Contents

Search

cycloserine (Seromycin, Pulvules)

Tradenames: Seromycin, Pulvules. Indications: 1) adjunctive treatment in pulmonary or extrapulmonary tuberculosis 2) treatment of acute urinary tract infection caused by Escherichia coli or Enterobacter species when less toxic conventional therapy has failed or is contraindicated Contraindications: 1) epilepsy 2) depression 3) severe anxiety 4) psychosis 5) severe renal insufficiency 6) chronic alcoholism Dosage: - tuberculosis 1) adults: a) 250 mg PO every 12 hours for 14 days, then b) 250-500 mg PO BID 2) children: 10-20 mg/kg/day PO divided BID up to 1000 mg QD 3) administer concurrently with pyridoxine 50 mg QD to minimize neurotoxic effects Capsule: 250 mg. Pharmacokinetics: 1) 70-90% absorption after oral administration 2) time to peak serum concentration (oral): 3-4 hours 3) tissue distribution a) crosses placenta b) appears in breast milk c) adequate CSF penetration 4) 60-70% eliminated unchanged in the urine 5) elimination 1/2life 10 hours with normal renal function Monitor: - cycloserine in serum [2] Adverse effects: 1) not common (1-10%) - drowsiness, headache 2) uncommon (< 1%) - cardiac arrhythmias, dizziness, tremor, vertigo, confusion, seizures, psychosis, depression, coma, paresis, rash, abnormal liver function tests, vitamin B12 deficiency, folate deficiency Overdose: 1) may occur with ingestions > 1 g 2) clinical manifestations: - confusion, CNS depression, psychosis, coma, seizures 3) management: a) decontaminate with activated charcoal b) can be hemodialyzed c) administer 100-300 mg of pyridoxine d) management is largely supportive Drug interactions: - increased toxicity with alcohol - pyridoxine may increase CNS adverse effects [2]

Interactions

drug interactions

General

anti-tuberculous agent

Properties

MISC-INFO: elimination route KIDNEY pregnancy-category - safety in lactation - elimination by hemodialysis +

Database Correlations

PUBCHEM correlations

References

  1. Kaiser Permanente Northern California Regional Drug Formulary, 1998
  2. Medical Knowledge Self Assessment Program (MKSAP) 17, American College of Physicians, Philadelphia 2015
  3. Department of Veterans Affairs, VA National Formulary