Drug of choice in type I lepra reaction with severe neuritis is:

Therapy for Reactions Type 1 lepra reactions are best treated with glucocoicoids (e.g., prednisone, initially at doses of 40-60 mg/d). As the inflammation subsides, the glucocoicoid dose can be tapered, but steroid therapy must be continued for at least 6 months Type 2 Lepra reaction: If ENL is mild (i.e., without fever or other organ involvement), it may be treated with antipyretics alone. In cases with many skin lesions, fever, malaise, and other tissue involvement, brief courses (1-2 weeks) of glucocoicoids are effective. If, despite two courses of glucocoicoid therapy ENL appears to be recurring and persisting, treatment with thalidomide should be initiated