how long is isoniazid treatment?

Precautions

Your doctor may tell you to take isoniazid for 6 months or longer. Continue to take isoniazid even if you feel well. Do not skip doses or stop taking isoniazid without talking to your doctor. Stopping isoniazid too soon may cause bacteria to become resistant to antibiotics.

How long do you have to take isoniazid?

About isoniazid. TB is a bacterial infection which mostly affects the lungs, but which can affect any part of your body. It is treatable with a course of medicines which usually lasts for six months in total. You will need to take several medicines to treat TB - isoniazid is just one of the medicines prescribed.

How long does isoniazid last for TB?

Short course regimens include: Short-course treatment regimens, like 3HP and 4R, are effective, safe, and have higher completion rates than longer 6 to 9 months of isoniazid monotherapy (6H/9H). Shorter, rifamycin-based treatment regimens generally have a lower risk of hepatotoxicity than 6H and 9H.

What are the different types of isoniazid treatment regimens?

Some side effects of isoniazid may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Do the side effects of isoniazid go away?

Why do I have to take isoniazid for 9 months?

A 9-month course of isoniazid monotherapy is currently recommended for the treatment of latent tuberculosis infection (LTBI) and has been shown to be effective in both children and adults. Reduced compliance with this regimen has forced physicians to explore shorter regimens.

How long is the typical course of treatment for tuberculosis?

RIPE regimens for treating TB disease have an intensive phase of 2 months, followed by a continuation phase of either 4 or 7 months (total of 6 to 9 months for treatment). This is the preferred regimen for patients with newly diagnosed pulmonary TB.

How long do you take isoniazid for latent TB?

A course of antibiotic medicine will treat latent TB. You may be given Rifampicin and Isoniazid for three months (which may be together in a tablet called Rifinah) or Isoniazid by itself for six months.

What is the minimum period of TB treatment?

Duration of treatment with the current first-line anti-TB drugs is a minimum of 6 months. Reducing the duration of the treatment from six to two months or less could result in significant increase of adherence to treatment and cost reduction.

How do you know if TB is cured?

After taking TB medicine for several weeks, a doctor will be able to tell TB patients when they are no longer able to spread TB germs to others. Most people with TB disease will need to take TB medicine for at least 6 months to be cured.

Why is TB treatment so long?

A long treatment is required because antibiotics work only when the bacteria are actively dividing, and the bacteria that cause TB can rest without growing for long periods. This treatment is necessary to keep the latent TB infection from developing into active disease.

Can latent TB come back after treatment?

Even if you successfully beat tuberculosis, you can get tuberculosis infection again. In fact, TB reinfection is becoming more common. Tuberculosis is a potentially life-threatening, airborne bacterial infection that can be found worldwide.

What happens if I stop taking isoniazid?

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.

What are the long term effects of isoniazid?

Severe and sometimes fatal hepatitis has been reported with isoniazid therapy and may occur even after many months of treatment. The risk for hepatitis increases with advancing age, concomitant alcohol use, chronic liver disease, and injection drug use.

Can I Stop TB medicine after 6 months?

Six months is a long time, however, and patients frequently discontinue anti-TB treatment once their symptoms have improved.

What happens if I skip 1 week of TB treatment?

If you stop taking your TB medicine or skip doses, these things could happen: Your TB infection could come back. Your TB infection could turn into active TB disease. With active TB, you will have symptoms and feel sick and you can pass TB on to your friends and family.

Why is TB treated with 4 drugs?

The standard of care for initiating treatment of TB disease is four-drug therapy. Treatment with a single drug can lead to the development of a bacterial population resistant to that drug. Likewise, the addition of a single drug to a failing anti-TB regimen can lead to additional resistance.

