Dr. Saltiel received his Pharm.D. from the University of California, San Francisco, in 1980, following undergraduate work at UCLA. At UCSF, he was the recipient of the Outstanding Service Award and the Bowl of Hygeia Award. He completed a residency in clinical pharmacy practice at the University of Illinois, in Chicago.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
DRUG CLASS AND MECHANISM: Isoniazid, or INH, is an anti-bacterial drug that has been used to prevent and to treat tuberculosis since 1952. Tuberculosis is an infectious diseased caused by a bacterium. Once the infection is acquired, it usually remains dormant in the lungs. Later, the infection may become active in the lungs and sometimes spreads throughout the body. Patients with a
tuberculosis skin test that has recently become abnormal (demonstrating recent infection with tuberculosis) but a normal
chest
X-ray (demonstrating inactive infection) are given INH alone for 6-9 months. Patients with active infection on chest
X-ray are given INH combined with other antituberculous drugs.
The mechanism of action of INH is not known, but it is thought to work through its effects on lipids (fats) and DNA within the tuberculosis bacterium. It is very selective for the tuberculosis bacteria, that is, it has few if any effects on other bacteria.
PRESCRIPTION: yes
GENERIC AVAILABLE: yes
PREPARATIONS: INH is available as 100 mg or 300 mg tablets and as a syrup (50 mg per teaspoonful).
STORAGE: Tablets and syrup should be stored at room temperature, 15-30 C (59-86 F).
PRESCRIBED FOR: INH is used to prevent active tuberculosis in persons who have an abnormal skin test for tuberculosis or in combination with other drugs for the treatment of active tuberculosis.
DOSING: INH is most commonly taken once daily. When used for the treatment of active tuberculosis, some physicians prefer using a high dose twice weekly. It is best to take INH on an empty stomach for maximum absorption into the body, but if it causes abdominal discomfort, it may be taken with food or with a non-aluminum antacid such as Tums or Titralac. (Aluminum-containing antacids bind to the INH in the intestine and prevent its absorption.)
DRUG INTERACTIONS: Antacids containing aluminum (for
example, Mylanta; Maalox, Gelusil; Amphojel; Alternagel) reduce the amount of INH that is absorbed from the intestine, and this can result in reduced blood levels and effect of INH. If aluminum-containing antacids must be taken, they should be taken at least one hour after the INH to prevent binding.
INH can increase the effectiveness of the blood thinner, warfarin (Coumadin) by interfering with the enzyme in the liver that eliminates warfarin.
INH can increase the effect of certain benzodiazepines, such as diazepam (Valium), triazolam (Halcion), and others, by interfering with the enzymes in the liver that eliminate benzodiazepines. This may result in excessive sedation.
Carbamazepine (Tegretol) taken at the same time as INH, can result in an increased risk of side effects from both carbamazepine and INH.
INH can decrease the rate at which the liver eliminates phenytoin (Dilantin), which can raise the blood levels and result in side effects of phenytoin.
Because rifampin can be toxic to the liver, the use of rifampin and INH together increases the risk of liver toxicity to a level that is greater than with either drug alone.
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PREGNANCY: INH has not been shown to cause birth defects in humans or animals; however, studies in rats and rabbits have shown that it may increase the risk of fetal death. Nevertheless, tuberculosis is a very serious infection, and many women have been treated with isoniazid during
pregnancy with no problems in their infants. Ultimately, the physician and the pregnant patient must evaluate the risks and benefits of INH.
Liver disease can be cause by a variety of things including infection (hepatitis), diseases such as gallstones, high cholesterol or triglycerides, blood flow obstruction to the liver, and toxins (medications and chemicals). Symptoms of liver disease depends upon the cause; however, common symptoms may include nausea, vomiting, upper right abdominal pain, and jaundice. Treatment depends upon the cause of the liver disease.
Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis bacteria. Symptoms include weakness, fever, weight loss, night sweats and in worse cases, chest pain, shortness of breath, and coughing up blood. A person with an active infection (a positive TB skin test, abnormal chest x-ray and TB bacteria in their sputum) requires treatment with izoniazid, rifampin, ethambutol and pyrazinaide.
The liver, located in the right upper portion of the abdominal cavity just
beneath the right side of the rib cage, has many vital functions. Briefly, some
of these functions are:
Detoxification of blood
Production of important clotting factor and other important proteins
Metabolizing (processing) medications and nutrients
Processing of waste products of hemoglobin
Storing of vitamins, fat, cholesterol, and bile
Production of glucose
What are common liver blood tests?
Liver blood tests are some of the most commonly performed blood tests. These tests can assess liver functions or liver injury. An initial step in detecting liver damage is a simple blood test to determine the presence of certain liver enzymes (proteins) in the blood. Under normal circumstances, these enzymes reside within the cells of the liv...
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