Isoniazid

Dosing

5 mg/kg PO q24h (max 300 mg/dose)

10-20 mg/kg PO div q12-24h

Hepatic impairmentUse with caution

HD5 mg/kg PO after HD

General Information

First line anti-tuberculosis drug.

  • Active tuberculosis.

  • Active tuberculosis, HIV infection.

  • Inactive tuberculosis.

  • HIV infection, inactive tuberculosis.

Obtain acid-fast bacilli smear and culture from sputum until 2 consecutive culture specimens are negative.

Perform chest x-rays after 2-3 months of treatment and at end of treatment.

Monitor hepatic function, signs and symptoms of hypersensitivity reactions and signs of treatment-associated side effects.

Perform ophthalmic examinations if visual symptoms occur.

Common

  • Increased liver enzymes

  • Neuropathy

  • Neurotoxicity

Serious

  • Rash

  • Agranulocytosis

  • Thrombocytopenia

  • Anemia

  • Hepatitis

  • Systemic lupus erythematosus

  • Rhabdomyolysis

  • Seizure

Monitor when used in combination with drugs at risk of liver damage such as Benzodiazepines and Acetaminophen. Directly observed therapy (DOT) advised for treatment of active TB.

Major drug-drug interactions:

  • Acetaminophen

  • Levodopa

  • Ketoconazole

  • Glimepiride

  • Carbamazepine

  • Tegafur

  • Pexidartinib

  • Bupropion

  • Domperidone

  • Piperaquine

  • Amiodarone

  • Donepezil

  • Amifampridine

Antimicrobial class: Antitubercular, Isonicotinic Acid

Pregnancy category: C

Average serum half life: 0.7-4 hours

CSF penetration: Therapeutic

Precautions:

  • Tyramine and histamine containing foods should be avoided during use.

  • Careful monitoring recommended for HIV seropositive patients; treatment interruption or discontinuation may be required.

  • Careful monitoring recommended for patients with preexisting peripheral neuropathy or conditions predisposing to neuropathy; treatment interruption or discontinuation may be required.

  • Discontinue use for recurrent hypersensitivity reactions.

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