Usual Adult Dose for Tuberculosis - Extrapulmonary

Pulmonary Tuberculosis without HIV Infection: OPTION 1: Initial regimen: 5 mg/kg orally once a day (maximum 300 mg/day) PLUS rifampin, pyrazinamide, and ethambutol/streptomycin -Duration of therapy: 8 weeks Continuation regimen: 5 mg/kg orally once a day (maximum 300 mg/day) OR 15 mg/kg orally 2 to 3 times a week (maximum 900 mg/day) PLUS rifampin -Duration of therapy: 16 weeks OPTION 2: Initial regimen: 5 mg/kg orally once a day (maximum 300 mg/day) PLUS rifampin, pyrazinamide, and streptomycin/ethambutol -Duration of therapy: 2 weeks Followed by: 15 mg/kg orally 2 times a week (maximum 900 mg/day) PLUS rifampin, pyrazinamide, and streptomycin/ethambutol -Duration of therapy: 6 weeks Continuation regimen: 15 mg/kg orally 2 times a week (maximum 900 mg/day) PLUS rifampin -Duration of therapy: 16 weeks OPTION 3: 15 mg/kg orally 3 times a week (maximum 900 mg/day) PLUS rifampin, pyrazinamide, and streptomycin/ethambutol -Duration of therapy: 6 months Extrapulmonary Tuberculosis: Daily dosing: 5 mg/kg orally once a day -Maximum dose: 300 mg/day Intermittent dosing: 15 mg/kg orally 2 to 3 times a week -Maximum dose: 900 mg/day Duration of therapy: -Extrapulmonary tuberculosis: 6 to 9 months -Bone/joint tuberculosis: 12 months -Miliary tuberculosis: 12 months Comments: -Doses given 2 or 3 times a week should be given via directly observed therapy (DOT). -Adjunctive treatment (e.g., surgery, corticosteroids) may be necessary in patients with extrapulmonary tuberculosis. -IM formulations may be used when oral administration is not possible. Use: Treatment for all forms of susceptible tuberculosis American Thoracic Society (ATS), US Centers for Disease Control and Prevention (US CDC), and Infectious Diseases Society of America (IDSA) Recommendations: Up to 40 kg: -Daily regimen: 10 to 15 mg/kg IM, IV, or orally once a day -Intermittent regimen: 20 to 30 mg IM, IV, or orally 2 to 3 times a week Over 40 kg: -Daily regimen: 5 mg/kg (usually 300 mg/day) IM, IV, or orally once a day -Intermittent regimen: 15 mg/kg (up to 900 mg/dose) IM, IV, or orally 2 to 3 times a week Comment: Pyridoxine 25 to 50 mg/day should be considered in all patients at risk of developing neuropathy; patients with peripheral neuropathy may be given 100 mg/day. Use: Treatment of drug-susceptible tuberculosis US Department of Health and Human Services (US HHS), National Institutes of Health (NIH), Health Resources and Services Administration (HRSA), and US CDC Recommendations: LATENT TUBERCULOSIS: Preferred therapy: 300 mg orally once a day OR 900 mg orally 2 times a week -Duration of therapy: 9 months Alternative therapy: 15 mg/kg orally once a week PLUS rifapentine -Duration of therapy: 12 weeks DRUG-SUSCEPTIBLE TUBERCULOSIS: Intensive Phase: 5 mg/kg orally once a day PLUS rifampin/rifabutin, ethambutol, and pyrazinamide -Duration of therapy: 2 months Continuation Phase: 5 mg/kg orally once a day for 5 to 7 days per week PLUS rifampin/rifabutin Duration of therapy: -Extrapulmonary in other sites: 6 months -Pulmonary, drug susceptible: 6 months -Extrapulmonary with bone/joint involvement: 6 to 9 months -Pulmonary and positive culture at 2 months of treatment: 9 months -Extrapulmonary with central nervous system involvement: 9 to 12 months DRUG-RESISTANT TUBERCULOSIS: Initial phase: 5 mg/kg orally once a day PLUS moxifloxacin/levofloxacin, ethambutol, rifampin/rifabutin, pyrazinamide, and an aminoglycoside/capreomycin Comments: -Pyridoxine 25 to 50 mg orally should be given to patients during treatment for latent tuberculosis. -If the organism is susceptible to this drug and rifampin, ethambutol may be discontinued during the intensive phase. -DOT is recommended for patients with HIV-related tuberculosis. Uses: -Preferred treatment to prevent tuberculosis in patients with a positive screening test for latent tuberculosis infection, no evidence of active tuberculosis, and no prior history of treatment for active or latent tuberculosis -Preferred treatment to prevent tuberculosis in patients with close contact with a person with infectious tuberculosis, regardless of a screening test result -First-line drug for the treatment of active tuberculosis caused by Mycobacterium tuberculosis.

Usual Adult Dose for Tuberculosis - Active

Pulmonary Tuberculosis without HIV Infection: OPTION 1: Initial regimen: 5 mg/kg orally once a day (maximum 300 mg/day) PLUS rifampin, pyrazinamide, and ethambutol/streptomycin -Duration of therapy: 8 weeks Continuation regimen: 5 mg/kg orally once a day (maximum 300 mg/day) OR 15 mg/kg orally 2 to 3 times a week (maximum 900 mg/day) PLUS rifampin -Duration of therapy: 16 weeks OPTION 2: Initial regimen: 5 mg/kg orally once a day (maximum 300 mg/day) PLUS rifampin, pyrazinamide, and streptomycin/ethambutol -Duration of therapy: 2 weeks Followed by: 15 mg/kg orally 2 times a week (maximum 900 mg/day) PLUS rifampin, pyrazinamide, and streptomycin/ethambutol -Duration of therapy: 6 weeks Continuation regimen: 15 mg/kg orally 2 times a week (maximum 900 mg/day) PLUS rifampin -Duration of therapy: 16 weeks OPTION 3: 15 mg/kg orally 3 times a week (maximum 900 mg/day) PLUS rifampin, pyrazinamide, and streptomycin/ethambutol -Duration of therapy: 6 months Extrapulmonary Tuberculosis: Daily dosing: 5 mg/kg orally once a day -Maximum dose: 300 mg/day Intermittent dosing: 15 mg/kg orally 2 to 3 times a week -Maximum dose: 900 mg/day Duration of therapy: -Extrapulmonary tuberculosis: 6 to 9 months -Bone/joint tuberculosis: 12 months -Miliary tuberculosis: 12 months Comments: -Doses given 2 or 3 times a week should be given via directly observed therapy (DOT). -Adjunctive treatment (e.g., surgery, corticosteroids) may be necessary in patients with extrapulmonary tuberculosis. -IM formulations may be used when oral administration is not possible. Use: Treatment for all forms of susceptible tuberculosis American Thoracic Society (ATS), US Centers for Disease Control and Prevention (US CDC), and Infectious Diseases Society of America (IDSA) Recommendations: Up to 40 kg: -Daily regimen: 10 to 15 mg/kg IM, IV, or orally once a day -Intermittent regimen: 20 to 30 mg IM, IV, or orally 2 to 3 times a week Over 40 kg: -Daily regimen: 5 mg/kg (usually 300 mg/day) IM, IV, or orally once a day -Intermittent regimen: 15 mg/kg (up to 900 mg/dose) IM, IV, or orally 2 to 3 times a week Comment: Pyridoxine 25 to 50 mg/day should be considered in all patients at risk of developing neuropathy; patients with peripheral neuropathy may be given 100 mg/day. Use: Treatment of drug-susceptible tuberculosis US Department of Health and Human Services (US HHS), National Institutes of Health (NIH), Health Resources and Services Administration (HRSA), and US CDC Recommendations: LATENT TUBERCULOSIS: Preferred therapy: 300 mg orally once a day OR 900 mg orally 2 times a week -Duration of therapy: 9 months Alternative therapy: 15 mg/kg orally once a week PLUS rifapentine -Duration of therapy: 12 weeks DRUG-SUSCEPTIBLE TUBERCULOSIS: Intensive Phase: 5 mg/kg orally once a day PLUS rifampin/rifabutin, ethambutol, and pyrazinamide -Duration of therapy: 2 months Continuation Phase: 5 mg/kg orally once a day for 5 to 7 days per week PLUS rifampin/rifabutin Duration of therapy: -Extrapulmonary in other sites: 6 months -Pulmonary, drug susceptible: 6 months -Extrapulmonary with bone/joint involvement: 6 to 9 months -Pulmonary and positive culture at 2 months of treatment: 9 months -Extrapulmonary with central nervous system involvement: 9 to 12 months DRUG-RESISTANT TUBERCULOSIS: Initial phase: 5 mg/kg orally once a day PLUS moxifloxacin/levofloxacin, ethambutol, rifampin/rifabutin, pyrazinamide, and an aminoglycoside/capreomycin Comments: -Pyridoxine 25 to 50 mg orally should be given to patients during treatment for latent tuberculosis. -If the organism is susceptible to this drug and rifampin, ethambutol may be discontinued during the intensive phase. -DOT is recommended for patients with HIV-related tuberculosis. Uses: -Preferred treatment to prevent tuberculosis in patients with a positive screening test for latent tuberculosis infection, no evidence of active tuberculosis, and no prior history of treatment for active or latent tuberculosis -Preferred treatment to prevent tuberculosis in patients with close contact with a person with infectious tuberculosis, regardless of a screening test result -First-line drug for the treatment of active tuberculosis caused by Mycobacterium tuberculosis.

