Cycloserine
Cycloserine
CLINICAL USE
Antibacterial agent:Tuberculosis
DOSE IN NORMAL RENAL FUNCTION
Initially 250 mg every 12 hours for 2 weeks; then increased according to blood concentration and response to maximum 500 mg every 12 hours
PHARMACOKINETICS
Molecular weight                           :102.1 %Protein binding                           :<20 %Excreted unchanged in urine     : 50–70 Volume of distribution (L/kg)       :0.11–0.26half-life – normal/ESRD (hrs)      :8–12/Increased DOSE IN RENAL IMPAIRMENT
GFR (mL/MIN)
20 to 50     : 250–500 mg every 12–24 hours. Monitor blood levels weekly 10 to 20     : 250–500 mg every 12–24 hours. Monitor blood levels weekly <10           : 250–500 mg every 24 hours. Monitor blood levels weekly DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES
CAPD                :Unknown dialysability. Dose as in GFR <10 mL/min HD                     :Dialysed. Dose as in GFR <10           : mL/minHDF/high flux   :Dialysed. Dose as in GFR <10           : mL/minCAV/VVHD      :Likely dialysability. Dose as in GFR 10 to 20 mL/min IMPORTANT DRUG INTERACTIONS
Potentially hazardous interactions with other drugsAlcohol: Increased risk of seizures ADMINISTRATION
Reconstition
– Route
Oral Rate of Administration
–Comments
_ OTHER INFORMATION
May cause drowsiness – increased cerebral sensitivity in patients with renal impairmentBlood concentration monitoring is required, especially in renal impairment, if dose exceeds 500 mg daily, or if signs of toxicity. Blood concentration should not exceed 30 mg/LContraindicated in severe renal insufficiencyCan cause CNS toxicity Pyridoxine has been used in an attempt to treat or prevent neurological reactions, but its value is unproven.
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