Dapsone use while Breastfeeding
Drugs containing Dapsone: Aczone
Dapsone Levels and Effects while Breastfeeding
Summary of Use during Lactation
Dapsone can be used during breastfeeding; however, hemolytic anemia might occur, especially in newborn infants and those with G-6-PD deficiency. One source states that use of dapsone in the treatment of leprosy is advantageous because it kills the organisms in breastmilk. Monitor the infant for signs of hemolysis, especially in newborn or premature breastfed infants.
Maternal Levels. In one mother who was 41 days postpartum, a random milk level of dapsone was about 1.1 mg/L with a maternal dose of 50 mg daily. Monoacetyldapsone was not detectable in milk although the maternal serum level was 744 mcg/L.
Three women who were 2 to 5 days postpartum were given a single dose of 100 mg of dapsone orally. Milk samples were obtained at various times up to about 220 hours after the dose. The authors calculated that the breastfed infants would receive an average of 9.6% (range 4.6 to 14.3%) of the maternal weight-adjusted dosage.
Infant Levels. A mother who was 41 days postpartum was taking dapsone 50 mg daily. Her breastfed infant's serum had levels of 439 mcg/L of dapsone and 204 mcg/L of monoacetyldapsone.
Effects in Breastfed Infants
A case of mild hemolytic anemia occurred in a 41-day-old breastfed infant whose mother was taking dapsone 50 mg daily. The hemolysis was probably caused by dapsone in milk.
A woman with leprosy took dapsone, clofazimine and rifampin during pregnancy and breastfeeding. Her infant developed skin discoloration attributed to clofazimine which reversed 3 months after cessation of breastfeeding. Her previous child had a similar discoloration from breastfeeding with maternal clofazimine. Both infants were reportedly healthy.
Effects on Lactation and Breastmilk
Relevant published information was not found as of the revision date.
Alternate Drugs to Consider
1. Jopling WH. Handbook of leprosy. 3rd Ed. London: Heinemann Medical Books Ltd. 1984: 86-7.
2. Sanders SW, Zone JJ, Foltz RL et al. Hemolytic anemia induced by dapsone transmitted through breast milk. Ann Intern Med. 1982;96:465-6. PMID: 7065565
3. Edstein MD, Veenendaal JR, Newman K, Hyslop R. Excretion of chloroquine, dapsone and pyrimethamine in human milk. Br J Clin Pharmacol. 1986;22:733-5. PMID: 3567020
4. Ozturk Z. Hansen's disease during pregnancy and lactation: Two babies born to a mother using antileprosy drugs. Naunyn-Schmiedeberg's Arch Pharmacol. 2016;389:S94-S95. Abstract. DOI: doi:10.1007/s00210-016-1213-y
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