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Rifamate (isoniazid / rifampin) Disease Interactions

There are 11 disease interactions with Rifamate (isoniazid / rifampin):

Major

Inh (Includes Rifamate) ↔ Hepatotoxicity

Severe Potential Hazard, High plausibility

Applies to: Liver Disease, Alcoholism

The use of isoniazid is contraindicated in patients with acute liver disease or a history of hepatic injury due to isoniazid. Caution is advised when using the drug in patients with chronic liver disease or a history of alcoholism. Isoniazid has been associated with severe and sometimes fatal hepatitis, which may occur even after many months of therapy. In a US Public Health Service Surveillance Study of nearly 14,000 isoniazid patients, the incidence of hepatitis was 1.25%, of which 4.6% was fatal. However, more recent studies have reported considerably lower rates when CDC guidelines for selection and monitoring of patients were followed. Epidemiologic studies indicate an increased incidence with increasing age, alcohol use, and female gender. As a precautionary measure, routine monitoring of serum transaminases (SGOT, SGPT) and bilirubin may be considered, although a transient and harmless increase in serum transaminase reportedly occurs in 10% to 20% of patients, usually in the first 3 months of therapy. Patients should be advised to promptly discontinue isoniazid therapy and seek medical attention if they experience signs or symptoms suggestive of liver damage such as fever, rash, anorexia, nausea, vomiting, fatigue, right upper quadrant pain, dark urine, and jaundice. Reinstitution of the drug should occur only after symptoms and laboratory abnormalities resolve, with low and gradually increasing dosages.

References

  1. Yamamoto T, Suou T, Hirayama C "Elevated serum aminotransferase induced by isoniazid in relation to isoniazid acetylator phenotype." Hepatology 6 (1986): 295-8
  2. "Product Information. INH (isoniazid)." Ciba Pharmaceuticals, Summit, NJ.
  3. Maddrey WC "Drug-related acute and chronic hepatitis." Clin Gastroenterol 9 (1980): 213-24
  4. Moulding TS, Redeker AG, Kanel GC "Twenty isoniazid-associated deaths in one state." Am Rev Respir Dis 140 (1989): 700-5
  5. U.S. Departmnet of Health and Human Services / Public Health Service "Severe isoniazid-associated hepatitis--New York, 1991-1993." MMWR Morb Mortal Wkly Rep 42 (1993): 545-7
  6. Maddrey WC, Boitnott JK "Isoniazid hepatitis." Ann Intern Med 79 (1973): 1-12
  7. Dutt AK, Moers D, Stead WW "Undesirable side effects of isoniazid and rifampin in largely twice-weekly short-course chemotherapy for tuberculosis." Am Rev Respir Dis 128 (1983): 419-24
  8. Mitchell JR, Zimmerman HJ, Ishak KG, et al "Isoniazid liver injury: clinical spectrum, pathology, and probable pathogenesis." Ann Intern Med 84 (1976): 181-92
  9. Israel HL, Gottlieb JE, Maddrey WC "Perspective: preventive isoniazid therapy and the liver." Chest 101 (1992): 1298-301
  10. Maddrey WC "Isoniazid-induced liver disease." Semin Liver Dis 1 (1981): 129-33
  11. Snider DE, Caras GJ "Isoniazid-associated hepatitis deaths: a review of available information." Am Rev Respir Dis 145 (1992): 494-7
  12. Bartelink AK, Lenders JW, van Herwaarden CL, et al "Fatal hepatitis after treatment with isoniazid and rifampicin in a patient on anticonvulsant therapy." Tubercle 64 (1983): 125-8
  13. Franks AL, Binkin NJ, Snider DE, et al "Isoniazid hepatitis among pregnant and postpartum Hispanic patients." Public Health Rep 104 (1989): 151-5
  14. Yoshikawa TT, Nagami PH "Adverse drug reactions in TB therapy: risks and recommendations." Geriatrics 37 (1982): 61-8
  15. "Product Information. Nydrazid (isoniazid)" Apothecon Inc, Princeton, NJ.
View all 15 references
Major

Inh (Includes Rifamate) ↔ Liver Disease

Severe Potential Hazard, High plausibility

Applies to: Liver Disease

Isoniazid is primarily metabolized by the liver. Patients with liver disease may be at greater risk for adverse effects from isoniazid due to decreased drug clearance. Dosage reductions are recommended in these patients.

