Clofazimine

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Clofazimine Brand Name– Lamprene

What is Clofazimine

Clofazimine is an oral antimycobacterial agent indicated for dapsone-sensitive or dapsone-resistant lepromatous leprosy as part of a combination regimen as well as lepromatous leprosy complicated by erythema nodosum leprosum. Because of resistance, clofazimine is not used alone for leprosy.

Clofazimine exerts a slow bactericidal effect on Mycobacterium leprae and possesses anti-inflammatory properties in treating erythema nodosum leprosum reactions.

Cases of QT prolongation with torsade de pointes have been reported with clofazimine; ECG monitoring is recommended.

Other significant adverse reactions associated with clofazimine include skin discoloration that has been reported to result in depression and suicide and intestinal obstruction.

Indications

  1. erythema nodosum leprosum (ENL)
  2. leprosy (Hansen’s disease)
  3. Mycobacterium leprae

Side Effects

  1. abdominal pain
  2. acneiform rash
  3. anemia
  4. anorexia
  5. bone pain
  6. constipation
  7. corneal deposits
  8. cystitis
  9. depression
  10. diarrhea
  11. dizziness
  12. drowsiness
  13. dysgeusia
  14. edema
  15. elevated hepatic enzymes
  16. eosinophilia
  17. fatigue
  18. fever
  19. GI bleeding
  20. GI obstruction
  21. headache
  22. hepatitis
  23. hepatomegaly
  24. hyperbilirubinemia
  25. hyperglycemia
  26. hypokalemia
  27. ichthyosis
  28. jaundice
  29. lymphadenopathy
  30. nausea
  31. ocular irritation
  32. ocular pruritus
  33. photosensitivity
  34. pruritus
  35. QT prolongation
  36. rash
  37. retinopathy
  38. skin discoloration
  39. stool discoloration
  40. suicidal ideation
  41. thromboembolism
  42. torsade de pointes
  43. urine discoloration
  44. visual impairment
  45. vomiting
  46. weight loss
  47. xerosis

Monitoring Parameters

  • ECG
  • pregnancy testing

Contraindications

  • apheresis
  • AV block
  • bradycardia
  • breast-feeding
  • cardiomyopathy
  • celiac disease
  • contraception requirements
  • females
  • fever
  • geriatric
  • heart failure
  • hepatic disease
  • human immunodeficiency virus (HIV) infection
  • hyperparathyroidism
  • hypocalcemia
  • hypokalemia
  • hypomagnesemia
  • hypothermia
  • hypothyroidism
  • infertility
  • long QT syndrome
  • myocardial infarction
  • pheochromocytoma
  • pregnancy
  • pregnancy testing
  • QT prolongation
  • reproductive risk
  • rheumatoid arthritis
  • sickle cell disease
  • sleep deprivation
  • stroke
  • systemic lupus erythematosus (SLE)
  • torsade de pointes

Clofazimine is contraindicated in any patient with known hypersensitivity to clofazimine or any of the excipients of clofazimine.

