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[Pharmacology](https://durgical.com/en/pharmacology/) · [Antileprosy drugs](https://durgical.com/en/pharmacology/classes/antileprosy-drugs/)

# Clofazimine

A red fat-soluble dye used in leprosy multidrug therapy and in drug-resistant tuberculosis. It turns the skin red-brown and can prolong the QT interval.

Updated 2026-11-01

- Class: [Antileprosy drugs](https://durgical.com/en/pharmacology/classes/antileprosy-drugs/)
- Target: Mycobacterial membrane and respiratory chain (several actions)
- ATC code: J04BA01
- WHO Model List of Essential Medicines

Also called: CFZ, Cfz

## Mechanism of action

Clofazimine is a riminophenazine dye whose action is spread over several targets: it disrupts the mycobacterial membrane, interferes with the electron transport chain, generates hydrogen peroxide and blocks potassium transport. It also has anti-inflammatory effects, useful in leprosy reactions.

- The dye builds up in the mycobacterial membrane
- It disturbs the respiratory chain and produces oxidants
- The bacillus loses energy and dies

## Pharmacokinetics

**Absorption**
Incomplete by mouth; fatty meals increase it and antacids lower it

**Distribution**
Very large volume of distribution; it deposits in fat, skin and tissues as crystals

## Indications

- Leprosy, multibacillary and paucibacillary, within multidrug therapy [Leprosy (Hansen disease) →](https://durgical.com/en/conditions/leprosy/)
- Leprosy reactions, including erythema nodosum leprosum
- Drug-resistant tuberculosis (BDLLfxC and longer regimens) [Tuberculosis →](https://durgical.com/en/conditions/tuberculosis/)
- Nontuberculous mycobacterial infections [Nontuberculous mycobacterial infections (MAC, M. abscessus, Buruli ulcer) →](https://durgical.com/en/conditions/nontuberculous-mycobacterial-infections/)

## Adverse effects

### Common

- Red-brown discoloration of skin, eyes and body fluids
- Dry, scaly skin (ichthyosis)
- Abdominal pain, nausea, diarrhoea

### Serious (rare, important)

- Crystal deposits in the bowel wall, with severe abdominal pain
- QT prolongation
- Distress or stigma from skin colour change

## Contraindications

- Hypersensitivity to clofazimine

## Key interactions

**Bedaquiline, delamanid and other QT-prolonging drugs**
QT effects add up: ECG monitoring

**Antacids**
Lower clofazimine absorption

**Dapsone**
May blunt clofazimine's anti-inflammatory effect

## What is monitored

- ECG, especially with other QT-prolonging drugs
- Persistent or severe abdominal pain
- Skin changes and the person's mood about them

## Administration and safety

- By mouth, with food
- In leprosy it comes in WHO multidrug therapy blister packs, free of charge

## Nursing care

- Warn before starting that skin, sweat, tears and urine turn red-brown
- Teach to report severe or lasting abdominal pain
- Offer support for the cosmetic change, which can be distressing or stigmatising
- Advise skin moisturisers for dryness

## Memory aid

CLOFazimine COLOURS: the skin goes red-brown.

## Test yourself

Think of the answer, then tap the question to see it.

## Which visible side effect is typical of clofazimine?

Red-brown discoloration of skin and body fluids, often with dry skin.

## Why does clofazimine help in leprosy reactions?

Besides killing the bacillus, it has an anti-inflammatory effect.

## Which cardiac risk does clofazimine share with bedaquiline?

QT prolongation; together they need ECG monitoring.

[Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/clofazimine/)

## Related drugs

- [Dapsone](https://durgical.com/en/pharmacology/dapsone/)
- [Rifampicin](https://durgical.com/en/pharmacology/rifampicin/)
- [Bedaquiline](https://durgical.com/en/pharmacology/bedaquiline/)

## Related conditions

- [Leprosy (Hansen disease)](https://durgical.com/en/conditions/leprosy/)
- [Tuberculosis](https://durgical.com/en/conditions/tuberculosis/)
- [Nontuberculous mycobacterial infections (MAC, M. abscessus, Buruli ulcer)](https://durgical.com/en/conditions/nontuberculous-mycobacterial-infections/)

[← Back to the class: Antileprosy drugs](https://durgical.com/en/pharmacology/classes/antileprosy-drugs/)

Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [Leprosy](https://www.who.int/news-room/fact-sheets/detail/leprosy) (World Health Organization (WHO), 2025); [WHO consolidated guidelines on tuberculosis: module 4: treatment and care](https://www.who.int/publications/i/item/9789240107243) (World Health Organization (WHO), 2025); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=J04BA01) (WHO Collaborating Centre for Drug Statistics Methodology, 2026); Goodman & Gilman's The Pharmacological Basis of Therapeutics, 14th ed., ch. 65 (McGraw Hill, 2023).

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Representative model, for educational purposes only.

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License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/clofazimine/