This panel provides information on interacting drugs and their ADRs along with references
| Interacting drug |
Toxicity |
Interaction Type |
Mechanism |
Reference |
|---|
| Acetaminophen (103-90-2) | Toxicity Of Paracetamol Is Increased | Antagonistic | Not Clear | Acetaminophen hepatotoxicity: potentiation by isoniazid
|
| Carbamazepine (298-46-4) | Aggression | Synergistic | It seems probable that isoniazid inhibits the activity of the cytochrome P450 isoenzyme CYP3A4, which is concerned with the metabolism of carbamazepine, causing it to accumulate in the body. | Carbamazepine intoxication caused by interaction with isoniazid
|
| Ethionamide (536-33-4) | Acute Psychotic Reaction | Additive | Not understood | Toxic psychosis to isoniazid and ethionamide in a patient with pulmonary tuberculosis
|
| Disulfiram (97-77-8) | Drowsiness | Synergistic | Not understood. One idea is that some kind of synergy occurs between the two drugs because both can produce similar adverse effects if given in high doses. Isoniazid and disulfiram together inhibit two of three biochemical pathways concerned with the metabolism of dopamine. This leaves a third pathway open, catalysed by COMT (catechol-O-methyl transferase), which produces a number of methylated products of dopamine. These methylated products may possibly have been responsible for the mental and physical reactions seen | Possible interaction between disulfiram and isoniazid
|
| Ethambutol (74-55-5) | Optic Neuropathy | Synergistic | Not understood | Serum concentration of isoniazid administered with & without ethambutol in pulmonary tuberculosis patients
|
| Pethidine (57-42-1) | Hypotension | Antagonistic | this reaction to the MAO-inhibitory properties of the isoniazid and equate it with the severe and potentially fatal ‘MAOI-pethidine interaction’, | Isoniazid, meperidine, and hypotension
|
| Pethidine (57-42-1) | Lethargy | Antagonistic | this reaction to the MAO-inhibitory properties of the isoniazid and equate it with the severe and potentially fatal ‘MAOI-pethidine interaction’, | Isoniazid, meperidine, and hypotension
|
| Rifabutin (72559-06-9) | Hepatotoxicity | Additive | Not understood | A study of the effects of rifabutin on isoniazid pharmacokinetics and metabolism in healthy volunteers
|
| Rifampicin (13292-46-1) | Hepatotoxicity | Additive | Not understood | Serum concentration and half-life of rifampicin after simultaneous oral administration of aminosalicylic acid or isoniazid
|
| Phenytoin (57-41-0) | Phenytoin Toxicity | Synergistic | Isoniazid inhibits the liver microsomal enzymes that metabolise phenytoin, and as a result the phenytoin accumulates and its serum levels rise | Inhibition of Cytochrome P450 (CYP450) Isoforms by Isoniazid: Potent Inhibition of CYP2C19 and CYP3A
|
| Levodopa (59-92-7) | Flushing | Synergistic | Not understood | Isoniazid therapy in Parkinson's disease
|
| Levodopa (59-92-7) | Hypertension | Synergistic | Not understood | Isoniazid therapy in Parkinson's disease
|
| Levodopa (59-92-7) | Tachycardia | Synergistic | Not understood | Isoniazid therapy in Parkinson's disease
|
| Levodopa (59-92-7) | Tremor | Synergistic | Not understood | Isoniazid therapy in Parkinson's disease
|
| Cycloserine (68-41-7) | Increased Adverse Cns Effects | Additive | Not known | Serum levels, urinary excretion, and side-effects of cycloserine in the presence of isoniazid and p-aminosalicylic acid
|
| Ethosuximide (77-67-8) | Insomnia | Synergistic | isoniazid may have inhibited the metabolism of the ethosuximide | Ethosuximide intoxication caused by interaction with isoniazid
|
| Warfarin (81-81-2) | Bleeding | Antagonistic | Not understood. It seems possible that isoniazid may inhibit the metabolism of the coumarin anticoagulants, since in vitro study in human liver microsomes has shown it inhibits S-warfarin 7-hydroxylation by the cytochrome P450 isoenzyme CYP2C9, but this needs confirmation in vivo | Interaction of isoniazid and warfarin
|
| Valproic Acid (99-66-1) | Asthenia | Synergistic | isoniazid inhibited the metabolism (oxidation) of valproate by the liver so that it accumulated | Interaction between isoniazid and valproate: a case of valproate overdosage
|
| Valproic Acid (99-66-1) | Drowsiness | Synergistic | isoniazid inhibited the metabolism (oxidation) of valproate by the liver so that it accumulated | Interaction between isoniazid and valproate: a case of valproate overdosage
|