Usual Adult Dose for Tuberculosis - Latent

Pulmonary Tuberculosis without HIV Infection: OPTION 1: Initial regimen: 5 mg/kg orally once a day (maximum 300 mg/day) PLUS rifampin, pyrazinamide, and ethambutol/streptomycin -Duration of therapy: 8 weeks Continuation regimen: 5 mg/kg orally once a day (maximum 300 mg/day) OR 15 mg/kg orally 2 to 3 times a week (maximum 900 mg/day) PLUS rifampin -Duration of therapy: 16 weeks OPTION 2: Initial regimen: 5 mg/kg orally once a day (maximum 300 mg/day) PLUS rifampin, pyrazinamide, and streptomycin/ethambutol -Duration of therapy: 2 weeks Followed by: 15 mg/kg orally 2 times a week (maximum 900 mg/day) PLUS rifampin, pyrazinamide, and streptomycin/ethambutol -Duration of therapy: 6 weeks Continuation regimen: 15 mg/kg orally 2 times a week (maximum 900 mg/day) PLUS rifampin -Duration of therapy: 16 weeks OPTION 3: 15 mg/kg orally 3 times a week (maximum 900 mg/day) PLUS rifampin, pyrazinamide, and streptomycin/ethambutol -Duration of therapy: 6 months Extrapulmonary Tuberculosis: Daily dosing: 5 mg/kg orally once a day -Maximum dose: 300 mg/day Intermittent dosing: 15 mg/kg orally 2 to 3 times a week -Maximum dose: 900 mg/day Duration of therapy: -Extrapulmonary tuberculosis: 6 to 9 months -Bone/joint tuberculosis: 12 months -Miliary tuberculosis: 12 months Comments: -Doses given 2 or 3 times a week should be given via directly observed therapy (DOT). -Adjunctive treatment (e.g., surgery, corticosteroids) may be necessary in patients with extrapulmonary tuberculosis. -IM formulations may be used when oral administration is not possible. Use: Treatment for all forms of susceptible tuberculosis American Thoracic Society (ATS), US Centers for Disease Control and Prevention (US CDC), and Infectious Diseases Society of America (IDSA) Recommendations: Up to 40 kg: -Daily regimen: 10 to 15 mg/kg IM, IV, or orally once a day -Intermittent regimen: 20 to 30 mg IM, IV, or orally 2 to 3 times a week Over 40 kg: -Daily regimen: 5 mg/kg (usually 300 mg/day) IM, IV, or orally once a day -Intermittent regimen: 15 mg/kg (up to 900 mg/dose) IM, IV, or orally 2 to 3 times a week Comment: Pyridoxine 25 to 50 mg/day should be considered in all patients at risk of developing neuropathy; patients with peripheral neuropathy may be given 100 mg/day. Use: Treatment of drug-susceptible tuberculosis US Department of Health and Human Services (US HHS), National Institutes of Health (NIH), Health Resources and Services Administration (HRSA), and US CDC Recommendations: LATENT TUBERCULOSIS: Preferred therapy: 300 mg orally once a day OR 900 mg orally 2 times a week -Duration of therapy: 9 months Alternative therapy: 15 mg/kg orally once a week PLUS rifapentine -Duration of therapy: 12 weeks DRUG-SUSCEPTIBLE TUBERCULOSIS: Intensive Phase: 5 mg/kg orally once a day PLUS rifampin/rifabutin, ethambutol, and pyrazinamide -Duration of therapy: 2 months Continuation Phase: 5 mg/kg orally once a day for 5 to 7 days per week PLUS rifampin/rifabutin Duration of therapy: -Extrapulmonary in other sites: 6 months -Pulmonary, drug susceptible: 6 months -Extrapulmonary with bone/joint involvement: 6 to 9 months -Pulmonary and positive culture at 2 months of treatment: 9 months -Extrapulmonary with central nervous system involvement: 9 to 12 months DRUG-RESISTANT TUBERCULOSIS: Initial phase: 5 mg/kg orally once a day PLUS moxifloxacin/levofloxacin, ethambutol, rifampin/rifabutin, pyrazinamide, and an aminoglycoside/capreomycin Comments: -Pyridoxine 25 to 50 mg orally should be given to patients during treatment for latent tuberculosis. -If the organism is susceptible to this drug and rifampin, ethambutol may be discontinued during the intensive phase. -DOT is recommended for patients with HIV-related tuberculosis. Uses: -Preferred treatment to prevent tuberculosis in patients with a positive screening test for latent tuberculosis infection, no evidence of active tuberculosis, and no prior history of treatment for active or latent tuberculosis -Preferred treatment to prevent tuberculosis in patients with close contact with a person with infectious tuberculosis, regardless of a screening test result -First-line drug for the treatment of active tuberculosis caused by Mycobacterium tuberculosis.

