Indications for: SEROMYCIN
In conjunction with other chemotherapy, for the treatment of active pulmonary and extrapulmonary tuberculosis (including renal disease) when the causative organisms are susceptible and when treatment with primary drugs (streptomycin, isoniazid, rifampin, ethambutol) has proved inadequate.
Initially 250mg twice daily at 12-hour intervals for the first 2 weeks. Usual dose: 500mg–1g daily in divided doses monitored by blood levels. Max 1g/day.
Epilepsy. Depression. Severe anxiety. Psychosis. Severe renal insufficiency. Excessive concurrent use of alcohol.
Discontinue or reduce dose if allergic dermatitis or CNS toxicity develops. Ratio of toxic dose to effective dose is small. Monitor blood levels, hematologic, renal, and liver function. Obtain weekly blood levels in patients with reduced renal function, patients receiving >500mg daily dosage, or those showing signs/symptoms suggestive of toxicity. Pregnancy (Cat.C). Nursing mothers: not recommended.
Neurotoxic effects with concomitant ethionamide. Increased risk of epileptic episodes with alcohol. Increased CNS effects with concomitant isoniazid; monitor closely.
CNS effects (eg, convulsions, drowsiness, somnolence, headache, tremor, dysarthria, vertigo, confusion, psychoses, character changes, hyperirritability, aggression, paresis, hyperreflexia, paresthesia, seizures, coma), CHF, allergy, rash, elevated serum transaminase (esp. with preexisting liver disease), anemia (monitor).