Therapeutic effects of adding rimactane (rifampicin) 450 milligrams daily or 1200 milligrams once monthly in a single dose to dapsone 50 milligrams daily in patients with lepromatous leprosy

Languillon, J.; Yawalkar, S.J.; Mcdougall, A.C.

International Journal of Leprosy and other Mycobacterial Diseases Official Organ of the International Leprosy Association 47(1): 37-43


ISSN/ISBN: 0148-916X
PMID: 376454
Accession: 006795931

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The clinical, bacteriologic and histopathologic effects of adding Rimactane 450 mg daily or 1200 mg once-monthly to a standard dapsone regimen were practically identical in 30 lepromatous leprosy patients. Rimactane 1200 mg once-monthly in a single dose for 6 mo. could, on the basis of this trial, be therapeutically and economically an ideal and easily supervisable component of combination regimes for large scale, initial and intensive treatment of multibacillary (LL, LI and BL) types of leprosy. This trial has to a great extent solved the problems of rifampicin therapy in leprosy with regard to dosage, dose intervals and duration of the treatment, which have baffled leprologists for so many years. This was the 1st controlled clinical trial to demonstrate the practicability and utility of a once-monthly single dose rifampicin schedule in the initial treatment of multibacillary forms of leprosy. It is suggested that a combination regimen comprising dapsone 50-100 mg daily (1.5-2 mg/kg body weight), Lamprene 100 mg on alternate days and rifampicin 1200 mg once-monthly in a single dose for 6 mo. using long-term follow-up merits further investigation. This triple-drug regimen might prove optimally effective, reasonably safe and fairly economical for the initial treatment of patients with LL, LI and BL leprosy. This combination regimen could result in faster arrest of transmission and may prevent the emergence of drug resistance.