Precautions and warnings

People with kidney or liver problems, seizure disorders, a history of mental illness, or a higher risk of nerve damage or vitamin B6 deficiency—such as those with diabetes, alcohol dependence, poor nutrition, kidney failure, or HIV infection—should use caution. Black and Hispanic women need careful monitoring of liver function, which should be checked before and during treatment. Special care is also needed during pregnancy and breastfeeding.

Drug Interactions

These drugs can slow down how the liver processes certain medications, such as antiepileptics (like carbamazepine, ethosuximide, primidone, and phenytoin), benzodiazepines (like diazepam and triazolam), chlorzoxazone, theophylline, and disulfiram. This may cause higher levels of these medicines in the body, which could lead to increased side effects or toxicity. They can also make the body break down enflurane faster, leading to high levels of fluoride, which might harm the kidneys. In addition, drugs like clofazimine, cycloserine, and warfarin may build up in the body and cause stronger or toxic effects. Taking these medicines with aluminum-containing antacids can reduce how well the body absorbs them. Finally, using zalcitabine or stavudine along with these drugs raises the risk of nerve damage (peripheral neuropathy).

Contraindications

Do not use if you have severe liver disease, a history of liver problems caused by INH treatment, or are allergic to this medication.

Mode of actions

Isoniazid works by blocking the production of mycolic acids in certain bacteria. This weakens the bacterial cell wall and causes them to lose their acid-fast property. At the doses used for treatment, isoniazid kills Mycobacterium tuberculosis bacteria that are actively growing, whether they are inside or outside of cells.

Dosage & Administration

Adult: PO Active tuberculosis 5 mg/kg/day. Max: 300 mg/day or 15 mg/kg up to 900 mg/day, 2 or 3 times wkly. Latent tuberculosis 300 mg/day for 6 mth.
Nontuberculous mycobacterial infections 5 mg/kg/day for at least 12 mth of culture-negative sputum. Max: 300 mg/day.

Child: 10-15 mg/kg up to 300 mg daily as a single dose or 20-40 mg/kg up to 900 mg/day, 2 or 3 times wkly.

Pregnancy & Lactation

Although animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in pregnant women, but during pregnancy, this medicine can be used just when definitely required despite potential risks.

Mothers with a newborn baby who have used this drug during the last 3 months of pregnancy may seldom create symptoms including drowsiness, muscle stiffness or shakiness, feeding or breathing troubles, constant crying. If you notice any of these symptoms of your baby's particularly during their first month, tell the doctor immediately.

This medicine passes into breast milk. Talk to your doctor before breastfeeding.

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