Isoniazid

Изониазид Drug photo

The description is actual on 10.06.2016

  • Latin name: Isoniazid
  • ATH code: J04AC01
  • Active ingredient: Isoniazid (Isoniazid)
  • Producer: "Tatkhimfarmpreparata", "Farmsintez", "Biosynthesis", "Rozfarm", JSC MOSKHIMFARMPREPARATY im. N. A. Semashko, "Quinacrine", "Valenta Farmatsevtika", "Veropharm", "Biochemist", "Bryntsalov-A", "AS-Farm" and others.

Structure

The tablet contains 0.1, 0.2 or 0.3 grams of active ingredient. Ampoules of 5 ml contain solution of 500 mg of concentration of 10%.

Release form

The isoniazid is issued in the tableted form, in the form of solution and powder.

Tablets are packed on 10 pieces into special blisters. Packaging contains 50, 100, 500 or 1000 tablets.

Solution is issued in ampoules on 5 ml. The pack contains 5 or 10 ampoules.

Pharmacological action

The tablets Isoniazid from what they?

Antituberculous remedy. Active component is the main representative among derivatives of isonicotinic acid, and found the application in antitubercular therapy. Other medicines from this group (for example, Ftivazidum) are considered as derivatives of hydrazide of isonicotinic acid. Concerning a mycobacterium – the causative agent of tuberculosis – active component the Isoniazid is shown high bacteriological activity. Concerning other causative agents of infectious diseases of the expressed chemotherapeutic effect it is not observed.

Active ingredient influences bakteritsidno the extracellular and intracellular Mycobacterium tuberculosis forms. Actively sharing forms of mycobacteria are subject to most of all effect of drug. There is no exact description of the mechanism of influence. There is an opinion that the principle of action of a medicine is based on ability to suppress process of synthesizing of mikoliyevy acids which are a part of a cell wall of a microorganism.

Pharmacodynamics and pharmacokinetics

Active component is well soaked up from a gleam of a digestive tract. In 1-4 hours after intake in blood the maximum concentration of active ingredient is registered. Tuberculostatic concentration (the level of active component in blood suppressing life activity of the causative agent of tuberculosis) remains within 6-24 hours. The isoniazid with ease passes through a blood-brain barrier and gets into various liquids and fabrics in an organism. The main way of removal – through renal system.

Indications to use of the Isoniazid

The medicine is appointed for treatment of active tuberculosis.

The main indications to use:

  • tubercular meningitis (combination therapy);
  • prevention of development of tuberculosis in persons who were in contact with the sick patient;
  • prevention of development of tuberculosis in the persons which gave positive reaction to tuberculine (it is more than 5 mm) at the confirmed X-ray pattern which indicates not progressing process;
  • prevention of development of tuberculosis in children is younger than 4 years which gave positive reaction to tuberculine (it is more than 10 mm) with high risk of dissimination.

High dosages possess toxic action therefore poison with the Isoniazid dogs.

Contraindications

Side effects of the Isoniazid

System of blood (hemostasis, hemopoiesis) and cardiovascular system:

  • pains in heart;
  • increase of level of a pulmonary blood pressure;
  • cardiopalmus;
  • stenocardia;
  • strengthening of expressiveness of ischemic processes in a myocardium at elderly people;
  • thrombocytopenia;
  • agranulocytosis;
  • increase of level of a blood pressure;
  • sideroblastny anemia;
  • hemolysis (at a shortcoming glyukozo-6-fosfatdegidrogenazy);
  • aplastic anemia.

Sense bodys, nervous system:

  • intoksikatsionny psychosis;
  • generalized spasms;
  • paresthesias;
  • dizzinesses;
  • polyneuritis;
  • paralysis of extremities;
  • atrophy and optic neuritis;
  • euphoria;
  • encephalopathy;
  • insomniya;
  • irritability;
  • headaches;
  • amnesia;
  • peripheral neuritis;
  • increase of attacks at the persons having epilepsy.

Digestive tract:

  • vomiting;
  • nausea;
  • dryness in an oral cavity;
  • toxic hepatitis;
  • increase of activity of ALT, nuclear heating plant, bilirubin;
  • prodromal symptoms of hepatitis (unusual weakness or fatigue, vomiting, loss of appetite and nausea);
  • hyperbilirubinemia.

Urinogenital path:

Allergic answers:

  • skin rashes, rash;
  • eosinophilia.

Other reactions:

  • fever;
  • muscular twitchings;
  • phlebitis (at intravenous injections);
  • "Cushingoid";
  • muscular atrophy;
  • hyperglycemia.

Side effects of Tubazidum are similar since active component is the same active ingredient.

Isoniazid, application instruction (Way and dosage)

The dose of drug is selected in an individual order taking into account a form of a basic disease, the accompanying pathology and nature of disease.

