Interactions between isoniazid and A pak laboratories paediatric analgesic paracetamol (acetaminophen)
acetaminophen and isoniazid (Moderate Drug-Drug)
MONITOR: Some reports have suggested that isoniazid may increase the potential hepatotoxicity of acetaminophen. The mechanism may be related to induction of CYP450 2E1 metabolism of acetaminophen to toxic metabolites during concurrent administration, or transient increased metabolism of acetaminophen after discontinuation of isoniazid. Study data have been conflicting and causality is unclear due to the presence of other drugs in some cases. Both isoniazid and acetaminophen have individually been associated with hepatotoxicity.
MANAGEMENT: Until more information is available, concurrent acetaminophen use should be limited. Close attention should be paid to clinical and laboratory evidence of hepatotoxicity. Both drugs should be discontinued if evidence of hepatoxicity is observed. Aspirin or nonsteroidal inflammatory agents may be safer alternatives.