Hansen's Disease (Leprosy)

Current and Future Pharmacotherapy and Treatment of Disease-related Immunologic Reactions

Davey P. Legendre, Pharm.D.; Christina A. Muzny, M.D.; Edwin Swiatlo, M.D., Ph.D.


Pharmacotherapy. 2012;32(1):27-37. 

In This Article


The mechanism of action of thalidomide in patients with Hansen's disease is not fully understood, but it does reduce systemic concentrations of TNF-α, a cytokine involved in systemic inflammation. Thalidomide is useful for treatment for ENL when corticosteroids are not effective or are contraindicated. The initial dose is 100–300 mg/day. Once symptoms subside, therapy can be tapered by 50 mg every 2–4 weeks. Thalidomide is known to cause birth defects and is a pregnancy category X drug. In this case, corticosteroids are the hallmark of therapy. Breastfeeding is also contraindicated while taking thalidomide. Those who wish to prescribe therapy must be licensed through the System for Thalidomide Education and Prescribing Safety (STEPS) program, and pharmacists are also responsible for complying with these regulations.


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