Leprosy
Mailing List – May 2nd, 2010
Ref.: Can
loose clofazimine be made available for the treatment of erythema
nodosum leprosum (ENL) reaction?
From: Pieter
de Koning, Würzburg, Germany
Dear
Sirs,
We
regularly get questions from our staff in the field regarding the
availability of loose clofazimine (or lamprene 100 mg caps and 50 mg
caps) for the treatment of ENL reaction in leprosy. Clofazimine in
high dosage (sometimes in combination with prednisolone) is
recommended by WHO for those cases not responding to prednisolone
alone or those cases where prednisolone is contra-indicated.
There
used to be a time when loose clofazimine was available for this use
(from CIBA GEIGY, now NOVARTIS) and provided free of charge by WHO. Nowadays
it seems it is no longer available, although still recommended in
(inter-)national guidelines. Field
workers therefore revert to not using clofazimine for ENL at all or
misusing MDT blister-packs by extracting the 50 mg clofazimine
capsules from the MB blister-packs and discarding the DDS and
rifampicine or using it for other purposes. Surely
this cannot be an acceptable state of affairs.
Therefore
my question is whether loose clofazimine can be made available again
and what are the steps to be taken (who to approach?) in order to
procure it.
Kind
regards,
Dr.
Pieter de Koning, MD,
MPH
Medical
Advisor
Deutsche
Lepra- und Tuberkulosehilfe e.V (DAHW)
Mariannhillstraße
1c, 97074 Würzburg
Telefon:
++49 (0)931 7948-113, Fax: -160
E-mail:
pieter.de-koning(at)dahw.de
