Monograph
J04AB01 - Cycloserine |
Propably not porphyrinogenic |
PNP |
Rationale
60-80% of a dose administered is excreted unchanged in the urine. Cycloserine is not involved in drug interactions with CYP enzymes, which may indicate that it is not an inhibitor or an inducer of CYP enzymes.
Therapeutic characteristics
Cycloserine is indicated in the treatment of active pulmonary and extra-pulmonary tuberculosis (including renal disease) when the organisms are susceptible to this drug and after failure of adequate treatment with the primary medications (streptomycin, isoniazid, rifampicin and ethambutol).
Metabolism and pharmacokinetics
Cycloserine is partially metabolised and between 60-80% of a dose administered is excreted unchanged in the urine (Craig 2004 and SPC). The metabolites have not yet been identified (SPC). Half-life elimination is 8-12 hours.
There are no drug-drug interactions involving CYP enzymes with cycloserine as a perpetrator observed (Interaktionsdatabasen), which may indicate that cycloserine is not an inhibitor or inducer of CYP enzymes.
Published experience
Cycloserine has been associated with clinical exacerbations of porphyria and has earlier not been recommended in porphyric patients (SPC and Moore 1997). We have however, not found any clinical data which supports these statements.
References
| # | Citation details | PMID |
|---|---|---|
| * | Scientific articles | |
| 1. | Drugs in the acute porphyrias--toxicogenetic diseases. Cell Mol Biol (Noisy-le-grand). 1997 Feb;43(1):89-94.
Moore MR, Hift RJ. |
9074793 |
| * | Drug interaction databases | |
| 2. | Interaktionsdatabasen. Cycloserine
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| * | Summary of Product Characteristics | |
| 3. | The electronic Medicines Compendium (emc). Summary of Product Characteristics (SPC). Cycloserine.
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| * | Other sources | |
| 4. | Craig CR and Stitzel RE, eds. (2004) Modern pharmacology with clinical applications â- 6th ed.
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