Isoniazid Injection

This product is an anti-tuberculosis drug. Isoniazid has a highly selective antibacterial effect on all types of Mycobacterium tuberculosis. It is the synthetic antibacterial drug with the strongest bactericidal effect among current anti-tuberculosis drugs, and has almost no effect on other bacteria. It has a strong effect on Mycobacterium tuberculosis in the growth and reproduction stage, but a weaker and slower effect on the dormant stage. Its mechanism of action may be to inhibit the synthesis of mycolic acid in sensitive bacteria and cause the cell wall to rupture.

Main ingredient: Isoniazid, its chemical name is 4-pyridinecarboxylic acid hydrazide. Molecular formula: C6H7N3O Molecular weight: 137.14

It is used in combination with other anti-tuberculosis drugs to treat various types of tuberculosis and some non-tuberculous mycobacterial diseases.

1 Intramuscular injection, intravenous injection or intravenous drip: Intramuscular injection is rarely used in China. Generally, intravenous drip is used during the intensive period or for patients with severe illness or who cannot take oral medication. It is used after dilution with sodium chloride injection or 5% glucose injection. (1) 0.3-0.4g or 5-10mg/kg per day for adults; 10-15mg/kg per day for children according to body weight, not exceeding 0.3g per day. (2) For patients with acute miliary tuberculosis or tuberculous meningitis, 10-15mg/kg per day for adults, not exceeding 0.9g per day. (3) When intermittent therapy is used, 0.6-0.8g per time for adults, 2-3 times a week. 2 Local medication (1) Nebulization inhalation: 0.1-0.2g per time, 2 times a day. (2) Local injection (pleural cavity, abdominal cavity or intraspinal canal), 50-200mg per time.

The incidence of adverse reactions at commonly used doses is low. When the dose is increased to 6 mg/kg, the incidence of adverse reactions increases significantly, mainly peripheral neuritis and liver toxicity. Although the addition of vitamin B6 can reduce toxic reactions, it can also affect the efficacy. 1. Hepatotoxicity: This product can cause mild transient liver damage such as elevated serum aminotransferase and jaundice, with an incidence of about 10% to 20%. Hepatotoxicity is related to the metabolite of this product, acetylhydrazine. For those who are fast acetylated, acetylhydrazine accumulates more in the liver, so it is easy to cause liver damage. Drinking alcohol during medication can increase liver damage. Toxic reactions manifest as poor appetite, abnormal fatigue or weakness, nausea or vomiting (prodromal symptoms of hepatotoxicity) and dark urine, yellow eyes or skin (hepatotoxicity). 2. Nervous system toxicity: Peripheral neuritis is more common in those who are slow acetylated, and has a significant relationship with the dose. Many patients show unsteady gait, numbness, tingling, burning sensation or pain in the hands and feet. This reaction is more likely to occur in lead poisoning, arteriosclerosis, hyperthyroidism, diabetes, alcohol poisoning, malnutrition and pregnant women. Other toxic reactions such as excitement, euphoria, insomnia, loss of autonomy, toxic encephalopathy or toxic psychosis are rare, and severe toxic reactions such as optic neuritis and atrophy are occasionally reported. 3. Allergic reactions include fever, polymorphic rash, lymphadenopathy, vasculitis, etc. Once they occur, the drug should be stopped immediately. If it is necessary to use it again, it should be started with a small dose and gradually increased. 4. The blood system may have granulocytopenia, eosinophilia, thrombocytopenia, methemoglobinemia, etc. 5. Others such as dry mouth, vitamin B6 deficiency, hyperglycemia, metabolic acidosis, endocrine dysfunction, etc. are occasionally reported. .

Patients who are allergic to this product are contraindicated.

1. Drinking alcohol every day while taking isoniazid can easily cause liver toxicity induced by this product and accelerate the metabolism of isoniazid. Therefore, the dosage of isoniazid needs to be adjusted and signs of liver toxicity need to be closely observed. Patients should be advised to avoid alcoholic beverages during medication. 2. Antacids can delay and reduce the absorption of isoniazid after oral administration, reducing blood drug concentrations. Therefore, it is necessary to avoid taking both at the same time, or take isoniazid at least 1 hour before oral antacids. 3. When anticoagulants (such as coumarin or indandione derivatives) are taken at the same time as isoniazid, the anticoagulant effect is enhanced due to the inhibition of the enzyme metabolism of the anticoagulant. 4. When taken at the same time as cycloserine, adverse reactions of the central nervous system (such as dizziness or drowsiness) may be increased. The dosage needs to be adjusted and signs of central nervous system toxicity need to be closely observed, especially for patients who are engaged in work that requires high sensitivity. 5. When rifampicin is used in combination with isoniazid, the risk of hepatotoxicity may increase, especially in patients with existing liver damage or those who are fast acetylated by isoniazid. Therefore, the first three months of treatment should be closely followed up for signs of hepatotoxicity. 6. Isoniazid is an antagonist of vitamin B6, which can increase the amount of vitamin B6 excreted by the kidneys, thus possibly causing peripheral neuritis. The requirement for vitamin B6 increases when taking isoniazid. 7. When used in combination with adrenal cortical hormones (especially prednisolone), it can increase the metabolism and excretion of isoniazid in the liver, resulting in low blood concentration of the latter and affecting the efficacy, which is more significant in fast acetylated patients, and the dose should be adjusted appropriately. 8. When used in combination with alfentanil, since isoniazid is a liver enzyme inhibitor, the effect of alfentanil can be prolonged: when used in combination with disulfiram (disulfirm), its central nervous system effects can be enhanced, resulting in dizziness, incoordination, irritability, insomnia, etc.; when used in combination with enflurane, the formation of inorganic fluorine metabolites with nephrotoxicity can be increased. 9 When used in combination with ethionamide or other anti-tuberculosis drugs, the adverse reactions of the latter two may be aggravated. When used in combination with other hepatotoxic drugs, the hepatotoxicity of this product may be increased. Therefore, it should be avoided as much as possible. 10 Isoniazid should not be used in combination with ketoconazole or miconazole, because it can reduce the blood concentration of the latter two. 11 When used in combination with phenytoin sodium or aminophylline, it can inhibit the metabolism of the two in the liver, resulting in an increase in the blood concentration of phenytoin sodium or aminophylline. Therefore, when isoniazid is used successively or in combination with the two, the dose of phenytoin sodium or aminophylline should be appropriately adjusted. 12 When used in combination with acetaminophen, isoniazid can induce hepatic cytochrome P-450, increasing the amount of toxic metabolites formed by the former, which can increase liver toxicity and kidney toxicity. 13 When used simultaneously with carbamazepine, isoniazid can inhibit its metabolism, increase the blood depth of carbamazepine, and cause toxic reactions; carbamazepine can induce the microsomal metabolism of isoniazid, resulting in an increase in the formation of hepatotoxic intermediate metabolites. 14 This product should not be used in combination with other neurotoxic drugs to avoid increasing neurotoxicity.

Keep away from light and store in a sealed container.

2ml:50mg

Guangzhou Baiyunshan Mingxing Pharmaceutical Co., Ltd.

• Founded in:

  1962-12-27

• Address:

  No. 48, North Industrial Avenue, Haizhu District, Guangzhou

• Tax NO.:

  9144010119046020XE

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