View Full Version : Ulternative drugs to help skin flares

05-05-2011, 10:05 AM
I found out today that when your skin rashes/flares are out of control and creams plus steroid based creams are no good anymore. Dermatologist's are left with the last option of treating you with tablets to control it, as apparentley the Lupus is working at it's most strongest.
I've been given the choice to take out of two lots of tablets but bloods have been run first to see if i'm ok to take them and my choice as been made for the Dapsone hoping my bloods come back ok to match the tablet.

I'm adding below information on both medications to help other member's, who are also suffering from bad flares.

05-05-2011, 10:07 AM
MEPACRINE (Antimalerial)

>> Mepacrine
Click here to download a printable version

Patient Information Leaflet
What are the aims of this leaflet?

This leaflet has been written to help you understand more about mepacrine. It tells you what it is, how it works, how it is used to treat skin conditions, and where you can find out more about it.

What is mepacrine and how does it work?

Mepacrine was introduced as a treatment for malaria and for certain other tropical infections. It is one of several antimalarial drugs that have been found also to have anti-inflammatory properties, which can help some skin conditions.

Which skin conditions are treated with mepacrine?

Mepacrine is used particularly to treat discoid lupus erythematosus and for subacute cutaneous lupus erythematosus. Mepacrine has also been used in the treatment of erythema multiforme and sarcoidosis. Please refer to the relevant leaflets issued by the British Association of Dermatologists.

What dose of mepacrine should I take?

Your doctor will advise you about this. For skin conditions, the dose may be as small as 50 mg (half a 100 mg tablet) taken three times a week. A maximum dose would be 100 mg, taken three times a day. The dose for children is 2 mg per kg bodyweight, given as a split dosage three times a day (to a maximum of 300 mg daily). It may take several weeks to reach its full effect.

What are the possible side effects of mepacrine?

Mepacrine is well tolerated at the low doses used in dermatology. However, it can have some undesirable side effects:

Yellow discoloration of the skin and urine may occur during long-term treatment or with large doses. This is common but quite harmless, and should not be a cause for concern as it goes away when you stop the drug. Similarly, the palate, nails and eyes may be discoloured blue or black, which also resolve when you stop taking the drug.

Mepacrine can cause dizziness, particularly when you get up from sitting or lying down. Getting up slowly should help to reduce this side effect.

Other possible side effects include stomach upsets, headaches, feeling and being sick, rashes (occasionally severe), and changes in mood or behaviour. Fits may occur with overdosing. Liver inflammation and alterations in the blood count can occur but are rare.
Mepacrine should be used with caution in:

patients with porphyria

elderly patients

the presence of liver disease
Mepacrine is best avoided by patients with psoriasis as it can make this condition worse. It should also be avoided in myasthenia gravis and by patients with a history of the severe forms of mental illness called psychoses.

How will I be monitored for the side effects of mepacrine treatment?

Blood tests are usually performed about twice a year to check your blood count and liver function.

Can I have vaccinations while I am on mepacrine?

Yes. This should not be a problem. If you are travelling to a place where malaria occurs, mepacrine alone will not provide adequate protection against it and you must see your GP to be prescribed additional antimalarial treatment which may be taken at the same time as mepacrine.

Does mepacrine affect fertility or pregnancy?

There are no data on the use of this drug in pregnancy and breastfeeding.

Consequently, it is recommended that you should avoid taking it if you are pregnant or planning a pregnancy, or if you are breast feeding.

May I drink alcohol while I am taking mepacrine?

Mepacrine has been reported to produce a mild flushing reaction when taken with alcohol. There may be symptoms such as a racing heartbeat, dizziness, headache, shortness of breath, and sickness. If you experience these symptoms it is advisable to avoid alcohol.

Can I take other medicines at the same time as mepacrine?

Mepacrine is often used in conjunction with hydroxychloroquine for additional benefits. This is safe. However some drugs do interact with mepacrine. For example, mepacrine may increase the blood level of primaquine, resulting in a higher risk of toxicity, and it has been recommended that these two drugs should not be used together. Other drugs that can interact are ciclosporin, digoxin, amiodarone, anticonvulsants, penicillamine, cimetidine and antacids among others. Always inform your doctor and pharmacist if you are taking other medication. Please refer to the relevant leaflets issued by the British Association of Dermatologists.