The application instruction of the Isoniazid for adult patients and teenagers: 2-3 times a week on 15 mg/kg a day or on 300 mg a day.

The application instruction of Tubazidum for children: 20-40 mg/kg 2-3 times a week or 10-20 mg/kg a day.

Intramusculary enter 15 mg/kg 2-3 times a week or on 5 mg/kg a day. To children the medicine is entered on 20-40 mg/kg by 2-3 times a week or on 10-20 mg/kg a day. Duration of therapy is defined in an individual order.

Treatment by inhalations: 5-10 mg/kg a day divided into 1-2 receptions.

At reception of per os and intravenous administration the maximum daily dosage makes 300 mg (for adult patients).

Overdose

Acute overdose

Reception of high doses can provoke development of a metabolic acidosis, cause epileptic seizures which do not give in to standard therapy. In hard cases the coma and a lethal outcome can develop.

The first symptoms of poisoning are registered in 30 minutes after reception of a medicine:

  • tachycardia;
  • vomiting;
  • dizziness;
  • speech illegibility.

At acute poisoning the epileptic seizure can immediately develop without the previous symptomatology. It is enough to accept 20 mg/kg of the Isoniazid for development of an attack. At a serious poisoning the coma which can last 24-36 hours develops.

Acute toxic displays of poisoning:

  • hyperthermia;
  • arterial hypotonia;
  • glucosuria;
  • hyperglycemia;
  • acute renal failure;
  • ketonuria.

Chronic overdose

Long therapy by high doses causes a necrosis of hepatocytes. In the first months of treatment quite often at patients increase of ALT and nuclear heating plant is registered. Within a year symptoms of hepatitis can be laboratory revealed. At the correct tactics of treatment and adequate dosing clinically significant hepatitis develops only at 0.1% of patients. Rate of mortality from damage of a liver at treatment by an antituberculous remedy makes 0.001%.

Often against long therapy by high doses the optic neuritis, polyneuropathy develops. Neurotoxic influence is shown at deficit of the Pyridoxine and considerably amplifies forming of inactive complexes of hydrazones with the Pyridoxine. Typical displays of polyneuropathy – disturbance of sensitivity as "socks" and "gloves" in distal departments of extremities with gradual distribution are higher. In addition muscular weakness, a mialgiya develops. At defeat of an optic nerve visual perception worsens, in hard cases the central scotoma forms. The neurotoxicity leads to development of psychosis, an ataxy, hallucinations and a coma.

Treatment at overdose

First aid is directed to stopping of an epileptic seizure, recovery of passability of respiratory tracts, stabilization of the main physiological indicators, carrying out infusional therapy.

At development of heavy acidosis intravenous administration of sodium bicarbonate is recommended. Reception of enterosorbents, Absorbent carbon for removal of active ingredient from a digestive tract is effective. Neurologic manifestations are stopped by administration of B6 Vitamin (at development of a coma, metabolic acidosis and convulsive syndrome). At the first introduction the maximum dose of the Pyridoxine makes 5 g. For strengthening of effect of B6 Vitamin appoint benzodiazepines. By means of a hemodialysis it is possible to accelerate removal of an antituberculous remedy (it is put seldom into practice).

Increase of liver enzymes three times indicates development of medicinal hepatitis and demands the termination of reception of a medicine. B6 vitamin in such cases is inefficient. The pyridoxine is applied only to prevention and treatment of polineyropatiya (50 mg/days).

Interaction

The risk of development of a gepatoktoksichnost considerably increases at a concomitant use of Rifampicin (especially at the persons having various diseases of hepatic system). The similar effect is observed at treatment by Paracetamol since. The isoniazid is capable to induce P450 cytochrome that promotes increase in quantity of the metabolites possessing toxicity.

Metabolism Phenytoinum and Carbamazepine it is slowed down because of increase of their concentration in plasma (strengthening of toxic influence is in addition noted). Absorption of active ingredient is slowed down at a concomitant use of antiacid means (the effect amplifies at reception of aluminum-bearing antacids).

Mutual strengthening of actions of other antitubercular medicines is noted. Renal removal is slowed down at simultaneous therapy of the Isoniazid and Streptomycin. Izofluran exponentiates a hepatotoxic. Expressiveness of side effects decreases at reception of Glutaminic acid and B6 Vitamin. The converse effect is observed at treatment by MAO inhibitors.

The isoniazid is capable to strengthen effect of Theophylline, anticoagulants of indirect action, the Ethosuximidum, Carbamazepine, benzodiazepines. Active agent reduces Ketokonazol's concentration.

Terms of sale

Drug can be bought in a drugstore, having shown the prescription medical form with the corresponding seals of the doctor and MPI.