Usual Adult Dose for Tuberculosis - Prophylaxis

Adults over 30 kg: 300 mg orally once a day Duration of therapy: -Close contact with newly diagnosed tuberculosis patients: At least 12 weeks -Fibrotic pulmonary lesions or pulmonary silicosis: 12 months (or 4 months PLUS rifampin) -Patients with HIV: At least 12 months Comments: -Bacteriologically positive or radiographically progressive tuberculosis should be excluded before starting treatment. -Pyridoxine is recommended in patients who are malnourished and those at risk of neuropathy (e.g., alcoholics, patients with diabetes). -IM formulations may be used when oral administration is not possible. Uses: Preventive therapy in: -Close contacts of persons with newly diagnosed infectious tuberculosis -IV drug users known to be HIV-seronegative -Patients with HIV infection and persons with risk factors for HIV infection whose status is unknown, but who are suspected of having HIV infection -Patients with the following medical conditions: clinical situations associated with substantial rapid weight loss/chronic undernutrition (e.g., carcinomas of the upper oropharynx and upper gastrointestinal tract that prevent adequate nutritional intake, chronic malabsorption syndromes, chronic peptic ulcer disease, intestinal bypass surgery, postgastrectomy state with/without weight loss), diabetes mellitus, end-stage renal disease, immunosuppressive therapy, prolonged adrenocorticosteroid therapy, silicosis, some hematologic and reticuloendothelial diseases (e.g., leukemia, Hodgkin's lymphoma) -Patients younger than 35 years in high-incidence groups (e.g., foreign-born patients from high-prevalence countries who never received bacilli Calmette-Guerin [BCG] vaccine, medically underserved, low-income populations, including high-risk racial or ethnic minority populations, especially blacks, Hispanics, and Native Americans, and residents of facilities for long-term care [e.g., correctional institutions, nursing homes, mental institutions]) -Patients younger than 35 years with a tuberculin skin test reaction of 15 mm or more -Persons with abnormal chest radiographs that show fibrotic lesions likely to represent old healed tuberculosis or pulmonary silicosis -Recent converters (e.g., tuberculin skin test with 10 mm or greater (younger than 35 years) OR 15 mm or greater (35 years and older) within a 2-year period) US HHS, NIH, HRSA, and US CDC Recommendations: Preferred choice: 300 mg orally once a day OR 900 mg orally 2 times a week -Duration of therapy: 9 months Alternative choice: 900 mg orally once a week PLUS rifapentine -Duration of therapy: 12 weeks Comments: -Patients receiving intermittent dosing should be given doses via DOT. -Pyridoxine 25 to 50 mg orally once a day should be given with this drug. Uses: -Prophylaxis to prevent the first episode of tuberculosis in patients with a positive screening test for latent tuberculosis infection, with no evidence of active tuberculosis, and no prior treatment for active or latent tuberculosis -Prophylaxis to prevent the first episode of tuberculosis in patients with close contact with a person with infectious tuberculosis, with no evidence of active tuberculosis, regardless of screening test results.

Usual Adult Dose for Mycobacterium kansasii

ATS and IDSA Recommendations: 5 mg/kg orally once a day Maximum dose: 300 mg/day Duration of therapy: 18 months Comment: Patients should have at least 12 months of negative sputum cultures. Use: Treatment of Mycobacterium kansasii pulmonary disease