References

  1. "Product Information. INH (isoniazid)." Ciba Pharmaceuticals, Summit, NJ.
  2. Reed MD, Blumer JL "Clinical pharmacology of antitubercular drugs." Pediatr Clin North Am 30 (1983): 177-93
  3. "Product Information. Nydrazid (isoniazid)" Apothecon Inc, Princeton, NJ.
  4. Acocella G, Bonollo L, Garimoldi M, et al "Kinetics of rifampicin and isoniazid administered alone and in combination to normal subjects and patients with liver disease." Gut 13 (1972): 47-53
  5. Ellard GA, Gammon PT "Pharmacokinetics of isoniazid metabolism in man." J Pharmacokinet Biopharm 4 (1976): 83-113
  6. Weber WW, Hein DW "Clinical pharmacokinetics of isoniazid." Clin Pharmacokinet 4 (1979): 401-22
View all 6 references
Major

Inh (Includes Rifamate) ↔ Peripheral Neuropathy

Severe Potential Hazard, High plausibility

Applies to: Malnourished, Diabetes Mellitus, Alcoholism, Peripheral Neuropathy

Isoniazid commonly causes dose-related peripheral neuropathy, which results from the depletion of pyridoxine in the presence of the drug. The neuropathy is usually preceded by paresthesias of the feet and hands. Therapy with isoniazid should be administered cautiously in patients with preexisting peripheral neuropathy or risk factors for developing the condition, such as malnutrition, diabetes and alcoholism. Pyridoxine (vitamin B6) at a dosage of 10 to 50 mg/day may prevent or attenuate isoniazid-related peripheral neuropathy and is recommended for these patients.

References

  1. Dippenaar J, Jameson C, Dowse R "Side-effects of isoniazid." S Afr Med J 72 (1987): 89
  2. Siskind MS, Thienemann D, Kirlin L "Isoniazid-induced neurotoxicity in chronic dialysis patients: report of three cases and a review of the literature." Nephron 64 (1993): 303-6
  3. "Product Information. Nydrazid (isoniazid)" Apothecon Inc, Princeton, NJ.
  4. Mandell GL, Bennett JE, Dolin R, eds.. "Mandell, Douglas and Bennett's Principles and Practice of Infectious Diseases. 4th ed." New York, NY: Churchill Livingston 1 (1995):
  5. Gonzalez-Gay MA, Sanchez-Andrade A, Aguero JJ, Alonso MD, Rodriguez E, Criado JR "Optic neuritis following treatment with isoniazid in a hemodialyzed patient." Nephron 63 (1993): 360
  6. "Product Information. INH (isoniazid)." Ciba Pharmaceuticals, Summit, NJ.
  7. Jimenez-Lucho VE, del Busto R, Odel J "Isoniazid and ethambutol as a cause of optic neuropathy." Eur J Respir Dis 71 (1987): 42-5
View all 7 references
Major

Rifampin (Includes Rifamate) ↔ Hematopoietic Disturbances

Severe Potential Hazard, Low plausibility

Applies to: Bone Marrow Depression/Low Blood Counts

Rifampin may infrequently cause hematopoietic abnormalities such as thrombocytopenia, leukopenia, decreased hemoglobin, and acute hemolytic anemia. Hemolysis has been described as part of an immune-mediated reaction which generally occurs after gaps in therapy. Thrombocytopenia is observed most frequently in patients receiving high-dose intermittent therapy or after a lapse in therapy, but very rarely during daily administration. It is reversible if rifampin is discontinued as soon as purpura appears. Patients with preexisting bone marrow depression or blood dyscrasias should be monitored closely during rifampin therapy for further decreases in blood counts. Although rifampin-related hematologic effects are often transient, cerebral hemorrhage and fatalities have been reported with the continued administration of rifampin after the appearance of purpura.

