Effectiveness of hemodialysis in acute dapsone overdose—a case report

Thunga, Girish MPharm
Sam, Kishore Gnana MPham
Patel, Dipish MPharm
Khera, Kanav MPharm
Sheshadhri, Subha MD MPharm
Bahuleyan, Shibu MD
Vansalan, Rohit MD
Pandit, Vinay R. MD
Manohar, Chetan MD

^aDepartment of Pharmacy Practice, SS Cancer Hospital and Research Center, Manipal College of Pharmaceutical Sciences, Manipal 576104, India
^bDepartment of Medicine KMC, Manipal 576104, India
^cDepartment of Medicine, KH, Manipal, India
^dDepartment of Pathology, KH, Manipal, India

^☆The authors wish to state that there is no conflict of interest among the authors, and there is no financial support received for this study.

^☆☆This study was approved by the Institutional Ethical Committee, Kasturba Hospital, Manipal, as part of a PhD program in toxicology.

E-mail address:[email protected]

American Journal of Emergency Medicine 26(9):p 1070e1-1070e4, November 2008.

The use of dapsone is increasing even though overdose is rarely reported and physicians must be aware of its toxicity and management. Mortality can occur due to methemoglobinemia and hemolytic anemia. Although activated charcoal and methylene blue are recommended, the use of hemodialysis is reported only in few studies. Literature on the kinetic profile indicates that 50% to 80% of dapsone is protein bound and indicates a possibility to dialyze the unbound form. This study describes a case of deliberate severe dapsone overdose with cyanosis, methemoglobinemia, and hemolytic anemia, which improved after repetitive hemodialysis.