Usual Pediatric Dose for Tuberculosis - Extrapulmonary

PULMONARY TUBERCULOSIS WITHOUT HIV INFECTION: Option 1: Initial regimen: 10 to 15 mg/kg IM or orally once a day (maximum 300 mg/day) PLUS rifampin, pyrazinamide, and ethambutol/streptomycin -Duration of therapy: 8 weeks Continuation regimen: 10 to 15 mg/kg IM or orally once a day (maximum 300 mg/day) OR 20 to 40 mg/kg IM or orally 2 to 3 times a week (maximum 900 mg/day) PLUS rifampin -Duration of therapy: 16 weeks Option 2: Initial regimen: 10 to 15 mg/kg IM or orally once a day (maximum 300 mg/day) PLUS rifampin, pyrazinamide, and streptomycin/ethambutol -Duration of therapy: 2 weeks Followed by: 20 to 40 mg/kg IM or orally 2 times a week (maximum 900 mg/day) PLUS rifampin, pyrazinamide, and streptomycin/ethambutol -Duration of therapy: 6 weeks Continuation regimen: 20 to 40 mg/kg IM or orally 2 times a week (maximum 900 mg/day) PLUS rifampin -Duration of therapy: 16 weeks Option 3: 20 to 40 mg/kg IM or orally 3 times a week (maximum 900 mg/day) PLUS rifampin, pyrazinamide, and streptomycin/ethambutol -Duration of therapy: 6 months EXTRAPULMONARY TUBERCULOSIS: Daily dosing: 10 to 15 mg/kg IM or orally once a day -Maximum dose: 300 mg/day Intermittent dosing: 20 to 40 mg/kg IM or orally 2 to 3 times a week -Maximum dose: 900 mg/day Duration of therapy: -Extrapulmonary tuberculosis: 6 to 9 months -Bone/joint tuberculosis: 12 months -Miliary tuberculosis: 12 months Comments: -Doses given 2 or 3 times a week should be given via DOT. -Adjunctive treatment (e.g., surgery, corticosteroids) may be necessary in patients with extrapulmonary tuberculosis. -IM formulations may be used when oral administration is not possible. Use: Treatment for all forms of susceptible tuberculosis American Academy of Pediatrics (AAP) Recommendations: Infants, Children, and Adolescents: Daily dosing: 10 to 15 mg/kg orally once a day -Maximum dose: 300 mg/day Intermittent dosing: 20 to 30 mg orally 2 times a week -Maximum dose: 900 mg/dose Duration of therapy: -Latent tuberculosis (drug-susceptible): 9 months -Pulmonary and extrapulmonary tuberculosis (except meningitis): 2 months (3-drug regimen), then 4 months for drug-susceptible M tuberculosis OR 9 to 12 months for drug-susceptible Mycobacterium bovis -Meningitis: 2 months (4-drug regimen), followed by 7 to 10 months of this drug and rifampin (once a day or 2 times a week) Comments: -Daily treatment is preferred for latent tuberculosis; however, DOT may be used if daily treatment is not possible. -Patients who receive a 3-drug regimen (e.g., this drug, rifampin, and pyrazinamide) should have a low risk of drug resistance. -Patients with only hilar adenopathy and a low risk of drug resistance may receive treatment with this drug and rifampin for 6 months. -Patients with meningitis caused by M bovis should receive treatment with this drug, rifampin, and an aminoglycoside or ethionamide for 2 months, followed by at least 7 to 10 months of this drug and rifampin. Uses: -Treatment of latent Mycobacterial tuberculosis infection (e.g., positive tuberculin skin tests or interferon-gamma release assay result, no disease) -Treatment of pulmonary and extrapulmonary Mycobacterial tuberculosis infection (except meningitis) caused by M tuberculosis or M bovis -Treatment of meningitis caused by M tuberculosis or M bovis ATS, US CDC, and IDSA Recommendations: Less than 15 years OR up to 40 kg: -Daily regimen: 10 to 15 mg/kg IM, IV, or orally once a day -Intermittent regimen: 20 to 30 mg IM, IV, or orally 2 to 3 times a week 15 years and older AND/OR over 40 kg: -Daily regimen: 5 mg/kg (usually 300 mg/day) IM, IV, or orally once a day -Intermittent regimen: 15 mg/kg (up to 900 mg/dose) IM, IV, or orally 2 to 3 times a week Comment: Pyridoxine 25 to 50 mg/day should be considered in all patients at risk of developing neuropathy; patients with peripheral neuropathy may be given 100 mg/day. Use: Treatment of drug-susceptible tuberculosis US HHS, NIH, HRSA, and US CDC Recommendations: Children: DRUG-SUSCEPTIBLE TUBERCULOSIS: Intensive Phase: 10 to 15 mg/kg orally once a day PLUS rifampin, pyrazinamide, and ethambutol Maximum dose: 300 mg/day Duration of therapy: 2 months Continuation Phase: 10 to 15 mg/kg (up to 300 mg/day) orally once a day PLUS rifampin OR 20 to 30 mg/kg IM or orally 3 times a week Duration of therapy: -Bone/joint disease or meningitis: Up to 10 months -Intrathoracic disease, lymph node tuberculosis: 7 months -Minimal disease and in the absence of significant immune compromise: 4 months Comment: The total duration of treatment is at least 12 months for minimal disease, and 18 to 24 months after non-bacteriological diagnosis or after culture conversion. Uses: -First-line drug for the treatment of active tuberculosis caused by M tuberculosis -Alternative drug (as part of a 3-drug regimen) for the treatment of fully drug-susceptible tuberculosis in the absence of significant immune compromise.

