Clofazimine treatment courses are long, and during medication attention should be focused on skin pigmentation, gastrointestinal reactions, and drug interactions.Standardized management can improve tolerability and safety.

I.Skin pigmentation

1.Manifestations and characteristics

After medication, the skin and mucous membranes (including conjunctiva and oral mucosa) may appear red-brown to purple-brown, with accumulation related to dose and treatment duration.The incidence is relatively high, and it is a common reversible reaction that gradually fades over months to years after discontinuation.

2.Response points

①Proactively inform patients before medication to reduce psychological burden and avoid self-discontinuation due to panic;②Generally no dose adjustment is needed, and continued treatment is not affected;③Recommend wearing dark clothing and reducing sun exposure, using sun protection when going out to reduce pigment darkening;④If accompanied by severe itching, rash, or desquamation, rule out allergic reactions and seek medical attention promptly.

II.Gastrointestinal reactions

1.Common manifestations

Abdominal pain, diarrhea, nausea, vomiting, and loss of appetite are relatively common, mostly related to gastrointestinal irritation by the drug and intestinal deposition.

2.Response points

①Insist on taking the drug with meals or immediately after meals, avoiding an empty stomach, which can significantly reduce irritation;②Eat small, frequent meals, avoiding spicy, cold, and excessively high-fat foods;③Mild symptoms can be observed and treated symptomatically, while recording bowel movement frequency and characteristics;④If persistent severe abdominal pain, bloody stools, abdominal distension and vomiting, or weight loss occur, be alert to serious complications such as intestinal obstruction or intestinal bleeding, and immediately discontinue the drug and seek medical attention; long-term users should regularly monitor abdominal symptoms.

III.Drug interactions

1.Major interactions

①Concomitant use with rifampicin can reduce clofazimine blood concentrations and may affect efficacy; evaluation is needed when used together;②Concomitant use with hepatotoxic drugs such as isoniazid and prothionamide can increase the risk of liver injury; liver function should be monitored;③Concomitant use with bile acid sequestrants such as cholestyramine may reduce absorption; dosing times should be staggered;④Concomitant use with amiodarone and some antiarrhythmic drugs can increase the risk of cardiotoxicity; vigilance for QT interval prolongation is needed.

2.Management points

①Provide the physician with a complete medication list before treatment (including prescription drugs, over-the-counter drugs, and health supplements);②Avoid self-administering other drugs; regimen adjustments must be evaluated by a physician;③When used with hepatotoxic or cardiotoxic drugs, regularly monitor liver function and electrocardiogram;④Seek medical attention promptly if fatigue, jaundice, palpitations, or syncope occur.