The recipe in Latin:
Rp. Tab. Isoniasidi 0.1
D.t.d.N 50 in tab.
S.по to the scheme.

Storage conditions

Observance of temperature condition (to 25 degrees) allows to keep efficiency of a medicine during the term declared by the producer. To store far from children.

Period of validity

Tablets can be stored 6 years, ampoules – 2 years.

Special instructions

The medicine is not appointed in a dose by more than 10 mg/kg at the following pathology:

  • widespread atherosclerosis;
  • heavy course of an arterial hypertension;
  • psoriasis;
  • bronchial asthma;
  • ISCHEMIC HEART DISEASE;
  • diseases of a nervous system;
  • myxedema;
  • eczema in an aggravation stage;
  • heavy course of cardiovascular insufficiency.

Parallel purpose of other antitubercular medicines allows to avoid fulminant development of resistance. Observance of a bed rest within 1-1.5 hours after carrying out an injection is recommended.

Decrease in expressiveness of side effects is reached by co-administration of Glutaminic acid (inside), the Pyridoxine (intramuscular introduction, intake), Thiamin (intramuscular introduction).

It is important to remember that the metabolism of active agent is carried out in hepatic system by acetylation to the metabolites which are not possessing activity. Extent of acetylation is influenced by genetic predisposition. Determination of speed of an inactivation of the Isoniazid on the level of active agent in urine and blood in connection with an unequal metabolism at patients is recommended. With a high speed of an inactivation of active ingredient purpose of high doses is shown to persons.

Isoniazid for dogs

In certain quantities the medicine makes toxic impact on animals. The deadly dosage for dogs depends on weight. Active agent is immediately soaked up from a digestive tract, coming to blood.

The main symptoms of poisoning of a dog with the Isoniazid are shown in 30 minutes:

  • plentiful salivation;
  • confusion of consciousness;
  • weakness of legs, swaying, animal "zavalivaniye" sideways;
  • spasms, muscular twitchings;
  • vomiting;
  • long spasms, respiratory depression, a coma and death – at a serious poisoning.

Tubazidum for dogs is also toxic and has similar effect. For cats the lethal dose is also calculated on weight.

Analogs of the Isoniazid

Coincidence on the ATH code of the 4th level:

Structural analogs:

  • Nydrazidum;
  • Izoniazid-Fereyn;
  • Izozid-200;
  • Izoniazid-N.S.;
  • Rimicidum;
  • Tubazidum;
  • Izoniazid-Darnitsa;
  • Izoniazid-AKOS;
  • INH.

Zdravzona

  • Isoniazid of 300 mg No. 100 of a tabletkimoskhimfarmpreparata to them N. A. Semashko of joint stock company
  • Isoniazid of 10% solution for injections of 5 ml No. 10 of an ampulymoskhimfarmpreparata to them N. A. Semashko of joint stock company
to show still

Apteka24

  • Izoniaziddarnitsa (Ukraine, Kiev)
  • Izoniazidborshchagovsky HFZ (Ukraine, Kiev)
  • Izoniazidlugansky HFZ (Ukraine, Luhansk)
  • Izoniaziddarnitsa (Ukraine, Kiev)
  • Izoniazidlugansky HFZ (Ukraine, Luhansk)

Paniapteka

  • Isoniazid solution for injections of 10% of an ampoule of 5 ml No. 10 the Luhansk HFZ
  • Isoniazid solution for injections of 10% of an ampoule of 5 ml No. 10 the Luhansk HFZ
  • Isoniazid solution for injections of 10% of an ampoule of 5 ml No. 10 the Luhansk HFZ
  • Isoniazid solution for injections of 10% of an ampoule of 5 ml No. 10 the Luhansk HFZ
  • Isoniazid solution for injections of 10% of an ampoule of 5 ml No. 10 the Luhansk HFZ
Section: Antibiotics Antimicrobic
in more detail

Education: Graduated from the Bashkir state medical university majoring in "Medical business". In 2011 gained the diploma and the certificate in Therapy. In 2012 received 2 certificate and the diploma in "Functional diagnosis" and "Cardiology". In 2013 completed courses on "Topical issues of otorhinolaryngology in therapy". In 2014 completed advanced training courses in "A clinical echocardiography" and courses in "Medical rehabilitation".

Experience: From 2011 to 2014 the Policlinic No. 33 Ufa worked as the therapist and the cardiologist in MBUZ. Since 2014 the Policlinic No. 33 Ufa works as the cardiologist and the doctor of functional diagnosis in MBUZ.

PAY ATTENTION! Information on drugs on the website is help generalizing, collected from public sources and can form the basis for making decision on use of medicines it is not aware of treatment. Before medicine use the Isoniazid surely consult with the attending physician.