CYCLOSERINE

Broad spectrum amino-acid antibiotic active against Mycobacterium tuberculosis. It is both bacteriostatic and bactericidal depending on the concentration at site of action.

Dosage Forms

Capsule

250 mg

Uses

  • Multi-drug-resistant tuberculosis (MDR-TB)

Dose and Duration

Blood-cycloserine concentration should not exceed a peak of 30 mg/litre (measured 3–4 hours after dose)
MDR-TB (second-line; in combination with other medicines)
Adult and child over 12 years: initially 250 mg every 12 hours for 14 days, increased according to blood concentration and response up to max 500 mg every 12 hours
Child 2–12 years:3 initially 5 mg/kg(max 250 mg) every 12 hours for 14 days, adjusted according to response and blood concentration up to max 10 mg/kg (max 500 mg) every 12 hours
Renal impairment:If creatinine clearance <50 ml/minute, increase dosing interval and monitor blood-cycloserine concentration

Contraindications

  • Epilepsy
  • Depression
  • Severe anxiety
  • Psychotic states
  • Alcohol dependence

Side Effects

  • Headache, dizziness, vertigo, drowsiness, tremor
  • Convulsions, confusion, psychosis, depression
  • Rashes, allergic dermatitis

Interactions

  • Alcohol (increased risk of convulsions)

Pregnancy

  • Can be used

Breastfeeding

  • Can be used

⚠️ Caution

  • Monitor renal, hepatic and haematological function
  • Cycloserine crosses the placenta, only use in pregnancy if benefit outweighs risk
  • Reduce dose or discontinue if symptoms of CNS toxicity or allergic dermatitis develop