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How safe is isoniazid?

J E Thompson

    The Medical Journal of Australia
    |February 11, 1978
    PubMed

    Insights

    Isoniazid (INH) chemoprophylaxis offers significant benefits outweighing hepatitis risks, especially for those under 50. Central nervous system disorders and hypersensitivity were also noted complications.

    Area of Science:

    • Pharmacology
    • Infectious Diseases
    • Hepatology

    Background:

    • Investigated complications of isoniazid (INH) in 1033 patients receiving treatment for at least 18 months.
    • Assessed adverse events associated with INH, alone or in combination with other drugs.

    Observation:

    • Hepatitis occurred in 25 patients, with varied attributions including rifampicin, infectious hepatitis, INH, and co-treatment.
    • Central nervous system disorders, primarily peripheral neuropathy, affected 12 patients over 40 years old.
    • Hypersensitivity to INH was observed in 12 patients.

    Findings:

    • Distinguishing INH-induced hepatitis from rifampicin-induced hepatitis presented challenges.
    • The benefits of INH chemoprophylaxis were found to outweigh the risks of hepatitis.
    • Risk-benefit analysis favored INH use, particularly in patients younger than 50 years.

    Implications:

    • Highlights the importance of monitoring for hepatitis and neurological adverse events during INH therapy.
    • Supports the continued use of INH chemoprophylaxis, with careful consideration of patient age and risk factors.
    • Informs clinical decision-making regarding tuberculosis prevention strategies.

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