Clofazimine is a second-line anti-TB antibiotic with bactericidal and anti-inflammatory activity. It is used in the treatment of leprosy and multidrug-resistant tuberculosis (MDR/XDR-TB).
Also known as: Lamprene
Rifampicin may reduce clofazimine levels via enzyme induction. Monitor clinical response.
Rifampicin induces hepatic enzymes (CYP3A4, CYP2C8) that metabolise clofazimine, potentially reducing its levels. Although clofazimine has an extremely long half-life (70 days) due to tissue accumulation, rifampicin enzyme induction may significantly reduce this accumulation over time. In MDR-TB regimens combining rifampicin and clofazimine (regimen B), monitor clinical response and skin discoloration (visual indicator of accumulation).
Clofazimine + rifampicin: enzyme induction may reduce clofazimine levels. Monitor response.
Rifampicin induces hepatic enzymes that metabolise clofazimine, potentially reducing its levels. The clinical effect may be significant in MDR-TB regimens.
Clinical response, skin discoloration, vision.
Therapeutic failure if levels reduced.
Monitor clinical response and skin discoloration (accumulation indicator). Consider dose adjustment if inadequate response.
DailyMed/FDA (NIH/NLM) — approved Clofazimine (Lamprene) label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=2e07448f-f888-4747-80ab-570c1b621250 ; approved Rifampicin label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=04e52489-77af-4b7f-b20b-3c5742e7b75e
Clofazimine absorption is improved by fatty food.
Take with food containing fat.
DailyMed/FDA (NIH/NLM) — approved Clofazimine (Lamprene) label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=2e07448f-f888-4747-80ab-570c1b621250
Clofazimine may cause QT prolongation. Patients with prolonged QT or risk factors are at increased risk of arrhythmias.
Baseline ECG before initiation. Avoid with other QT-prolonging drugs.
DailyMed/FDA (NIH/NLM) — approved Clofazimine (Lamprene) label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=2e07448f-f888-4747-80ab-570c1b621250
WHO recommends use during pregnancy for multibacillary leprosy when benefit outweighs risk.
Can be used in the 2nd and 3rd trimesters when indicated.
Excreted in breast milk. Artificial feeding is recommended.
Reliable contraception is recommended.
DailyMed/FDA (NIH/NLM) — approved Clofazimine (Lamprene) label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=2e07448f-f888-4747-80ab-570c1b621250
Clinical and educational support tool. The information does not replace a medical prescription or the opinion of a qualified healthcare professional.
Clofazimine has bactericidal activity against Mycobacterium tuberculosis and M. leprae, plus anti-inflammatory properties. The exact mechanism is not fully elucidated — may involve binding to mycobacterial DNA.
Binds to mycobacterial DNA, inhibiting RNA and protein synthesis. Anti-inflammatory properties modulate the immune response.
Oral bioavailability: low and variable. Tmax: ~8 hours. Absorption improved with fatty food.
Hepatically metabolised. Extremely long half-life (weeks to months) due to tissue accumulation (skin, liver, spleen).
70 days (extremely long — tissue accumulation). Elimination: faeces (primary), urine (minimal).
Medicines from the same therapeutic group (ATC classification) or the same pharmacological class.