References

  1. "Product Information. Rifadin (rifampin)." Hoechst Marion-Roussel Inc, Kansas City, MO.
  2. Lee M, Berger HW "Eosinophilia caused by rifampin." Chest 77 (1980): 579
  3. Dutt AK, Moers D, Stead WW "Undesirable side effects of isoniazid and rifampin in largely twice-weekly short-course chemotherapy for tuberculosis." Am Rev Respir Dis 128 (1983): 419-24
  4. Brook G, Pain A "Major adverse reactions to a short course of daily rifampicin." Scand J Infect Dis 19 (1987): 271-2
  5. Lee CH, Lee CJ "Thrombocytopenia: a rare but potentially serious side effect of initial daily and interrupted use of rifampicin." Chest 96 (1989): 202-3
  6. van Assendelft AH "Renal failure and haemolysis caused by rifampicin." Tubercle 67 (1986): 234-5
  7. Nolan RL, Cleary JD, Chapman SW "Fever associated with daily rifampin therapy." Clin Pharm 9 (1990): 57-8
  8. Mariette X, Mitjavila MT, Moulinie JP, et al "Rifampicin-induced pure red cell aplasia." Am J Med 87 (1989): 459-60
  9. Ferguson GC "Rifampicin and thrombocytopenia." Br Med J 3 (1971): 638
  10. Hall AP, Thorpe JW, Seaton D "New hazard of meningococcal chemoprophylaxis." J Antimicrob Chemother 31 (1993): 451
  11. Levine M, Collin K, Kassen BO "Acute hemolysis and renal failure following discontinuous use of rifampin." DICP 25 (1991): 743-4
  12. Allen RJ, Almond SN, Caiolsa SM, et al "Rifampin." Drug Intell Clin Pharm 5 (1971): 364-5
  13. Tahan SR, Diamond JR, Blank JM, Horan RF "Acute hemolysis and renal failure with rifampicin-dependent antibodies after discontinuous administration." Transfusion 25 (1985): 124-7
  14. Kindelan JM, Serrano I, Jurado R, Villanueva JL, Garcialazaro M, Garciaherola A, Cisneros JT "Rifampin-induced severe thrombocytopenia in a patient with pulmonary tuberculosis." Ann Pharmacother 28 (1994): 1304-5
  15. Hadfield JW "Rifampicin-induced thrombocytopenia." Postgrad Med J 56 (1980): 59-60
View all 15 references
Major

Rifampin (Includes Rifamate) ↔ Hepatotoxicity

Severe Potential Hazard, High plausibility

Applies to: Liver Disease, Alcoholism

The use of rifampin has been associated with hepatocellular injury and liver dysfunction. Hepatitis and jaundice resulting in death have occurred, mostly in patients with underlying liver disease and during coadministration with other hepatotoxic agents including other antituberculous drugs such as isoniazid and pyrazinamide. Therapy with rifampin should be administered cautiously and under strict medical supervision in patients with liver disease or a history of alcoholism. Serum transaminases (ALT, AST) and bilirubin should be measured at baseline and every 2 to 4 weeks during therapy, but keeping in mind that elevated levels may occur transiently in 10% to 15% of patients, usually during the early days of treatment. Patients should be instructed to discontinue the drug promptly and seek medical attention if signs and symptoms of hepatic injury develop, including fever, rash, anorexia, nausea, vomiting, fatigue, right upper quadrant pain, dark urine, and jaundice.

