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Isoniazid (INH)

Category:

  • Miscellaneous

Description:

  • Antituberculosis agent

Indications:

  • Treatment and prophylaxis of tuberculosis

  • Severe tremor in patients with multiple sclerosus (non-FDA approved)

Contraindications:

  • Previous isoniazid-associated hepatic injury

Precautions:

  • Pregnancy category C; safe to use in pregnancy; safe to breast feed if infant periodically examined for signs and symptoms of peripheral neuritis or hepatitis

  • Active chronic liver disease, severe renal dysfunction, malnutrition

  • Slow acetylators, elderly, diabetes, alcoholics (increased risk of peripheral neuropathy)

Adverse Reactions (Side Effects):

  • CNS: fever, memory impairment, peripheral neuropathy, seizures, toxic encephalopathy, toxic psychosis

  • EENT: optic neuritis and atrophy

  • GI: epigastric distress, hepatotoxicity, nausea, vomiting

  • HEME: agranulocytosis, eosinophilia, hemolytic, sideroblastic, or aplastic anemia; thrombocytopenia

  • METAB: gynecomastia, hyperglycemia, hypocalcemia, hypophosphatemia, metabolic acidosis, pellegra, pyridoxine deficiency

  • SKIN: skin eruptions, vasculitis

  • MISC: rheumatic syndrome, systemic lupus erythematosis-like syndrome

Dosage:

Administered orally

  • Adult:            

    • Treatment: PO 5 mg/kg/day (up to 300mg total) in a single dose; use in conjunction with other effective antituberculosis agents; duration of treatment 9 months to 2 years

    • Disseminated disease: PO 10 mg/kg/day in 1-2 divided doses

    • Prophylaxis: PO 300mg daily

  • Child:            

    • Treatment: PO 10-20 mg/kg/day (up to 300mg total) in 1-2 divided doses

    • Prophylaxis: PO 10 mg/kg/day every day, not to exceed 300mg daily

Drug interactions:

  • Disulfuram: adverse mental changes and coordination problems

  • Acetaminophen, carbamazepine, cycloserine, theophylline, valproic acid: increased concentrations, possibly to toxic levels

  • Rifampin: incresed hepatotoxicity of isonizid in some patients

  • Ethanol: increased incidence of isoniazid-induced hepatitis in alcoholics

 


The information contained here is an abbreviated summary. For more detailed and complete information, consult the manufacturer's product information sheets or standard textbooks

Source: Operational Medicine 2001,  Health Care in Military Settings, NAVMED P-5139, May 1, 2001, Bureau of Medicine and Surgery, Department of the Navy, 2300 E Street NW, Washington, D.C., 20372-5300

This information is provided by The Brookside Associates.  The Brookside Associates, LLC. is a private organization, not affiliated with any governmental agency. The opinions presented here are those of the author and do not necessarily represent the opinions of the Brookside Associates or the Department of Defense. The presence of any advertising on these pages does not constitute an endorsement of that product or service by either the US Department of Defense or the Brookside Associates. All material presented here is unclassified.

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