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isoniazid

Pronunciation

Generic Name: isoniazid (eye so NYE a zid)
Brand Name: Nydrazid

What is isoniazid?

Isoniazid is an antibiotic that fights bacteria.

Isoniazid is used to treat and to prevent tuberculosis (TB). You may need to take other TB medicines in combination with isoniazid.

When treating active TB, isoniazid must be used with other TB medicines. Tuberculosis can become resistant to treatment if isoniazid is used alone. Take all your medicines as prescribed by your doctor.

Isoniazid may also be used for purposes not listed in this medication guide.

What is the most important information I should know about isoniazid?

You should not use this medicine if you have active liver disease, or if you have taken isoniazid in the past and it caused liver problems, fever, chills, joint pain, or severe allergic reaction.

Serious and sometimes fatal liver problems may occur during treatment with isoniazid or after you stop taking this medicine, even months after stopping. The risk of liver problems is highest in adults between the ages of 35 and 65. Your liver function may need to be checked every month while you are taking this medicine.

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Call your doctor right away if you have: nausea, upper stomach pain, loss of appetite, and feeling weak or tired.

Avoid drinking alcohol. It may increase your risk of liver damage while you are taking isoniazid.

What should I discuss with my healthcare provider before taking isoniazid?

You should not use isoniazid if you are allergic to it, or if you have:

  • active liver disease;

  • a history of severe allergic reaction to isoniazid;

  • a history of hepatitis or other liver problems caused by taking isoniazid; or

  • a history of severe isoniazid side effects such as fever, chills, or joint pain and swelling.

To make sure isoniazid is safe for you, tell your doctor if you have:

  • a history of liver disease;

  • kidney disease;

  • nerve problems that cause pain, weakness, or numbness;

  • diabetes;

  • HIV or AIDS;

  • if you are 35 or older;

  • if you drink alcohol daily;

  • if you are malnourished;

  • if you use any medicines that are injected; or

  • if you have ever had to stop taking isoniazid for any reason.

If you are 35 years or older, your doctor will check your liver enzymes before you start treatment, to make sure you can safely use isoniazid.

Serious and sometimes fatal liver problems may occur during treatment with isoniazid or after you stop taking this medication, even months after stopping. The risk of liver problems is highest in adults between the ages of 35 and 65.

Serious liver problems may be more likely to occur in women, especially after childbirth, or in women of Hispanic or African-American ancestry. Ask your doctor about your specific risk.

FDA pregnancy category C. It is not known whether isoniazid will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medicine.

Talk to your doctor if you will be breast-feeding a baby during your treatment with isoniazid. This medicine can pass into breast milk, but it will not treat or prevent tuberculosis in the nursing infant.

How should I take isoniazid?

Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Take isoniazid on an empty stomach, at least 1 hour before or 2 hours after a meal.

Use this medicine for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Skipping doses may also increase your risk of further infection that is resistant to antibiotics. Isoniazid will not treat a viral infection such as the flu or a common cold.

Your liver function may need to be checked every month while you are taking this medicine.

Your doctor may have you take extra vitamin B6 while you are taking isoniazid. Take only the amount of vitamin B6 that your doctor has prescribed.

Store at room temperature away from moisture, heat, and light. Keep the bottle tightly closed when not in use.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include vomiting, severe dizziness or drowsiness, slurred speech, blurred vision, hallucinations, trouble breathing, increased thirst, increased urination, fruity breath odor, or loss of consciousness.

What should I avoid while taking isoniazid?

Avoid drinking alcohol. It may increase your risk of liver damage while you are taking isoniazid.

Ask your doctor or pharmacist before taking acetaminophen (Tylenol) while you are taking isoniazid.

