Oral activated charcoal and dapsone elimination

Area of Science:

• Pharmacology
• Toxicology

Background:

• Dapsone is a medication with a long elimination half-life.
• Intoxication with dapsone can occur, necessitating effective treatment strategies.

Purpose of the Study:

• To investigate the efficacy of activated charcoal in accelerating dapsone elimination.
• To evaluate activated charcoal's effect on both therapeutic and toxic doses of dapsone.

Main Methods:

• A randomized crossover study involving healthy subjects and intoxicated patients.
• Administration of dapsone followed by multiple doses of activated charcoal.
• Measurement of serum dapsone and monoacetyldapsone (MADDS) levels and urinary excretion rates.

Main Results:

• Activated charcoal significantly reduced the half-life of serum dapsone from 20.5 hr to 10.8 hr (p < 0.01).
• The half-life of serum monoacetyldapsone (MADDS) was similarly shortened by charcoal (19.3 hr to 9.5 hr, p < 0.01).
• In intoxicated patients, activated charcoal increased the elimination rate of dapsone and MADDS threefold to fivefold.

Conclusions:

• Multiple-dose activated charcoal is effective in enhancing the elimination of dapsone.
• This treatment is particularly beneficial in post-absorption phase intoxications involving drugs with long half-lives and enterohepatic recirculation.
• Activated charcoal serves as a valuable supplementary treatment for dapsone overdose.