Dapsone

Dapsone is a sulphone used to treat acne vulgaris, leprosy or Hansen's disease and dermatitis herpetiformis. It is also used in pneumocystis pneumonia, malaria prophylaxis, and in the treatment of actinomycetoma and cutaneous leishmaniasis. Oral or topical cutaneous administration.

It is excreted in breast milk in moderate amounts at relative doses of 6-20% ^{(Edstein 1986, Sanders 1982)}

Plasma levels in the infant are a quarter of the mother's plasma levels ^{(Sanders 1982)}. Among infants born to mothers taking dapsone, three had no problems ^{(Edstein 1986)}, one 41-day-old infant had (along with his mother) moderate haemolytic anaemia ^{(Sanders 1982)} and another infant had skin discolouration attributed to concomitant clofacimin. ^{(Ozturk 2017)}

There is a risk of hemolytic anemia in all newborns exposed to hemolysis-inducing drugs due to glutathione instability in the first 8 days of life, especially in those with glucose-6-phosphate dehydrogenase insufficiency ^{(Zao 2014)}. These drugs should be avoided for the first two weeks and in all patients with glucose-6-phosphate dehydrogenase insufficiency.

Transcutaneous absorption of dapsone is minimal, its use is safe even in individuals with 6PD glucose deficiency, and it is considered compatible with breastfeeding. ^{(Kong 2013)}

WHO essential medicines list: Compatible with breastfeeding. Watch for possible haemolysis and jaundice, especially in premature infants and infants under 1 month of age. Avoid if G-6-PD deficiency. ^{(WHO-UNICEF 2002)}

American Academy of Pediatrics: medication usually compatible with breastfeeding.^{(AAP 2001)}