Clofazimine ? Still used for treatmentof MAC ?
May 25, 1997
Dear Dr. Gallant: My boyfriend was diagnosed with MAC about 6 months ago, when his first drug combo failed, and the infection returned, his Doctor added Clofazimine (along with some other changes). I've been reading a lot of info that states that this drug is not a good choice, that it shows no improvement to this disease, etc (in recent studies). Was this a long time ago, has something new developed regarding using this drug for MAC or is he wasting his time taking it (along with the other 16 drugs a day he must take). What is the last/updated info on CLOFAZIMINE/LAMPRENE? Any help you could give me would be greatly appreciated. Thank you!
Response from Dr. Gallant
Clofazamine (Lamprene) was shown to add no additional benefit in treating MAC compared to a two drug regimen of clarithromycin (Biaxin) plus ethambutol (Myambutol). In fact, the use of clofazamine was associated with increased toxicity and even increased mortality. Thus, it is now felt that clofazamine has no role in the initial treatment of MAC, which should usually be with clarithromycin (or azithromycin) plus ethambutol, plus or minus rifabutin (Mycobutin).
That doesn't mean that in the occasional patient who has developed resistant MAC while on standard therapy, there might not be a role for clofazamine. When people have failed their initial therapy there are often few good options, and it might not be unreasonable to reach for less effective, more toxic alternatives like clofazmine for lack of any good alternatives.
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