Cycloserine

Cycloserine is a second-line, broad-spectrum antibiotic, produced by Streptococcus orchidaceus. In 1955, it was first isolated from a fermentation brew and was later synthesized. Cycloserine is used in the treatment of active pulmonary and extrapulmonary tuberculosis (TB), when primary agents have failed (such as INH, rifampin, streptomycin etc). When Cycloserine is employed to treat tuberculosis, it must be given together with other effective agents. Cycloserine is given orally. It was approved by the FDA in 1956.

Brands
CLOSERIN CLOSIP TUBERSERINE TUBERSERINE TUBERSERINE CYCLOSEN
Adult Dose
Dose: 0.5 to 1 g
Single Dose: 0.75 (0.75)
Frequency: 12 hourly
Route: PO
Instructions:
Neonatal
Paedriatic
Dose: 5 to 10 mg/kg
Single Dose: 7.5 (7.5)
Frequency: 12 hourly
Route: to maximum dose of 1g daily.
Instructions:
Characteristics
. It is of Natural/Synthetic origin and belongs to Aminoisoxazolidin. . The Molecular Weight of Cycloserine is 102.10. Its pKa is 4.4, 7.4.
Contraindications
Cycloserine is contraindicated in conditions like Epilepsy,Renal failure,Hypersensitivity,Mental illness.
Effects
The severe or irreversible adverse effects of Cycloserine, which give rise to further complications include Congestive heart failure, Psychiatric disturbances, Megaloblastic anemia, Excitement.Cycloserine produces potentially life-threatening effects which include Convulsions, Nervous system manifestation. which are responsible for the discontinuation of Cycloserine therapy.The symptomatic adverse reactions produced by Cycloserine are more or less tolerable and if they become severe, they can be treated symptomatically, these include Vertigo, Headache, Drowsiness, Irritability, Nausea, Fever, Anxiety, Rashes, Confusion, Photosensitivity, Depression, Cardiac arrhythmias, Tremor, Disorientation, Peripheral neuropathy, Aggression, Hyper-reflexia, Confusion, Suicidal tendencies.
Indications
Cycloserine is primarily indicated in conditions like Mycobacterial infection, Pophylaxis of acute renal transplant rejection, Tuberculosis, and can also be given in adjunctive therapy as an alternative drug of choice in Minor surgical and medical procedures.
Interactions
Cycloserine is known to interact with other drugs, the details of drug interactions is as follows:DrugDetailsSeverityOnsetManagementEthionamidepellagra like encephalopathy can occur when both drugs are given in combinationIsoniazidIsoniazid enhances the adverse nervous system effects of Cycloserine.MinorClosely monitor the adverse nervous system effects.VORICONAZOLEVoriconazole may increase the serum concentration of cyclosporine by decreasing its metabolism. Consider reducing the dose of cyclosporine. These interactions are sometimes beneficial and sometimes may pose threats to life. Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.
Interfrence
Risks
Drug should not be given to Pregnant Mothers, patients suffering from Kidney dysfunction, and Neonates.If prescribing authority justifies the benefits of the drug against the possible damages he/she should reevaluate them and consult the reference material and previous studies.
Storage
Caps Store in a well closed container, at room temperature. Protect from Moisture.
Warnings
It has a low therapeutic index and its dosage should be adjusted according to plasma concentration which should be monitored atleast weekly in patinet with renal impairment and in patients showing sings of neurological toxicity. Patients with renal impairment require lower doses.
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