Usual Pediatric Dose for Tuberculosis - Active

PULMONARY TUBERCULOSIS WITHOUT HIV INFECTION: Option 1: Initial regimen: 10 to 15 mg/kg IM or orally once a day (maximum 300 mg/day) PLUS rifampin, pyrazinamide, and ethambutol/streptomycin -Duration of therapy: 8 weeks Continuation regimen: 10 to 15 mg/kg IM or orally once a day (maximum 300 mg/day) OR 20 to 40 mg/kg IM or orally 2 to 3 times a week (maximum 900 mg/day) PLUS rifampin -Duration of therapy: 16 weeks Option 2: Initial regimen: 10 to 15 mg/kg IM or orally once a day (maximum 300 mg/day) PLUS rifampin, pyrazinamide, and streptomycin/ethambutol -Duration of therapy: 2 weeks Followed by: 20 to 40 mg/kg IM or orally 2 times a week (maximum 900 mg/day) PLUS rifampin, pyrazinamide, and streptomycin/ethambutol -Duration of therapy: 6 weeks Continuation regimen: 20 to 40 mg/kg IM or orally 2 times a week (maximum 900 mg/day) PLUS rifampin -Duration of therapy: 16 weeks Option 3: 20 to 40 mg/kg IM or orally 3 times a week (maximum 900 mg/day) PLUS rifampin, pyrazinamide, and streptomycin/ethambutol -Duration of therapy: 6 months EXTRAPULMONARY TUBERCULOSIS: Daily dosing: 10 to 15 mg/kg IM or orally once a day -Maximum dose: 300 mg/day Intermittent dosing: 20 to 40 mg/kg IM or orally 2 to 3 times a week -Maximum dose: 900 mg/day Duration of therapy: -Extrapulmonary tuberculosis: 6 to 9 months -Bone/joint tuberculosis: 12 months -Miliary tuberculosis: 12 months Comments: -Doses given 2 or 3 times a week should be given via DOT. -Adjunctive treatment (e.g., surgery, corticosteroids) may be necessary in patients with extrapulmonary tuberculosis. -IM formulations may be used when oral administration is not possible. Use: Treatment for all forms of susceptible tuberculosis American Academy of Pediatrics (AAP) Recommendations: Infants, Children, and Adolescents: Daily dosing: 10 to 15 mg/kg orally once a day -Maximum dose: 300 mg/day Intermittent dosing: 20 to 30 mg orally 2 times a week -Maximum dose: 900 mg/dose Duration of therapy: -Latent tuberculosis (drug-susceptible): 9 months -Pulmonary and extrapulmonary tuberculosis (except meningitis): 2 months (3-drug regimen), then 4 months for drug-susceptible M tuberculosis OR 9 to 12 months for drug-susceptible Mycobacterium bovis -Meningitis: 2 months (4-drug regimen), followed by 7 to 10 months of this drug and rifampin (once a day or 2 times a week) Comments: -Daily treatment is preferred for latent tuberculosis; however, DOT may be used if daily treatment is not possible. -Patients who receive a 3-drug regimen (e.g., this drug, rifampin, and pyrazinamide) should have a low risk of drug resistance. -Patients with only hilar adenopathy and a low risk of drug resistance may receive treatment with this drug and rifampin for 6 months. -Patients with meningitis caused by M bovis should receive treatment with this drug, rifampin, and an aminoglycoside or ethionamide for 2 months, followed by at least 7 to 10 months of this drug and rifampin. Uses: -Treatment of latent Mycobacterial tuberculosis infection (e.g., positive tuberculin skin tests or interferon-gamma release assay result, no disease) -Treatment of pulmonary and extrapulmonary Mycobacterial tuberculosis infection (except meningitis) caused by M tuberculosis or M bovis -Treatment of meningitis caused by M tuberculosis or M bovis ATS, US CDC, and IDSA Recommendations: Less than 15 years OR up to 40 kg: -Daily regimen: 10 to 15 mg/kg IM, IV, or orally once a day -Intermittent regimen: 20 to 30 mg IM, IV, or orally 2 to 3 times a week 15 years and older AND/OR over 40 kg: -Daily regimen: 5 mg/kg (usually 300 mg/day) IM, IV, or orally once a day -Intermittent regimen: 15 mg/kg (up to 900 mg/dose) IM, IV, or orally 2 to 3 times a week Comment: Pyridoxine 25 to 50 mg/day should be considered in all patients at risk of developing neuropathy; patients with peripheral neuropathy may be given 100 mg/day. Use: Treatment of drug-susceptible tuberculosis US HHS, NIH, HRSA, and US CDC Recommendations: Children: DRUG-SUSCEPTIBLE TUBERCULOSIS: Intensive Phase: 10 to 15 mg/kg orally once a day PLUS rifampin, pyrazinamide, and ethambutol Maximum dose: 300 mg/day Duration of therapy: 2 months Continuation Phase: 10 to 15 mg/kg (up to 300 mg/day) orally once a day PLUS rifampin OR 20 to 30 mg/kg IM or orally 3 times a week Duration of therapy: -Bone/joint disease or meningitis: Up to 10 months -Intrathoracic disease, lymph node tuberculosis: 7 months -Minimal disease and in the absence of significant immune compromise: 4 months Comment: The total duration of treatment is at least 12 months for minimal disease, and 18 to 24 months after non-bacteriological diagnosis or after culture conversion. Uses: -First-line drug for the treatment of active tuberculosis caused by M tuberculosis -Alternative drug (as part of a 3-drug regimen) for the treatment of fully drug-susceptible tuberculosis in the absence of significant immune compromise.

What is isoniazid used for?

Isoniazid, also known as isonicotinic acid hydrazide ( INH ), is an antibiotic used for the treatment of tuberculosis. For active tuberculosis it is often used together with rifampicin, pyrazinamide, and either streptomycin or ethambutol. For latent tuberculosis it is often used by itself.

What is the mechanism of action of isoniazid?

