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QuickView for Isoniazid (compound)


PubChem
Name: Isoniazid
PubChem Compound ID: 10846163
Description: Antibacterial agent used primarily as a tuberculostatic. It remains the treatment of choice for tuberculosis.
Molecular formula: C6H7N3O
Molecular weight: 138.133 g/mol
DrugBank
Identification
Name: Isoniazid
Name (isomeric): DB00951
Drug Type: small molecule
Description: Antibacterial agent used primarily as a tuberculostatic. It remains the treatment of choice for tuberculosis.
Synonyms:
HIA; INH; Isonicotinhydrazid; Isonicotinyl hydrazide; Hydrazide; Isonicotinylhydrazine; Hydrazid; Isonicotinohydrazide; Isohydrazide; Isonicotinic acid hydrazide.
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Brand: Isobicina, Defonin, Isonilex, Isonicazide, Isonikazid, Isoniton, Inah, Robisellin, Hidrulta, Laniazid, Isopyrin, Nicizina, Tekazin, Inizid, Tibazide, Sanohidrazina, Ebidene, Niadrin, Pyrizidin, Mybasan, Neoteben, Isotebe, Nydrazid, Isonin, Sauterazid, Rimicid, Tebenic, Stanozide, Tibivis, Tubecotubercid, Phthisen, Laniozid, Nicazide, Isonindon, TB-Vis, Iscotin, Zonazide, Unicozyde, Isonicid, Tuberian, Nicotisan, Unicocyde, Tebexin, Tubazide, Chemidon, Niplen, Isocotin, Isoniazid SA, Cemidon, Ido-tebin, Atcotibine, Isoniacid, Idrazil, FSR 3, Razide, Pyreazid, Pelazid, Bacillin, TB-Razide, Roxifen, Tubeco, Armazide, Dibutin, Isocid, Tubomel, Cotinizin, Diforin, Isotamine, Ditubin, Isozide, Pyridicin, Azuren, Rifamate, TB-Phlogin, Isolyn, Isonizide, Vederon, Isidrina, Neumandin, Tebecid, Isoniazide, Armacide, Hidranizil, Rimiphone, Isonico, Isotinyl, Tubazid, Tebos, Andrazide, Nicozide, Isozyd, Pyricidin, Pycazide, Hyzyd, Hidrun, Cortinazine, Tubicon, Rimitsid, Tibison, Isonerit, Ismazide, Nyscozid, Tubilysin, Hyozid, Antituberkulosum, Robiselin, Sauterzid, Isonex, Evalon, Isonide, Armazid, Zinadon, Fimalene, Cotinazin, Isonidrin, Cedin, Tibemid, Nidrazid, Vazadrine, Hycozid, Eralon, Antimicina, Tyvid, GINK, Retozide, Isonirit, Tibusan, Nidaton, Isotebezid, Nikozid, Chemiazid, Tebilon, Ertuban, Nitadon, Hidrasonil, Nevin, Raumanon, Teebaconin, Neoxin, Percin, Nicetal, Isonicotil, Isocidene, Rimifon, Eutizon, Niconyl, Nicotibina, Neo-Tizide, Nicotibine, Dinacrin, Isonicotan, Zidafimia
Brand name mixture: Rifater(Isoniazid + Pyrazinamide + Rifampin), Isotamine B 300(Isoniazid + Pyridoxine Hydrochloride)
Category: Antitubercular Agents, Fatty Acid Synthesis Inhibitors
CAS number: 54-85-3
Pharmacology
Indication: For the treatment of all forms of tuberculosis in which organisms are susceptible.
Pharmacology:
Isoniazid is a bactericidal agent active against organisms of the genus Mycobacterium, specifically M. tuberculosis, M. bovis and M. kansasii. It is a highly specific agent, ineffective against other microorganisms. Isoniazid is bactericidal to rapidly-dividing mycobacteria, but is bacteriostatic if the mycobacterium is slow-gr...
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Mechanism of Action:
Isoniazid is a prodrug and must be activated by bacterial catalase. Specficially, activation is associated with reduction of the mycobacterial ferric KatG catalase-peroxidase by hydrazine and reaction with oxygen to form an oxyferrous enzyme complex. Once activated, isoniazid inhibits the synthesis of mycoloic acids, an essential component of the b...
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Absorption: Readily absorbed following oral administration; however, may undergo significant first pass metabolism. Absorption and bioavailability are reduced when isoniazid is administered with food.
Protein binding: Very low (0-10%)
Biotransformation: Primarily hepatic. Isoniazid is acetylated by N -acetyl transferase to N -acetylisoniazid; it is then biotransformed to isonicotinic acid and monoacetylhydrazine. Monoacetylhydrazine is associated with hepatotoxicity via formation of a reactive intermediate metabolite when N-hydroxylated by the cytochrome P450 mixed oxidase system. The rate of acetylation is genetically determined. Slow acetylators are characterized by a relative lack of hepatic N -acetyltransferase.
Route of elimination: From 50 to 70 percent of a dose of isoniazid is excreted in the urine within 24 hours.
Half Life: Fast acetylators: 0.5 to 1.6 hours. Slow acetylators: 2 to 5 hours.
Toxicity: LD50 100 mg/kg (Human, oral). Adverse reactions include rash, abnormal liver function tests, hepatitis, peripheral neuropathy, mild central nervous system (CNS) effects. In vivo, Isoniazid reacts with pyridoxal to form a hydrazone, and thus inhibits generation of pyridoxal phosphate. Isoniazid also combines with pyridoxal phosphate; high doses interfere with the coenzyme function of the latter.
Affected organisms: Mycobacteria
Interactions
Food interaction:
Avoid alcohol.
Avoid aged foods (cheese, red wine), pickled foods, cured foods (bacon/ham), chocolate, fava beans, beer, unless approved by your physician.
Take on empty stomach: 1 hour before or 2 hours after meals.
Increase dietary intake of magnesium, folate, vitamin B6, B12, and/or consider taking a multivitamin.
Do not take calcium, aluminum, magnesium or Iron supplements within 2 hours of taking this medication.
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Drug interaction:
DisulfiramIncreased risk of CNS adverse effects
VerapamilIsoniazid, a strong CYP3A4 inhibitor, may increase the serum concentration of Veramapil, a CYP3A4 substrate, by decreasing its metabolism and clearance. Consider alternate therapy or monitor for changes in the therapeutic/adverse effects of Verapamil if Isoniazid is initiated, discontinued or dose changed.
FosphenytoinIsoniazid may increase the effect of phenytoin in 20% of patients.
TamoxifenIsoniazid may increase the serum concentration of Tamoxifen by decreasing its metabolism and clearance. Isoniazid may also decrease the therapeutic effect of Tamoxifen by decreasing active metabolite production. Monitor for changes in the therapeutic/adverse effects of Tamoxifen if Isoniazid is initiated, discontinued or dose changed.
AminophyllineIsoniazid may increase the effect and toxicity of oxtriphylline.
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