Agranulocytosis associated with maloprim: review of cases

Twenty-one cases of agranulocytosis following dosage with one tablet of Maloprim given once or twice weekly are reviewed. Of the 18 individuals for whom the dose is certain 12 were taking twice-weekly Maloprim. Time of onset was 7-9 weeks in 15 of 19 cases where duration of dosage is known. Nine patients died, 12 recovered. Of those who died six were taking Maloprim twice weekly, one once weekly and two at an uncertain dosage. The available data suggest that this is an idiosyncratic reaction to dapsone exacerbated by the concomitant administration of pyrimethamine.