Mechanism of action. Isoniazid is a prodrug that inhibits the formation of the mycobacterial cell wall. Isoniazid must be activated by KatG, a bacterial catalase-peroxidase enzyme in Mycobacterium tuberculosis.

Why is pyridoxine given?

Pyridoxine may be given to reduce the risk of side effects. Isoniazid works in part by disrupting the formation of the bacteria's cell wall which results in cell death. Isoniazid was first made in 1952. It is on the World Health Organization's List of Essential Medicines.

How is isoniazid metabolized?

It is metabolized in the liver via acetylation into acetylhydrazine. Two forms of the enzyme are responsible for acetylation, so some patients metabolize the drug more quickly than others. Hence, the half-life is bimodal, with "slow acetylators" and "fast acetylators". A graph of number of people versus time shows peaks at one and three hours. The height of the peaks depends on the ethnicities of the people being tested. The metabolites are excreted in the urine. Doses do not usually have to be adjusted in case of renal failure .

What is the antibiotic used for tuberculosis?

Isoniazid. Isoniazid, also known as isonicotinic acid hydrazide ( INH ), is an antibiotic used for the treatment of tuberculosis. For active tuberculosis it is often used together with rifampicin, pyrazinamide, and either streptomycin or ethambutol. For latent tuberculosis it is often used by itself.

Does isoniazid affect ketoconazole?

It is possible that isoniazid may decrease the serum levels of ketoconazole after long-term treatment. This is seen with the simultaneous use of rifampin, isoniazid, and ketoconazole. Isoniazid may increase the amount of phenytoin in the body. The doses of phenytoin may need to be adjusted when given with isoniazid.

Is isoniazid a boxed warning?

Isoniazid has a boxed warning for severe and sometimes fatal hepatitis, which is age-dependent at a rate of 0.3% in people 21 to 35 years old and over 2% in those over age 50. Symptoms suggestive of liver toxicity include nausea, vomiting, abdominal pain, dark urine, right upper quadrant pain, and loss of appetite.

How often should I take isoniazid?

Isoniazid is usually is taken once a day; it may also be taken one, two, or three times weekly. Take isoniazid at around the same time every scheduled day.

What is isoniazid used for?

Isoniazid is also used with other drugs to treat people with latent (resting or nongrowing) TB including those in close contact with people who have active TB, a positive tuberculin skin test, human immunodeficiency virus (HIV), and those with pulmonary fibrosis (scarring of the lungs with an unknown cause).

What to do if you are allergic to isoniazid?

tell your doctor and pharmacist if you are allergic to isoniazid, any other medications, or any of the ingredients in isoniazid tablets or oral solution. Ask your pharmacist for a list of the ingredients.

What foods should I avoid with isoniazid?

These foods and beverages include certain cheeses, red wine, and certain fish (e.g., tuna, other tropical fish).

Can you drink alcohol while taking isoniazid?

tell your doctor if you are pregnant or plan to become pregnant. If you become pregnant while taking isoniazid, call your doctor. you should know that you should not drink alcohol while taking this drug.

How long does isoniazid last?

It is treatable with a course of medicines which usually lasts for six months in total. You will need to take several medicines to treat TB - isoniazid is just one of the medicines prescribed.

How often should I take isoniazid?

Isoniazid is one of several medicines that you will need to take to treat tuberculosis (TB). It is important that you take the tablets regularly every day. The ideal time to take the tablets is half an hour before breakfast.

What is the name of the drug that is used to treat tuberculosis?

Tuberculosis (TB) Also called. Rifinah® (isoniazid with rifampicin); Rifater® (isoniazid with rifampicin and pyrazinamide); Voractiv®, Rimstar® (isoniazid with rifampicin, pyrazinamide and ethambutol) Available as. Tablets. Isoniazid is used to treat tuberculosis (TB). TB is a bacterial infection which mostly affects the lungs, ...

Is isoniazid bad for you?

If you are pregnant, trying for a baby or breastfeeding. Although isoniazid is not known to be harmful in pregnancy, it is important that you tell your doctor, as you may need to be given a vitamin supplement. If you have any problems with the way your kidneys work, or the way your liver works.

Can I take isoniazid while pregnant?

For these reasons, before you start taking isoniazid it is important that your doctor knows : If you are pregnant, trying for a baby or breastfeeding.

Can isoniazid cause side effects?

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains the most common ones associated with isoniazid. You will find a full list in the manufacturer's information leaflet supplied with your medicine.

Can you take more than the prescribed dose of a sulfate?

Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.

What is isoniazid used for?

It has been used for over 50 years in the prophylaxis and treatment of tuberculosis. Patients are generally prescribed daily doses for 6-9 month periods. So-called “slow acetylators” may develop chronic side effects more readily with daily dosing, such as peripheral neuropathy, agitation, insomnia, and abdominal complaints; these patients sometimes benefit from every-other-day dosing schedules. Acute overdose of INH has the unique toxicological profile of causing the sudden onset of seizures. High level of clinical suspicion and prompt treatment with a specific antidote can prevent serious adverse outcomes.

How long does it take for an INH overdose to cause a seizure?

Seizures can occur 30 minutes to 3 hours after acute INH overdose. Typically, INH-induced seizures are brief in duration but multiple, generalized, unremitting episodes may occur. Onset of seizures is abrupt, and often without warning.

What happens to INH after an overdose?

After acute overdose, INH saturates the metabolic pathways that produce the toxic intermediates that cause hepatic damage. Saturation of these pathways, along with the short half-life of INH, prevents excessive amounts of toxic intermediates from being produced in the acute overdose setting.

