collapsed, had a seizure, has trouble breathing, or can’t be awakened, call 911.

Information can also be found online at https://www.poisonhelp.org/help

What if I miss a dose?

As soon as you recall that you have missed a dose, apply the missed dose. However, skip the missed dose if it is almost time for your next dose and continue with your prescribed dosing schedule. Do not increase the quantity or frequency of application to make up for the missed dose. 

Storage:

Store your medication in the container that the pharmacist provided and keep it out of reach and out of sight of children. Many containers can be opened by children. Keep the container tightly closed. Always lock safety caps and immediately place the medication in a safe location that is up and away from the sight of young children, to prevent poisoning (www.upandaway.org).

Store the medication at room temperature. Keep the medication away from excessive heat and moisture – do not store in the bathroom. Do not freeze dapsone.

Disposal:

Do not keep outdated medication and medication that you no longer use. Unneeded medications should be disposed of in a way that pets, children, and other people cannot consume them. Do not flush the medication down the toilet. Contact your pharmacist to learn about the availability of a medicine take-back program in your neighborhood, or get in touch with your local garbage/recycling department to ensure safe disposal. If you do not have access to a take-back program, you can find more information on safe disposal of medication on the FDA website: (https://www.fda.gov/Drugs/ResourcesForYou/Consumers/BuyingUsingMedicineSafely/EnsuringSafeUseofMedicine/SafeDisposalofMedicines/ucm186187.htm)