Multidrug regimens for treatment of leprosy in children

	National Hansen's Disease Program (NHDP)*		World Health Organization (WHO)^¶
Regimen	Dose	Duration	Dose	Duration
Tuberculoid ("paucibacillary"): TT, BT^Δ
Dapsone^◊	1 mg/kg daily (not to exceed 100 mg/day)	12 months	50 mg daily^§	6 months
Rifampin^◊	10 to 20 mg/kg daily (not to exceed 600 mg/day)	12 months	450 mg once a month^§	6 months
Lepromatous ("multibacillary"): LL, BL, BB^Δ
Dapsone^◊	1 mg/kg daily (not to exceed 100 mg/day)	24 months	50 mg daily^§	12 months
Rifampin^◊	10 to 20 mg/kg daily (not to exceed 600 mg/day)		450 mg once a month^§
Clofazimine	1 mg/kg daily^¥ (not to exceed 50 mg daily)		150 mg once a month, and 50 mg every other day^¥

TT: tuberculoid; BT: borderline tuberculoid; LL: lepromatous; BL: borderline lepromatous; BB: mid-borderline.
* Additional information available at NHDP website: http://www.hrsa.gov/hansensdisease/diagnosis/recommendedtreatment.html.
¶ These are the 1982 WHO recommendations. The 2018 WHO recommendations are still under consideration in most countries. Additional information available at WHO website: http://www.who.int/lep/mdt/regimens/en/index.html.
Δ TT, BT, BB, BL, and LL refer to the Ridley-Jopling classification (refer to the text).
◊ Oral suspension may be compounded. Refer to the Lexicomp pediatric drug information on extemporaneous preparations.
§ WHO advises dose adjustment for children <10 years: dapsone 25 mg daily and rifampin 300 mg monthly.
¥ As there is no formulation of clofazimine less than 50 mg and the capsule should never be cut open, alternate-day dosing (2 mg/kg every other day) may be used. Clofazimine should be taken either with or immediately after food or milk to facilitate absorption. In the United States, the NHDP holds the Investigational New Drug (IND) for treatment of leprosy. For further information or to request investigator status to use clofazimine, contact the NHDP: 1-800-642-2477.

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