References

  1. Dutt AK, Moers D, Stead WW "Short-course chemotherapy for tuberculosis with mainly twice-weekly isoniazid and rifampin: community physicians' seven-year experience with mainly outpatients." Am J Med 77 (1984): 233-42
  2. "Product Information. Rifadin (rifampin)." Hoechst Marion-Roussel Inc, Kansas City, MO.
  3. Yoshikawa TT, Nagami PH "Adverse drug reactions in TB therapy: risks and recommendations." Geriatrics 37 (1982): 61-8
  4. Allen RJ, Almond SN, Caiolsa SM, et al "Rifampin." Drug Intell Clin Pharm 5 (1971): 364-5
  5. Maddrey WC "Drug-related acute and chronic hepatitis." Clin Gastroenterol 9 (1980): 213-24
  6. Gabriel R "Rifampin jaundice." Br Med J 3 (1971): 182
  7. O'Brien RJ, Long MW, Cross FS, et al "Hepatotoxicity from isoniazid and rifampin among children treated for tuberculosis." Pediatrics 72 (1983): 491-9
  8. Bartelink AK, Lenders JW, van Herwaarden CL, et al "Fatal hepatitis after treatment with isoniazid and rifampicin in a patient on anticonvulsant therapy." Tubercle 64 (1983): 125-8
  9. Dutt AK, Moers D, Stead WW "Undesirable side effects of isoniazid and rifampin in largely twice-weekly short-course chemotherapy for tuberculosis." Am Rev Respir Dis 128 (1983): 419-24
  10. CDC. Centers for Disease Control. "Update: fatal and severe liver injuries associated with rifampin and pyrazinamide for latent tuberculosis infection, and revisions in American Thoracic Society/CDC recommendations--United States, 2001." Morb Mortal Wkly Rep 50 (2001): 733-5
View all 10 references
Major

Rifampin (Includes Rifamate) ↔ Liver Disease

Severe Potential Hazard, High plausibility

Applies to: Liver Disease

Rifampin is primarily metabolized by the liver. Patients with liver disease may be at greater risk for adverse effects from rifampin due to decreased drug clearance. In addition, the accumulation of rifampin may result in hyperbilirubinemia because rifampin competes with bilirubin for uptake by hepatocytes. Dosage adjustments are recommended in patients with liver disease. Withdrawal of rifampin therapy may be required if serum bilirubin is persistently high.

References

  1. Nitti V, Virgilio R, Patricolo MR, Iuliano A "Pharmacokinetic study of intravenous rifampicin." Chemotherapy 23 (1977): 1-6
  2. Acocella G "Clinical pharmacokinetics of rifampicin." Clin Pharmacokinet 3 (1978): 108-27
  3. "Product Information. Rifadin (rifampin)." Hoechst Marion-Roussel Inc, Kansas City, MO.
  4. Loos U, Musch E, Jensen JC, et al "Pharmacokinetics of oral and intravenous rifampicin during chronic administration." Klin Wochenschr 63 (1985): 1205-11
View all 4 references
Major

Rifampin (Includes Rifamate) ↔ Porphyria

Severe Potential Hazard, Moderate plausibility

Applies to: Porphyria

Rifampin may induce the activity of delta amino levulinic acid synthetase, an enzyme involved in the biosynthesis of porphyrins. The use of rifampin has been associated with isolated cases of porphyria exacerbation. Therapy with rifampin should be administered cautiously in patients with a history of porphyria.

References

  1. "Product Information. Rifadin (rifampin)." Hoechst Marion-Roussel Inc, Kansas City, MO.
Moderate

Antibiotics (Includes Rifamate) ↔ Colitis

Moderate Potential Hazard, Low plausibility

Applies to: Colitis/Enteritis (Noninfectious)

Pseudomembranous colitis has been reported with most antibacterial agents and may range in severity from mild to life-threatening, with an onset of up to two months following cessation of therapy. Antibiotic therapy can alter the normal flora of the colon and permit overgrowth of Clostridium difficile, whose toxin is believed to be a primary cause of antibiotic- associated colitis. The colitis is usually characterized by severe, persistent diarrhea and severe abdominal cramps, and may be associated with the passage of blood and mucus. The most common culprits are clindamycin, lincomycin, the aminopenicillins (amoxicillin, ampicillin), and the cephalosporins. Therapy with broad-spectrum antibiotics and other agents with significant antibacterial activity should be administered cautiously in patients with a history of gastrointestinal diseases, particularly colitis. There is some evidence that pseudomembranous colitis, if it occurs, may run a more severe course in these patients and that it may be associated with flares in their underlying disease activity. The offending antibiotic(s) should be discontinued if significant diarrhea occurs during therapy. Stool cultures for Clostridium difficile and stool assay for C. difficile toxin may be helpful diagnostically. A large bowel endoscopy may be considered to establish a definitive diagnosis in cases of severe diarrhea.

