Isoniazid

Brand names of isoniazid

  • Dom-Isoniazid
  • Isotamine
  • Laniazid
  • Nydrazid
  • P-I-N Forte [CD]
  • PMS-Isoniazid
  • Rifamate [CD]
  • Rifater [CD]
  • Seromycin w/Isoniazid [CD]
  • Teebaconin

Isoniazid is an organic amalgam that is the most important medicine for preventing as well as treating tuberculosis (TB). While this amalgam was synthesized for the first time in the early part of the 20th century, the efficiency of this medication in treating tuberculosis was reported for the first time during the beginning of the 1950s. It is interesting to note that three pharmaceutical firms unsuccessfully endeavoured to patent this drug simultaneously - the most notable among them being Roche, which introduced its version of this medication called Rimifon in 1952. In fact, the cure for tuberculosis was considered to be feasible when isoniazid was introduced for the first time. This medication acts by eliminating the bacteria responsible for developing tuberculosis.

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Things you need to tell your physician before taking isoniazid

There are a number of things that you must tell your physician as well as pharmacist prior to starting treatment with isoniazid, or for that matter, any other medication.

Before you start taking isoniazid, you must tell your physician and pharmacist regarding all the prescription and over-the-counter drugs that you are already using, particularly if you are using antacids, acetaminophen (Tylenol), disulfiram (Antabuse), carbamazepine (Tegretol), phenytoin (Dilantin), ketoconazole (Nizoral), valproic acid (Depakote, Depakene), theophylline (Theo-Dur, Theobid) and vitamins.

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Also tell your physician if you are suffering from or have ever suffered from diabetes, kidney ailments, stinging, burning sensations and soreness in the fingers and toes (nerve damage or peripheral neuropathy) and/ or human immunodeficiency virus (HIV). Women who are planning to take isoniazid should tell their physician if they are pregnant or planning to become pregnant. In case any woman becomes pregnant while undergoing treatment with isoniazid, she should right away consult her physician regarding what she ought to do next.

It is worth mentioning here that while you are undergoing treatment with isoniazid, consumption of alcoholic beverages is strictly prohibited.

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Treatment with isoniazid is likely to result in severe and, at times, even fatal liver damage. Therefore, before starting treatment with this drug, it is essential to tell your physician whether you have or have ever suffered from any liver ailment; have a history of heavy drinking or injection drug use. It is important that you keep all the appointments with your physician as well as the laboratory. In most cases your physician will ask you to undertake specific laboratory tests to determine your response to treatment with isoniazid.

Contact your physician right away if you experience debility, excessive exhaustion, and absence of vivacity, stomach disorder, and lack of appetite, dark yellow or brownish urine and / or the skin and eyes turning yellow.

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Usage

The drug isoniazid is used to prevent as well as cure tuberculosis. This medication may be taken individually to avoid developing tuberculosis, but it is essential to take it in combination with other anti-tubercular medications to cure an active instance of tuberculosis.

How to use isoniazid

Isoniazid should be taken orally and on an empty stomach, generally one hour prior to or two hours following meals. You may also take this medication as recommended by your physician. In case you are using the liquid form of isoniazid, you should measure the dosage carefully using a specific measuring spoon. Never use a domestic spoon to measure the dose of this medication, for you may not get the accurate amount. In case you are also taking antacids containing aluminum, you should take isoniazid no less than an hour before taking the antacid. The dosage of isoniazid is dependent on the patient's age, body weight, medical condition and his/ her response to the treatment.

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Isoniazid is basically an antibiotic and like all other antibiotics, it works excellently when the amount of the medication in the body is maintained at a steady level. Hence, it is important to take this medication at regular intervals. Provided you are taking isoniazid every day, you should take it around the same time daily. In case you are taking this drug once in a week, always take it on the same day and at the same time every week. It is prudent to mark the days as well as the timing of taking this medication on the calendar. Even if the symptoms of tuberculosis (TB) go away, continue taking isoniazid along with other anti-tuberculosis drugs for the entire prescription period.

