Introduction
Servizid is an antibiotic used for the treatment and prevention of tuberculosis (TB) and inactive (latent) TB (a serious infection caused by bacteria that affects the lungs and in certain cases other parts of the body). It works by killing the bacteria that cause tuberculosis.
Servizid should be used in the dose and duration as advised by your doctor. It is to be taken on an empty stomach. Do not skip any doses and finish the full course of treatment even if you feel better. Stopping it early can result in treatment failure and increase the side effects too. Do not take a double dose to make up for a missed dose. Simply take the next dose as planned.
It may cause tingling and numbness of feet and hand (peripheral neuropathy) as a side effect of this medicine. Inform your doctor if you notice signs of jaundice i.e. yellowing of eyes or skin, dark urine, stomach pain or joint pain. You may also develop hepatitis (viral infection of the liver) or increased liver enzymes as side effects of this medicine. Please consult your doctor, as these side effects require medical attention and need dose modification.
Your doctor may monitor your liver function while on treatment with this medicine. Avoid drinking alcohol as this may have additional adverse effects on the liver. Pregnant or breastfeeding women should consult their doctor before using this medicine.
Side effects of Servizid
Common
- Peripheral neuropathy (tingling and numbness of feet and hand)
- Increased liver enzymes
- Hepatitis (viral infection of liver)
- Jaundice
How to use Servizid
Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Servizid is to be taken empty stomach.
Avoid Servizid with tyramine-rich food such as cheese, smoked fish, meats and some types of beer.
How Servizid works
Servizid is an antibiotic. It works by killing the bacteria that causes tuberculosis.
What if you forget to take Servizid?
If you miss a dose of Servizid, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular schedule. Do not double the dose.
Administration
Should be taken on an empty stomach. Best taken on an empty stomach 1 hr before or 2 hr after meals. May be taken w/ meals to reduce GI discomfort.
Adult Dose
Oral
Active Tuberculosis Disease
5 mg/kg PO qDay, not to exceed 300 mg qDay
15 mg/kg PO up; not to exceed 900 mg 1-3 times/week
Used in multi-drug regimen containing rifampin (or ribabutin or rifapentin), pyrazinamide, and ethambutol
Latent Tuberculosis Infection
Treatment of latent TB infection greatly reduces the risk that TB infection will progress to acitve disease
>30 kg: 300 mg PO qDay x9 months
Child Dose
Active Tuberculosis Disease
10-15 mg/kg PO qDay; not to exceed 300 mg/day OR
20-30 mg/kg (up to 900 mg) 2 times/week
Used in multi-drug regimen
Latent Tuberculosis Infection
Treatment of latent TB infection greatly reduces the risk that TB infection will progress to acitve disease
10-15 mg/kg PO qDay; not to exceed 300 mg/day
Renal Dose
Renal impairment: Severe: Dose reduction may be needed.
Contraindication
Acute liver disease or history of hepatic damage during INH therapy; hypersensitivity.
Mode of Action
Isoniazid inhibits the synthesis of mycoloic acids in susceptible bacteria which results in loss of acid-fastness and disruption of bacterial cell wall. At therapeutic levels, it is bacteriocidal against actively growing intracellular and extracellular Mycobacterium tuberculosis organisms.
Precaution
Renal or hepatic impairment; convulsive disorders; history of psychosis; patients at risk of neuropathy or pyridoxine deficiency eg, diabetic, alcoholic, malnourished, uraemic, infected with HIV. Careful monitoring of hepatic function is necessary for black and hispanic women. Check hepatic function before and during treatment. Pregnancy and lactation.
Lactation: distributed into milk but safe for nursing infants
Side Effect
>10%
Mild incr LFTs (10-20%),Peripheral neuropathy (dose-related incidence, 10-20% incidence with 10 mg/kg/d)
Loss of appetite,Nausea,Vomiting,Stomach pain,Weakness
1-10%
Dizziness,Slurred speech,Lethargy,Progressive liver damage (increases with age; 2.3% in pts > 50 yo),Hyperreflexia
<1%
Agranulocytosis,Anemia,Megaloblastic anemia,Thrombocytopenia,Systemic lupus erythematosus,Seizure
Potentially Fatal: Hepatotoxicity.
Interaction
Inhibit the hepatic metabolism of antiepileptics (e.g. carbamazepine, ethosuximide, primidone, phenytoin), benzodiazepines (e.g. diazepam, triazolam), chlorzoxazone, theophylline, disulfiram, sometimes leading to increased toxicity. Increased metabolism of enflurane, resulting in potentially nephrotoxic levels of fluoride. Increased concentrations and enhanced effects or toxicity of clofazimine, cycloserine and warfarin. Reduced absorption w/ Al-containing antacids. Increased risk of peripheral neuropathy w/ zalcitabine and stavudine.