Isoniazid side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Stop using isoniazid and call your doctor at once if you have signs of a liver problems such as:

  • itching, tired feeling, weakness, fever for 3 days or longer;

  • upper stomach pain, loss of appetite; or

  • dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Call your doctor at once if you have:

  • severe tingling, numbness, pain, muscle weakness;

  • vision changes, pain behind your eyes;

  • confusion, hallucinations, unusual thoughts or behavior;

  • seizure (convulsions);

  • pale skin, easy bruising or bleeding (nosebleeds, bleeding gums); or

  • sudden weakness or ill feeling, sore throat, mouth sores, red or swollen gums, trouble swallowing.

Common side effects may include:

  • numbness, tingling, or burning pain in your hands or feet;

  • joint pain; or

  • nausea, vomiting, upset stomach.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Isoniazid dosing information

Usual Adult Dose for Tuberculosis -- Active:

Active infection: 5 mg/kg (up to 300 mg) IM or orally once a day, or 15 mg/kg (up to 900 mg) 2 to 3 times a week. Therapy is usually continued for 6 months, or 3 months beyond culture conversion (when given with rifampin and pyrazinamide).

Latent infection: 10-20 mg/kg/day orally once a day, not to exceed 300 mg/day

If isoniazid and pyrazinamide are used alone, isoniazid should be continued for 9 months. If the patient is HIV-positive, therapy should be continued for at least 9 months, or for 6 months beyond culture conversion. Longer duration of therapy should be considered for silico-, bone, and meningeal tuberculosis.

Usual Adult Dose for Tuberculosis -- Prophylaxis:

300 mg orally once a day or 900 mg orally 2 to 3 times a week. Isoniazid should be continued for 6 months to prevent the development of active tuberculosis in patients with no complicating factors. Patients with complicating factors such as HIV infection, diabetes, hematologic malignancy, or scars on chest X-ray should receive prophylaxis for 12 months.

Usual Adult Dose for Mycobacterium kansasii:

600 to 900 mg IM or orally once a day.

Usual Pediatric Dose for Tuberculosis -- Active:

Oral, IM:
Infants, Children 40 kg or less, and Adolescents 14 years or less and less than 40 kg:

Treatment of active infection: CDC Recommendations: 10 to 15 mg/kg/day once daily (maximum dose: 300 mg/day) or 20 to 30 mg/kg/dose (maximum dose: 900 mg/day) 2 times weekly as part of a multidrug regimen.

Treatment of latent infection: 10 to 20 mg/kg/day once daily (maximum dose: 300 mg/day) or 20 to 40 mg/kg/dose (maximum dose: 900 mg/day) 2 times weekly. Treatment duration: 9 months.

Primary prophylaxis for TB in HIV-exposed positive patients: 10 to 15 mg/kg/day once daily (maximum dose: 300 mg/day) or 20 to 30 mg/kg/dose twice weekly (maximum dose: 900 mg/day). Treatment duration: 9 months.

Usual Pediatric Dose for Tuberculosis -- Latent:

Oral, IM:
Infants, Children 40 kg or less, and Adolescents 14 years or less and less than 40 kg:

Treatment of active infection: CDC Recommendations: 10 to 15 mg/kg/day once daily (maximum dose: 300 mg/day) or 20 to 30 mg/kg/dose (maximum dose: 900 mg/day) 2 times weekly as part of a multidrug regimen.

Treatment of latent infection: 10 to 20 mg/kg/day once daily (maximum dose: 300 mg/day) or 20 to 40 mg/kg/dose (maximum dose: 900 mg/day) 2 times weekly. Treatment duration: 9 months.

Primary prophylaxis for TB in HIV-exposed positive patients: 10 to 15 mg/kg/day once daily (maximum dose: 300 mg/day) or 20 to 30 mg/kg/dose twice weekly (maximum dose: 900 mg/day). Treatment duration: 9 months.

What other drugs will affect isoniazid?

Many drugs can interact with isoniazid. Tell your doctor about all your medications and any you start or stop using during treatment with isoniazid. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Give a list of all your medicines to any healthcare provider who treats you.

Where can I get more information?

  • Your pharmacist can provide more information about isoniazid.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 4.01. Revision Date: 2014-04-16, 7:46:24 AM.

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