Q: My son has vitiligo for the last three years. The doctors have mostly given him topical steroids. Recently, a doctor has prescribed levamisole 50 mg in combination with topical corticosteroids. I am very apprehensive about levamisole. Do you think it is safe to give oral levamisole to my son who is 10 years old?

A:Levamisole is approved by the Drugs Controller General, India (DCGI) for use in the treatment of roundworms and hookworms only. The dose is 150mg only once in the case of roundworms and 4 times for hookworms. In children the dose is 2.5-5mg per kg of the body weight. It is generally well tolerated and side effects are usually minimal. However when used over long periods in conditions such as cancer, kidney disorders and vitiligo, the side effects can be many more and sometimes quite serious. For example in one trial involving 2635 patients, 38 (1.5%) developed severe blood disorder called agranulocytosis (i.e. depression and disappearance of a certain type of white cells that fight infection). Out of these two died due to lack of immunity. Levamisole also affects liver adversely when used over long periods. Since Levamisole is only approved for the treatment of worms, its prescription for other disorders on an experimental basis is unlawful on the part of doctors as per Section 1.9 of the Regulations governing the conduct of medical practice notified by the Indian Medical Council in the year 2002. Unfortunately many doctors are not aware of this law.