Isoniazid

Table of contents

  • Brand Names
  • Drug Combinations
  • Chemistry
  • Pharmacologic Category
  • Mechanism of Action
  • Therapeutic Use
  • Pregnancy and Lactation Implications
  • Contraindications
  • Warnings and Precautions
  • Adverse Reactions
  • Caution and personalized dose adjustment in patients with the following genotypes
  • Other genes that may be involved
  • Substrate of
  • Inhibits
  • Induces
  • Drug Interactions
  • Nutrition/Nutraceutical Interactions
  • Dosage
  • Pharmacokinetics and Pharmacodynamics
  • Special Considerations

Brand Names

Europe

Austria: INH; Belgium: Nicotibine; Bulgaria: Isonid, Rimicid; Czech Republic: Nidrazid; Denmark: Isoniazid; Finland: Tubilysin; France: Isoniazide, Rimifon; Germany: Isozid, Tebesium-S; Greece: Dianicotyl, Isoniazid; Hungary: Isonicid; Italy: Isoniazi FN, Nicozid; Luxembourg: Nicotibine; Malta: Isoniazid; Netherlands: Isoniazide; Poland: Isoniazidum, Nidrazid; Portugal: Hidrazida, Isoniazida; Romania: Isoniazida; Slovakia: Nidrazid; Spain: Cemidon; Sweden: Tibinide; UK: Isoniazid.

North America

Canada: Isoniazid, Isotamine; USA: Isoniazid.

Latin America

Argentina: Isoniac, Isoniazida, Nicotibina; Mexico: Hidrasix, Isodo Tbal, Valifol.

Asia

Japan: Diazid, Hydra, Hydrazide, IHMS, INH, Iscotin, Neoiscotin.

Drug combinations

Isoniazid and Pyridoxine (Vitamin B~6~)

Isoniazid and Rifampin

Isoniazid, Pyrazinamide, and Rifampin

Isoniazid, Ethambutol, Pyrazinamide, and Rifampin

Chemistry

Isoniazid: C~6~H~7~N~3~O. Mw: 137.14. (1) 4-Pyridinecarboxylic acid, hydrazide; (2) Isonicotinic acid hydrazide. CAS-54-85-3.

Pharmacologic Category

Antimycobacterials; Antituberculosis Agents. (ATC-Code: J04AC01).

Mechanism of action

A highly specific antibacterial agent; active only against Mycobacterium. Interferes with metabolism of bacterial proteins, nucleic acids, carbohydrates, and lipids. Appears to inhibit mycolic acid synthesis in susceptible bacteria which results in loss of acid-fastness and disruption of bacterial cell wall.

Therapeutic use

Treatment of susceptible or latent tuberculosis infections.

Pregnancy and lactiation implications

Embryocidal in animal studies. Teratogenic effects not noted. Isoniazid crosses human placenta. Due to risk of tuberculosis to fetus, treatment is recommended when probability of maternal disease is moderate to high. Small amounts of isoniazid are excreted in breast milk. Breast-feeding infants receiving isoniazid should also receive pyridoxine supplementation.

Unlabeled use

Contraindications

Hypersensitivity to isoniazid or any component of the formulation. Acute liver disease. Previous history of hepatic damage during isoniazid therapy. Previous severe adverse reaction (arthritis, chills, drug fever) to isoniazid.

Warnings and precautions

Risk of developing hepatitis. Use with caution in hepatic impairment, and in severe renal impairment. Periodic ophthalmic examinations recommended. Hypersensitivity reactions might occur. Peripheral neuritis reported. Must be used in conjunction with other antituberculosis agents. Used in infants and children for treatment of active (clinical) tuberculosis and treatment of latent tuberculosis infection. Contraindicated in acute liver disease.

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