References

  1. Moriarty HJ, Scobie BA "Pseudomembranous colitis in a patient on rifampicin and ethambutol." N Z Med J 04/23/80 (1980): 294-5
  2. Thomas E, Mehta JB "Pseudomembranous colitis due to oxacillin therapy." South Med J 77 (1984): 532-3
  3. Meadowcroft AM, Diaz PR, Latham GS "Clostridium difficile toxin-induced colitis after use of clindmycin phosphate vaginal cream." Ann Pharmacother 32 (1998): 309-11
  4. Dan M, Samra Z "Clostridium difficile colitis associated with ofloxacin therapy." Am J Med 87 (1989): 479
  5. Saadah HA "Carbenicillin and pseudomembranous enterocolitis." Ann Intern Med 93 (1980): 645
  6. Bauwens JE, McFarland LV, Melcher SA "Recurrent clostridium difficile disease following ciprofloxacin use." Ann Pharmacother 31 (1997): 1090
  7. Daly JJ, Chowdary KV "Pseudomembranous colitis secondary to metronidazole." Dig Dis Sci 28 (1983): 573-4
  8. Trexler MF, Fraser TG, Jones MP "Fulminant pseudomembranous colitis caused by clindamycin phosphate vaginal cream." Am J Gastroenterol 92 (1997): 2112-3
  9. Lyon JA "Imipenem/cilastatin: the first carbapenem antibiotic." Drug Intell Clin Pharm 19 (1985): 894-8
  10. O'Meara TF, Simmons RA "Carbenicillin and pseudomembranous enterocolitis." Ann Intern Med 92 (1980): 440-1
  11. Harmon T, Burkhart G, Applebaum H "Perforated pseudomembranous colitis in the breast-fed infant." J Pediatr Surg 27 (1992): 744-6
  12. Ehrenpreis ED, Lievens MW, Craig RM "Clostridium difficile-associated diarrhea after norfloxacin." J Clin Gastroenterol 12 (1990): 188-9
  13. Davies J, Beck E "Recurrent colitis following antibiotic-associated pseudomembranous colitis." Postgrad Med J 57 (1981): 599-601
  14. Cone JB, Wetzel W "Toxic megacolon secondary to pseudomembranous colitis." Dis Colon Rectum 25 (1982): 478-82
  15. Cannon SR, Dyson PH, Sanderson PJ "Pseudomembranous colitis associated with antibiotic prophylaxis in orthopaedic surgery." J Bone Joint Surg Br 70-B (1988): 600-2
  16. Wang C, Calandra GB, Aziz MA, Brown KR "Efficacy and safety of imipenem/cilastatin: a review of worldwide clinical experience." Rev Infect Dis 7 (1985): s528-36
  17. Clissold SP, Todd PA, Campoli-Richards DM "Imipenem/cilastatin: a review of its antibacterial activity, pharmacokinetic properties and therapeutic efficacy." Drugs 33 (1987): 185-241
  18. Pokorney BH, Nichols TW, Jr "Pseudomembranous colitis. A complication of sulfasalazine therapy in a patient with Crohn's colitis." Am J Gastroenterol 76 (1981): 374-6
  19. Miller DL, Sedlack JD, Holt RW "Perforation complicating rifampin-associated pseudomembranous enteritis." Arch Surg 124 (1989): 1082
  20. Miller SN, Ringler RP "Vancomycin-induced pseudomembranous colitis." J Clin Gastroenterol 9 (1987): 114-5
  21. Osler T, Lott D, Bordley J, et al "Cefazolin-induced pseudomembranous colitis resulting in perforation of the sigmoid colon." Dis Colon Rectum 29 (1986): 140-3
  22. Parry MF, Rha CK "Pseudomembranous colitis caused by topical clindamycin phosphate." Arch Dermatol 122 (1986): 583-4
  23. Milstone EB, McDonald AJ, Scholhamer CF Jr "Pseudomembranous colitis after topical application of clindamycin." Arch Dermatol 117 (1981): 154-5
  24. Burt RA "A review of the drug events reported by 12,917 patients treated with cephalexin." Postgrad Med J 59 (1983): 47-50,51-3
  25. Sankarankutty M, McGeorge D, Galasko CS "Pseudomembranous colitis following cephradine prophylaxis." Postgrad Med J 58 (1982): 726-8