How is INH absorbed?

In the liver, INH enters 4 metabolic pathways: (1) methylation and (2) acetylation, both of which yield inactive metabolites ; (3) cytochrome P-450 hydrolysis, which yields toxic hydrazines and hydrazides (these intermediates may cause mild hepatic toxicity over time); and (4) dehydrazination, which yields a group of toxic compounds known as hydrazones. Dehydrazination and production of hydrazones are significantly enhanced with acute overdose of INH.

How long did the seizure last in the ED?

The seizure lasted for 2 minutes, followed by another seizure 5 minutes later.

Can INH cause seizures?

So-called “slow acetylators” may develop chronic side effects more readily with daily dosing, such as peripheral neuropathy, agitation, insomnia, and abdominal complaints; these patients sometimes benefit from every-other-day dosing schedules. Acute overdose of INH has the unique toxicological profile of causing the sudden onset of seizures.

How long should I take isoniazid?

You may have to take it every day for as long as 6 months to 2 years. It is important that you do not miss any doses. Your doctor may also want you to take pyridoxine (e.g., Hexa-Betalin, vitamin B 6) every day to help prevent or lessen some of the side effects of isoniazid.

How much does isoniazid cost?

ISONIAZID is used to prevent or to treat tuberculosis (TB). The lowest GoodRx price for the most common version of isoniazid is around $6.92, 66% off the average retail price of $20.81. Compare antimycobacterials. Prescription Settings.

What is isoniazid used for?

Overview TOP. Isoniazid is used to treat tuberculosis (TB) or prevent its return (reactivation). It may be given alone, or in combination with other medicines, to treat TB or to prevent its return (reactivation). This medicine may also be used for other problems as determined by your doctor.

How much meds should I take for a pound?

The usual dose is 10 to 20 mg per kg (4.5 to 9.1 mg per pound) of body weight , up to 300 mg, once a day; or 20 to 40 mg per kg (9.1 to 18.2 mg per pound) of body weight, up to 900 mg, two times a week or three times a week, depending on the schedule your doctor chooses for you.

How many times a day should I take a sulfate supplement?

Adults and teenagers—300 mg once a day; or 15 mg per kg (6.8 mg per pound) of body weight, up to 900 mg, two times a week or three times a week, depending on the schedule your doctor chooses for you. Children—Dose is based on body weight.

Can isoniazid cause hepatitis?

Intramuscular route (Solution) Severe and sometimes fatal hepatitis has been reported with isoniazid therapy and may occur even after many months of treatment. The risk for hepatitis increases with advancing age, concomitant alcohol use, chronic liver disease, and injection drug use. Patients given isoniazid should be carefully monitored ...

Can isoniazid cause side effects?

Isoniazid can cause serious side effects in any patient. Therefore, it is especially important that you discuss with the child's doctor the good that this medicine may do as well as the risks of using it.

What should a clinic decide on TB treatment?

Clinicians should choose the appropriate treatment regimen based on drug susceptibility results of the presumed source case (if known), coexisting medical conditions (e.g., HIV. ), and potential for drug-drug interactions. Consultation with a TB expert is advised if the known source of TB infection has drug-resistant TB.

What is the name of the drug that is used to treat TB?

Isoniazid (INH) Rifapentine (RPT) Rifampin (RIF) These medications are used on their own or in combination, as shown in the table below. CDC and the National Tuberculosis Controllers Association (NTCA) preferentially recommend short-course, rifamycin-based, 3- or 4-month latent TB infection treatment regimens over 6- or 9-month isoniazid ...

Is 6H or 9H better for TB?

Although effective, 6H and 9H have higher toxicity risk and lower treatment completion rates than most short-term treatment regimens. All treatment must be modified if the patient is a contact of an individual with drug-resistant TB disease.

Does isoniazid cause side effects?

Side effects requiring immediate medical attention. Along with its needed effects, is oniazid may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Does isoniazid increase the risk of hepatitis?

The risk for hepatitis increases with advancing age, concomitant alcohol use, chronic liver disease, and injection drug use. Patients given isoniazid should be carefully monitored and interviewed at monthly intervals.

Does isoniazid need medical attention?

Side effects not requiring immediate medical attention. Some side effects of isoniazid may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine.

Can isoniazid cause hepatitis?

Severe and sometimes fatal hepatitis has been reported with is oniazid therapy and may occur even after many months of treatment. The risk for hepatitis increases with advancing age, concomitant alcohol use, chronic liver disease, and injection drug use. Patients given isoniazid should be carefully monitored and interviewed at monthly intervals. For persons 35 and older, in addition to monthly symptom reviews, hepatic enzymes (specifically, AST and ALT (formerly SGOT and SGPT, respectively) should be measured prior to starting isoniazid therapy and periodically throughout treatment. An increased risk of fatal hepatitis associated with isoniazid has been reported in women, particularly black and Hispanic women. The risk may also be increased during the post partum period. More careful monitoring should be considered in these groups, possibly including more frequent laboratory monitoring.

Overview

Medical uses

Side effects

Drug interactions

Mechanism of action

Metabolism

Isoniazid is often used to treat latent and active tuberculosis infections. In persons with isoniazid-sensitive Mycobacterium tuberculosis infection, drug regimens based on isoniazid are usually effective when persons adhere to the prescribed treatment. However, in persons with isoniazid-resistant Mycobacterium tuberculosis infection, drug regimens based on isoniazid have a high rate of failure.

History

Preparation