It follows that you should always let any doctors who are treating you know that you are taking mepacrine.

Where can I find out more about mepacrine?

If you want to know more about mepacrine, or if you are worried about your treatment, you should speak to your doctor or pharmacist. This information sheet does not list all of the side effects of mepacrine. For fuller details, look at the medicine information sheet which comes as an insert with your prescription for mepacrine.

05-05-2011, 10:10 AM
DAPSONE (Sulpha)

>> Dapsone
You can download this leaflet by clicking here

Patient Information Leaflet

What are the aims of this leaflet?

This leaflet has been written to help you understand more about dapsone. It tells you what it is, how it can be used to treat skin conditions, and where you can find out more about it.

What is dapsone and how does it work?

Dapsone is an antibacterial medicine belonging to the sulphonamide class, which is available on prescription from your doctor. It was originally used for treatment of leprosy. More recently it has been used as a treatment for several other skin conditions.

Which skin conditions are treated with dapsone?

Dapsone is used to control inflammation in a variety of conditions such as dermatitis herpetiformis, pyoderma gangrenosum, vasculitis, Henoch Schönlein purpura, Sweet's disease, bullous pemphigoid and other diseases.

When should you not use dapsone?

If you know that you are allergic to dapsone, or have had serious reactions to the sulphonamide group of tablets, you should not take dapsone. Let your doctor know if you have significant heart or lung disease because the dose of dapsone may then have to be lower than usual.

What are the potential side effects of dapsone?

Some people experience mild headaches or sickness. Changes in the red blood pigment (haemoglobin) can lead to a bluish discolouration of lips and fingertips that does not cause other symptoms.

More important problems require medical monitoring but fortunately are rare. They include anaemia, shortness of breath and tiredness. This is much more prominent if you have a genetic condition called glucose-6-phosphate dehydrogenase (G6PD) deficiency. People of Mediterranean, African and Asian ancestry are especially at risk and can be tested for this deficiency before dapsone is started.

Rarely, a serious fall in the blood count can cause fever, mouth ulcers, a sore throat or bruising. Allergy to dapsone can cause fever, a rash and swelling of glands in the neck, armpits and groins. Dapsone should be stopped if an allergy is suspected.

Are there any other side effects if dapsone is taken for a long time?

Rarely, prolonged use at high doses can lead to impaired function of nerves in the limbs, causing weakness of muscles in the hands and feet.

What dose should I take?

Your doctor will advise you here. Dapsone is available in tablet form at strengths of 50 mg and 100 mg. Normal doses would be in the range of 50 to 200 mg daily.

How will I be monitored for the side effects of dapsone treatment?

You will need blood tests to make sure that your blood and liver are working normally before starting dapsone. These tests will take place frequently after starting it, and thereafter every three months while you remain on the dapsone. An urgent blood count needs to be taken in between if you develop any of the symptoms or the more important side effects mentioned above.

Does dapsone affect fertility or pregnancy?

Dapsone can reduce the number of sperm and their mobility. It does not affect the development of the growing baby. Dapsone should be avoided in pregnancy if possible, but has been used safely. The greatest risk to a baby in the womb is in the last three months, and can be reduced if folic acid, a vitamin, is taken. Dapsone enters breast milk and can be harmful to babies with G6PD deficiency.

May I drink alcohol while taking dapsone?


Can I take other medicines at the same time as dapsone?

The more important drug interactions are with probenecid (a treatment for gout), which increases dapsone levels in your blood, and with the antibiotics trimethoprim and rifamycins, which lower blood levels.

ortant that you always tell your doctor and pharmacist that you are taking dapsone.

Where can I find out more about dapsone?

This information sheet does not list all the side effects this type of drug can cause. For fuller details, please look at the drug information leaflet that comes with your medicine. Your doctor will assess your medical circumstances and draw your attention to side effects that may be relevant in your particular case.