  26. Gordin F, Gibert C, Schmidt ME "Clostridium difficile colitis associated with trimethoprim-sulfamethoxazole given as prophylaxis for pneumocystis carinii pneumonia." Am J Med 96 (1994): 94-5
  27. Sugarman B "Trimethoprim-sulfamethoxazole, pseudomembranous colitis, and spinal cord injury." South Med J 78 (1985): 711-3
  28. Calandra GB, Brown KR, Grad LC, et al "Review of adverse experiences and tolerability in the first 2,516 patients treated with imipenem/cilastatin." Am J Med 78 (1985): 73-8
  29. Golledge CL, Riley TV "Clostridium difficile-associated diarrhoea after doxycycline malaria prophylaxis." Lancet 345 (1995): 1377-8
  30. Ring FA, Hershfield NB, Machin GA, Scott RB "Sulfasalazine-induced colitis complicating idiopathic ulcerative colitis." Can Med Assoc J 131 (1984): 43-5
  31. Leigh DA, Simmons K, Williams S "Gastrointestinal side effects following clindamycin and lincomycin treatment: a follow up study." J Antimicrob Chemother 6 (1980): 639-45
  32. Bernstein L "Adverse reaction to trimethoprim-sulfamethoxazole, with particular reference to long-term therapy." Can Med Assoc J 112 (1975): s96-8
  33. Friedman RJ, Mayer IE, Galambos JT, Hersh T "Oxacillin-induced pseudomembranous colitis." Am J Gastroenterol 73 (1980): 445-7
  34. "Multum Information Services, Inc. Expert Review Panel"
  35. Edlund C, Lidbeck A, Kager L, Nord CE "Effect of enoxacin on colonic microflora of healthy volunteers." Eur J Clin Microbiol 6 (1987): 298-300
  36. Hutcheon DF, Milligan FD, Yardley JH, Hendrix TR "Cephalosporin-associated pseudomembranous colitis." Am J Dig Dis 23 (1978): 321-6
  37. Bingley PJ, Harding GM "Clostridium difficile colitis following treatment with metronidazole and vancomycin." Postgrad Med J 63 (1987): 993-4
  38. Van Ness MM, Cattau EL Jr "Fulminant colitis complicating antibiotic-associated pseudomembranous colitis: case report and review of the clinical manifestations and treatment." Am J Gastroenterol 82 (1987): 374-7
  39. Hinton NA "The effect of oral tetracycline HCl and doxycycline on the intestinal flora." Curr Ther Res Clin Exp 12 (1970): 341-52
  40. Hecht JR, Olinger EJ "Clostridium difficile colitis secondary to intravenous vancomycin." Dig Dis Sci 34 (1989): 148-9
  41. Brause BD, Romankiewicz JA, Gotz V, Franklin JE Jr, Roberts RB "Comparative study of diarrhea associated with clindamycin and ampicillin therapy." Am J Gastroenterol 73 (1980): 244-8
  42. Midtvedt T, Carlstedt-Duke B, Hoverstad T, et al "Influence of peroral antibiotics upon the biotransformatory activity of the intestinal microflora in healthy subjects." Eur J Clin Invest 16 (1986): 11-7
  43. Altamirano A, Bondani A "Adverse reactions to furazolidone and other drugs. A comparative review." Scand J Gastroenterol Suppl 169 (1989): 70-80
  44. Boriello SP, Jones RH, Phillips I "Rifampicin-associated pseudomembranous colitis." Br Med J 281 (1980): 1180-1
  45. Klinger D, Radford P, Collin J "Pneumoperitoneum without faecal peritonitis in a patient with pseudomembranous colitis." Br Med J 288 (1984): 1271-2
  46. Saginur R, Hawley CR, Bartlett JG "Colitis associated with metronidazole therapy." J Infect Dis 141 (1980): 772-4
  47. Edlund C, Brismar B, Nord CE "Effect of lomefloxacin on the normal oral and intestinal microflora." Eur J Clin Microbiol Infect Dis 1 (1990): 35-9
View all 47 references
Moderate

Inh (Includes Rifamate) ↔ Hemodialysis

Moderate Potential Hazard, High plausibility

Applies to: hemodialysis

Isoniazid is substantially removed by hemodialysis and should be administered after dialysis.

