Clofazimine

Lepromatous Leprosy (including Dapsone resistant)
1. Must be used as part of multi-drug regimen (high risk of developed Antibiotic Resistance)
Lepromatous Leprosy Type 2 Reaction (Erythema Nodosum)

Rimino-phenazine dye (red color) synthetically derived from lichen extracts (Buellia canescens)
Anti-inflammatory properties (used in treatment of Leprosy type 2 reaction)
Anti-Mycobacterial
1. Preferentially binds Mycobacterial DNA, inhibiting DNA Replication and cell growth
2. Activity against Mycobacterium leprae (as well as other Mycobacteria)
3. Slowly bactericidal

Precautions
1. Clofazimine must be used in combination with other agents (risk of resistance)
2. Decrease dose for significant gastrointestinal adverse effects
3. Discontinue for significant QTc Prolongation
Lepromatous Leprosy (in combination with other agents)
1. Clofazimine 50 mg orally daily for 2 years
2. FDA label dosing is 100 mg daily for 2 years (3 years if Dapsone resistance)
Lepromatous Leprosy Type 2 Reaction (Erythema Nodosum)
1. Other treatment regimens are preferred (e.g. Corticosteroids, Methotrexate)
2. Clofazimine 100 to 200 mg orally daily for up to 3 months (taper to 100 mg as soon as possible)

Skin and body fluid reddish discoloration (40-50% of patients)
1. Deposits in skin, mucosa and Conjunctiva
2. Leprosy lesions treated with Clofazimine will appear tan or black
Gastrointestinal (related to drug deposits in intestinal mucosa)
1. Small Bowel Obstruction
2. Gastrointestinal Hemorrhage
3. Splenic infarction
Cardiovascular
1. QTc Prolongation (esp. dose >100 mg/day)