Leprosy Mailing List – May 8, 2015
Ref.: (LML) Parenteral treatment of leprosy reactions
From: Herman Harun, Jakarta, Indonesia
Dear Pieter,
May I summarize the initial parenteral treatment for leprosy reactions, as follows:
In Type 1 reaction, we can give 125 mg methylprednisolone (the equivalent of approximately 150 mg of prednisone) in one bolus. We may use less, but since each ampoule already contains 125 mg prednisolone (and there is actually ‘no’ maximum dose of corticosteroids in emergency cases), I would suggest not to dispose of excessive prednisolone). After that, proceed with oral prednisone as prescribed.
In type 2 reaction, we can give up to three days, each day a bolus of 125 mg prednisolone parenteral. Then proceed with oral prednisone as prescribed.
If gastric complaints are present or suspected, I would give 20 mg omeprazole before breakfast. The injections can also be given intramuscularly, same dose.
Let it be clear, I am not introducing a new method of treating leprosy reactions, it is only to find out, whether by parenteral addition of corticosteroids, we can much sooner relieve the severe pain and agony caused by the leprosy reactions.
With sincere thanks to Dr Ben Naafs for his instructive advice on this subject,
Muherman Harun
LML - S Deepak, B Naafs, S Noto and P Schreuder
LML blog link: http://leprosymailinglist.blogspot.it/
Contact: Dr Pieter Schreuder << editorlml@gmail.com
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