Discontinuing the medication very early or missing doses may permit the bacteria to continue growing, as a result of which, the disease may reoccur. In such conditions, it will be extremely difficult to treat the disease, as the bacteria become resistant to the drugs. In addition to taking isoniazid and other anti-TB drugs, it is possible that your physician will ask you to take vitamin B6 (also known as pyridoxine) with a view to aid you to avoid particular side effects of using this medicine, for instance, problems related to the nerves. People taking isoniazid should strictly follow the instructions of their physician.

It may be noted that isoniazid is likely to interact with certain foods, especially those enclosing tyramine, histamine, for instance, particular types of cheeses, red wine and fish. Such drug interaction may possibly result in raised blood pressure, headache, light-headedness, reddening of the skin, and/ or very fast heart beats. If you experience any of these symptoms, contact with your physician right away. When you are undergoing treatment with isoniazid, it is possible that your physician may ask you to pursue a special diet. It is advisable that you talk to your physician for further details. Also tell your physician if your condition continues as it is or deteriorates.

How isoniazid works

While the precise method of action of isoniazid is yet to be ascertained, it is believed that this medication has the aptitude to avoid the bacteria responsible for tuberculosis from producing substances known as mycolic acids - substances required to compose the bacteria's cell wall. In addition, isoniazid also merges with an enzyme that obstructs the bacteria's cell metabolism. Consequently, the disturbance in the cell metabolism of the bacteria coupled with the absence of a cell wall results in the death of the bacteria.

The treatment of tuberculosis (TB) involves two main stages. During the initial two months of the disease, the treatment is projected at eliminating the maximum number of bacteria feasible. Hence, numerous anti-tuberculosis medications with dissimilar modus operandi are employed simultaneously - generally the drugs used during this period include isoniazid, rifampicin, ethambutol and pyrazinamide. Following this, a number of medications are discontinued, while others, such as isoniazid and rifampicin, are continued for another four months with a view to eliminate any bacteria that might have been left out during the earlier stage of the treatment. In effect, isoniazid is used in both the stages of treatment for tuberculosis.

It may be noted that it is difficult to treat the bacteria that is responsible for causing tuberculosis. Use of numerous medications simultaneously helps to target the bacteria in many dissimilar ways and, therefore, the treatment may possibly be more effectual compared to using a solitary medication. Moreover, using different medications in conjunction also makes it less possible that the bacteria would be able to put up a resistance to the treatment.

Side effects

Serious
Common
Less common

Possible interactions

Herbal medicines or minerals:
A number of people use the herb Echinacea with a view to perk up their immune systems. However, it is unfortunate that using Echinacea is not advisable by people having impaired immune systems. In effect, this herb is likely to make any immune system weaker provided it is used very frequently and also for a prolonged period of time. People taking isoniazid should never take certain herbs like oak bark, mistletoe, licorice or marshmallow root.
Foods:
Provided you are taking isoniazid, you need to exercise caution while consuming certain foods till you are sure of your endurance. The foods you should take with caution include skipjack fish, tuna fish, Sardinella species as well as Swiss and Cheshire cheeses. These foods are likely to interact with isoniazid and result in side effects like itching, skin rashes, perspiration, headache, chills, dizziness and/ or very fast heart beats. When isoniazid is taken with food, it also diminishes the body's ability to absorb the drug as well as the remedial benefits of the medication. Specific types of red wines as well as chesses also enclose elevated levels of tyramine. When these red wines and cheeses are consumed, it may cause an unwanted rise in the blood pressure. Hence, it is advisable to keep away from these foods while you are undergoing treatment with isoniazid.
Alcohol:
Consumption of alcoholic beverages while undergoing treatment with isoniazid is likely to diminish the efficiency of this medicine, while augmenting the chances of liver toxicity.

Discontinuation

Isoniazid needs to be taken for a long-term to completely cure tuberculosis. It is important that you do not stop taking this medication all of a sudden and without consulting your physician.

Storage instructions

Isoniazid should always be stored in the container it came in. Seal the lid of the container tightly and keep it in a place that is beyond the reach of children and pets. This medication should be stored at room temperature and in a place away from too much heat and dampness. Never keep this medication in your bathroom, which is mostly damp. Discard all medications that are needed no more or have become outdated. Unless instructed otherwise, never dispose of the drug by flushing it down the toilet or pouring it into a drain. Consult your physician or your neighbourhood waste disposal company regarding the safe and appropriate manner of disposing of the unwanted medications.

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