References

  1. "Product Information. Nydrazid (isoniazid)" Apothecon Inc, Princeton, NJ.
  2. Gold CH, Buchanan N, Tringham V, et al "Isoniazid pharmacokinetics in patients with chronic renal failure." Clin Nephrol 6 (1976): 365-9
  3. "Product Information. INH (isoniazid)." Ciba Pharmaceuticals, Summit, NJ.
Moderate

Inh (Includes Rifamate) ↔ Renal Dysfunction

Moderate Potential Hazard, Moderate plausibility

Applies to: Renal Dysfunction

Isoniazid is metabolized primarily by acetylation and dehydrazination in the liver. It is not significantly excreted by the kidney. Dosage adjustments in renal impairment are generally not necessary except in slow acetylators with a creatinine clearance below 10 mL/min. The rate of acetylation is genetically determined. Approximately 50% of blacks and caucasians are slow acetylators, and the majority of Eskimos and Asians are rapid acetylators.

References

  1. "Product Information. Nydrazid (isoniazid)" Apothecon Inc, Princeton, NJ.
  2. Gold CH, Buchanan N, Tringham V, et al "Isoniazid pharmacokinetics in patients with chronic renal failure." Clin Nephrol 6 (1976): 365-9
  3. Boxenbaum HG, Bekersky I, Mattaliano V, Kaplan SA "Plasma and salivary concentrations of isoniazid in man: preliminary findings in two slow acetylator subjects." J Pharmacokinet Biopharm 3 (1975): 443-56
  4. Mitchison DA, Ellard GA "Tuberculosis in patients having dialysis." Br Med J 280 (1980): 1533
  5. "Product Information. INH (isoniazid)." Ciba Pharmaceuticals, Summit, NJ.
  6. Andrew OT, Schoenfeld PY, Hopewell PC, Humphreys MH "Tuberculosis in patients with end-stage renal disease." Am J Med 68 (1980): 59-65
  7. Kim YG, Shin JG, Shin SG, Jang IJ, Kim SG, Lee JS, Han JS, Cha YN "Decreased acetylation of isoniazid in chronic renal failure." Clin Pharmacol Ther 54 (1993): 612-20
  8. Bowerson DW, Winterbauer RH, Stewart GL, et al "Isoniazid dosage in patients with renal failure." N Engl J Med 289 (1973): 84-7
  9. Reidenberg MM, Shear L, Cohen RV "Elimination of isoniazid in patients with impaired renal function." Am Rev Respir Dis 108 (1973): 1426-8
View all 9 references
Moderate

Rifampin (Includes Rifamate) ↔ Enzyme Induction

Moderate Potential Hazard, Moderate plausibility

Applies to: Hyperthyroidism, Hyperadrenocorticism, Hypoparathyroidism, Hypothyroidism, Panhypopituitarism, Hyperparathyroidism, Adrenal Insufficiency

Rifampin has enzyme-inducing effects that can enhance the metabolism of many endogenous substrates, including adrenal hormones, thyroid hormones, and vitamin D, the latter of which may affect serum calcium, phosphate and parathyroid hormone levels. Patients with preexisting imbalances of these hormones should be monitored more closely during long-term therapy with rifampin. In patients whose hormonal condition is stabilized on treatment, adjustments may be necessary in their treatment regimen to compensate for these effects.

References

  1. "Product Information. Rifadin (rifampin)." Hoechst Marion-Roussel Inc, Kansas City, MO.

Rifamate (isoniazid / rifampin) drug Interactions

There are 870 drug interactions with Rifamate (isoniazid / rifampin)

Rifamate (isoniazid / rifampin) alcohol/food Interactions

There are 2 alcohol/food interactions with Rifamate (isoniazid / rifampin)

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No information available.

Do not stop taking any medications without consulting your healthcare provider.

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