Interactions

  • Aclidinium; Formoterol
  • Albuterol
  • Albuterol; Ipratropium
  • Alfentanil
  • Alfuzosin
  • Amiodarone
  • Amitriptyline
  • Amitriptyline; Chlordiazepoxide
  • Amoxicillin; Clarithromycin; Lansoprazole
  • Amoxicillin; Clarithromycin; Omeprazole
  • Anagrelide
  • Apomorphine
  • Arformoterol
  • Aripiprazole
  • Arsenic Trioxide
  • Artemether; Lumefantrine
  • Asenapine
  • Atomoxetine
  • Azithromycin
  • Bedaquiline
  • Belladonna Alkaloids; Ergotamine; Phenobarbital
  • Bismuth Subcitrate Potassium; Metronidazole; Tetracycline
  • Bismuth Subsalicylate; Metronidazole; Tetracycline
  • Budesonide; Formoterol
  • Buprenorphine
  • Buprenorphine; Naloxone
  • Caffeine; Ergotamine
  • Carbamazepine
  • Ceritinib
  • Chloroquine
  • Chlorpromazine
  • Ciprofloxacin
  • Cisapride
  • Citalopram
  • Clarithromycin
  • Clomipramine
  • Clozapine
  • Codeine; Phenylephrine; Promethazine
  • Codeine; Promethazine
  • Crizotinib
  • Cyclosporine
  • Dasatinib
  • Degarelix
  • Desflurane
  • Desipramine
  • Deutetrabenazine
  • Dextromethorphan; Promethazine
  • Dextromethorphan; Quinidine
  • Dihydroergotamine
  • Disopyramide
  • Dofetilide
  • Dolasetron
  • Dolutegravir; Rilpivirine
  • Donepezil
  • Donepezil; Memantine
  • Doxepin
  • Dronedarone
  • Droperidol
  • Efavirenz
  • Efavirenz; Emtricitabine; Tenofovir
  • Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
  • Eliglustat
  • Emtricitabine; Rilpivirine; Tenofovir alafenamide
  • Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate
  • Encorafenib
  • Enflurane
  • Entrectinib
  • Ergotamine
  • Eribulin
  • Erythromycin
  • Erythromycin; Sulfisoxazole
  • Escitalopram
  • Ethosuximide
  • Everolimus
  • Ezogabine
  • Fentanyl
  • Fingolimod
  • Flecainide
  • Fluconazole
  • Fluoxetine
  • Fluoxetine; Olanzapine
  • Fluphenazine
  • Fluticasone; Salmeterol
  • Fluticasone; Umeclidinium; Vilanterol
  • Fluticasone; Vilanterol
  • Fluvoxamine
  • Formoterol
  • Formoterol; Mometasone
  • Foscarnet
  • Gemifloxacin
  • Gemtuzumab Ozogamicin
  • Gilteritinib
  • Glasdegib
  • Glycopyrrolate; Formoterol
  • Goserelin
  • Granisetron
  • Halogenated Anesthetics
  • Haloperidol
  • Halothane
  • Histrelin
  • Hydroxychloroquine
  • Hydroxyzine
  • Ibutilide
  • Iloperidone
  • Imipramine
  • Indacaterol
  • Indacaterol; Glycopyrrolate
  • Inotuzumab Ozogamicin
  • Isoflurane
  • Itraconazole
  • Ivosidenib
  • Ketoconazole
  • Lapatinib
  • Lefamulin
  • Lemborexant
  • Lenvatinib
  • Leuprolide
  • Leuprolide; Norethindrone
  • Levalbuterol
  • Levofloxacin
  • Lithium
  • Lofexidine
  • Long-acting beta-agonists
  • Loperamide
  • Loperamide; Simethicone
  • Lopinavir; Ritonavir
  • Macimorelin
  • Maprotiline
  • Mefloquine
  • Meperidine; Promethazine
  • Metaproterenol
  • Methadone
  • Metronidazole
  • Midostaurin
  • Mifepristone
  • Mirtazapine
  • Moxifloxacin
  • Nilotinib
  • Nortriptyline
  • Octreotide
  • Ofloxacin
  • Olanzapine
  • Olodaterol
  • Ondansetron
  • Osilodrostat
  • Osimertinib
  • Oxaliplatin
  • Ozanimod
  • Paliperidone
  • Panobinostat
  • Pasireotide
  • Pazopanib
  • Pentamidine
  • Perphenazine
  • Perphenazine; Amitriptyline
  • Phenylephrine; Promethazine
  • Pimavanserin
  • Pimozide
  • Pirbuterol
  • Pitolisant
  • Posaconazole
  • Primaquine
  • Procainamide
  • Prochlorperazine
  • Promethazine
  • Propafenone
  • Protriptyline
  • Quetiapine
  • Quinidine
  • Quinine
  • Ranolazine
  • Ribociclib
  • Ribociclib; Letrozole
  • Rilpivirine
  • Risperidone
  • Romidepsin
  • Salmeterol
  • Saquinavir
  • Selpercatinib
  • Sertraline
  • Sevoflurane
  • Short-acting beta-agonists
  • Siponimod
  • Sirolimus
  • Solifenacin
  • Sorafenib
  • Sotalol
  • Sunitinib
  • Tacrolimus
  • Tamoxifen
  • Telavancin
  • Telithromycin
  • Terbutaline
  • Tetrabenazine
  • Thioridazine
  • Tiotropium; Olodaterol
  • Tolterodine
  • Toremifene
  • Trazodone
  • Tricyclic antidepressants
  • Trifluoperazine
  • Trimipramine
  • Triptorelin
  • Umeclidinium; Vilanterol
  • Vandetanib
  • Vardenafil
  • Vemurafenib
  • Venlafaxine
  • Voriconazole
  • Vorinostat
  • Ziprasidone

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