Summary In a study conducted among out-patients in Hyderabad, it was shown that the precision of the dapsone/creatinine method for monitoring dapsone compliance could be improved if patients were prescribed specially fo rmulated dapsone capsules containing 6 mg isoniazid as an innocuous marker. Urine samples were obtained by means of surprise home visits; the ingestion of the isoniazid marker was revealed by a simple colorimetric procedure which gives reliably positive results for about 18 h. The study showed that such capsules were acceptable to the patients and, in the short run, were taken more regularly than the standard tablets. However, a small proportion of patients took both capsules and tablets very irregularly, indicating that poor compliance was not overcome by simply changing the dapsone formulation.The dapsone/creatinine ratio (D/e ratio) method has been widely used fo r monitoring the regularity with which leprosy patients ingest their prescribed daily dapsone treatment.! Estimates of the overall level of dapsone compliance have been obtained by comparing the mean Die ratios of urine samples collected from out-patients with those from suitable groups of controls. Although such an approach has demonstrated the ubiquity of poor dapsone compliance, it suffers fr om 3 important limitations:Because of the lack of specificity of simple colorimetric procedures fo r determining dapsone and the presence of interfering compounds in normal urine samples, such samples appear to have significant dapsone concentrations. Thus in order to assess the compliance of out-patients, the apparent Die ratios of untreated controls must also be determined. 2 Because of the relatively slow elimination of dapsone2 and its metabolites 0305-751 8/83/0543 17 +09 $0 1 .00