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Clofazimine Side Effects

Medically reviewed by Drugs.com. Last updated on Feb 15, 2024.

Applies to clofazimine: oral capsules.

Side effects include:

Discoloration of skin, eyes, urine, feces, sputum, sweat, tears; GI effects (abdominal and epigastric pain, diarrhea, nausea, vomiting, GI intolerance); eye irritation, itching, dryness, burning.

For Healthcare Professionals

Applies to clofazimine: oral capsule.

Gastrointestinal

Gastrointestinal (GI) side effects have included clofazimine enteropathy. Abdominal and epigastric pain, diarrhea, nausea, vomiting, and GI intolerance have been reported in 40% to 50% of patients. Rare reports of GI bleeding, bowel obstruction, anorexia, constipation, weight loss, and eosinophilic enteritis have been reported in less than 1% of patients.[Ref]

Clofazimine enteropathy may manifest as colicky abdominal pain, nausea, vomiting, diarrhea, and weight loss. In some cases these side effects have prompted unnecessary discontinuation or exploratory laparotomy. Exploratory laparotomy findings in some patients with clofazimine-associated severe abdominal pain have often shown diffuse visceral hyperpigmentation, lymphadenopathy, eosinophilic mucosal and submucosal infiltration. Clofazimine crystalline infiltration in the intestinal and gall bladder mucosa, and in the bile, liver, and spleen have been documented.[Ref]

Dermatologic

Dermatologic side effects have been commonly reported. These have included pigmentation from pink to brownish-black in 75% to 100% of the patients within a few weeks of treatment. Ichthyosis and dryness have been reported in 8% to 28% of patients. Rash and pruritus have been reported in 1% to 5% of patients. Erythroderma, acneiform eruptions, monilial cheilosis have been reported in less than 1% of patients. Phototoxicity and erythroderma have been reported rarely. Melanosis has also been observed, which resolved at a slower rate after the drug was discontinued.[Ref]

The reddish-brown rash may become generalized, but typically involves only lepromatous lesions in patients with leprosy. The discoloration is reversible upon drug discontinuation, may be seen for up to 5 years, and may also involve the tears, saliva, feces, and sputum.[Ref]

Ocular

Rare cases of "bull's eye" retinopathy due to annular macular pigmentary abnormalities have been reported, but may have been associated with CMV retinitis in some of the patients since they also had AIDS and, in some cases, evidence of CMV infection.[Ref]

Ocular side effects have included corneal and conjunctival pigmentation and decreased visual acuity. Diminished vision and ocular dryness, burning, itching, and irritation have been reported in greater than 1% of patients. Macular pigmentary abnormalities have also been reported.[Ref]

Metabolic

Metabolic side effects have been unusually reported. These have included significant increases in the fasting serum glucose and hypokalemia.[Ref]

Hypersensitivity

Rare cases of exfoliative dermatitis have been believed to be due to hypersensitivity since rechallenge with even small doses reproduced the signs and symptoms.[Ref]

Hypersensitivity side effects have rarely included exfoliative dermatitis.[Ref]

Cardiovascular

Cardiovascular side effects including thromboembolism have been reported.

Genitourinary

Genitourinary side effects including cystitis have been reported in less than 1% of patients.

Musculoskeletal

Musculoskeletal side effects including bone pain have been reported in less than 1% of patients.

Nervous system

Nervous system side effects including dizziness, drowsiness, fatigue, headache, giddiness, neuralgia, taste disorder, and vascular pain have been reported in less than 1% of patients.[Ref]

Psychiatric

Psychiatric side effects including depression secondary to skin discoloration have been reported. At least two cases of suicides have also been reported.

Hematologic

Hematologic side effects including elevated erythrocyte sedimentation rate (ESR) have been reported in greater than 1% of patients. Eosinophilia, splenic infarction, anemia, and lymphadenopathy have been reported in less than 1% of patients.[Ref]

Hepatic

Hepatic side effects including hepatitis, jaundice, enlarged liver, elevated AST (SGOT), and elevated total bilirubin have been reported in less than 1% of patients.[Ref]

Other

Other side effects including elevated albumin, fever, and edema have been reported in less than 1% of patients.

References

1. Merrett MN, King RW, Farrell KE, Zeimer H, Guli E. Orange/black discolouration of the bowel (at laparotomy) due to clofazimine. Aust N Z J Surg. 1990;60:638-9.

2. Belaube P, Devaux J, Pizzi M, Boutboul R, Privat Y. Small bowel deposition of crystals associated with the use of clofazimine (Lamprene) in the treatment of prurigo nodularis. Int J Lepr Other Mycobact Dis. 1983;51:328-30.

3. Venencie PY, Cortez A, Orieux G, Jost JL, Chomette G, Puissant A. Clofazimine enteropathy. J Am Acad Dermatol. 1986;15:290-1.

4. Holdiness MR. Clinical pharmacokinetics of clofazimine: a review. Clin Pharmacokinet. 1989;16:74-85.

5. Ravi S, Holubka J, Veneri R, Youn K, Khatib R. Clofazimine-induced eosinophilic gastroenteritis in AIDS. Am J Gastroenterol. 1993;88:612-3.

6. Chong PY, Ti TK. Severe abdominal pain in low dosage clofazimine. Pathology. 1993;25:24-6.

7. Walinder PE, Gip L, Stempa M. Corneal changes in patients treated with clofazimine. Br J Ophthalmol. 1976;60:526-8.

8. Karat AB, Jeevaratnam A, Karat S, Rao PS. Controlled clinical trial of clofazimine in untreated lepromatous leprosy. Br Med J. 1971;4:514-6.

9. Pavithran K. Exfoliative dermatitis after clofazimine. Int J Lepr Other Mycobact Dis. 1985;53:645-6.

10. Job CK, Yoder L, Jacobson RR, Hastings RC. Skin pigmentation from clofazimine therapy in leprosy patients: a reappraisal. J Am Acad Dermatol. 1990;23:236-41.

11. Craythorn JM, Swartz M, Creel DJ. Clofazimine-induced bull's-eye retinopathy. Retina. 1986;6:50-2.

12. Brandt L. Reduced number of peripheral blood granulocytes in chronic myeloid leukaemia during administration of clofazimine (B 663). Scand J Haematol. 1972;9:159-66.

13. Product Information. Lamprene (clofazimine). Novartis Pharmaceuticals. 2002;PROD.

14. Oommen T. Clofazimine-induced lymphoedema . Lepr Rev. 1990;61:289.

Further information

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Some side effects may not be reported. You may report them to the FDA.