• Terizidone is a derivative of cycloserine and it has a bacteriostatic action. It is used in the treatment of multidrug-resistant and extensively drug-resistant tuberculosis.
• It is a WHO categorized group IV antitubercular drug.
Terizidone is a second-line antitubercular drug which is prescribed for the treatment of both pulmonary and extra pulmonary tuberculosis caused by resistant strains of Mycobacterium tuberculosis or M. avium. Pulmonary tuberculosis is limited to the lungs, while extra-pulmonary tuberculosis refers to the infection at other sites of the body. Terizidone is used in multi-drug resistant and extensively drug-resistant tuberculosis.
Terizidone is effective against Mycobacterium strains which are resistant to first-line drugs both in intensive and continuation phase.
It is not recommended to be used as a single drug in treating tuberculosis, or for other infections despite being a broad-spectrum antibiotic. Terizidone is a drug of choice in treating urogenital tuberculosis such as cystitis (bladder infection) or epididymoorchitis (infection of the testes in males).
Terizidone has a similar effect as cycloserine and inhibits the bacterial wall synthesis. It, however, has lesser side effects including low blood pressure and has an advantage of treating tuberculosis patients with schizophrenia and alcoholics.
It has been found more useful in treating drug-resistant cases of TB which require dialysis.
Terizidone should not be used by patients with:
• Allergy to terizidone and cycloserine
• History of epilepsy or seizures
• Severe depression or psychosis
• Treatment of bacterial infections other than tuberculosis
• The recommended oral dose is 15 - 20 mg/kg per day in three to four divided doses.
• The maximum dose is 1g daily (4 capsules of 250 mg daily)
• The usual dose is 10 - 20mg/kg daily in two divided doses
• Terizidone comes as a hard gelatin capsule of 250 mg which should be taken by mouth after food to avoid gastric discomfort.
• Terizidone therapy should be stopped immediately if the patient shows any sign of suicidal risk or tendency.
• Patients receiving terizidone therapy should take 50mg of pyridoxine for every 250 mg of terizidone to avoid peripheral neuropathy.
• Gastrointestinal: Nausea and vomiting
• Cardiovascular system: Tremors, congestive heart failure
• Central Nervous System: Suicidal tendency, headache, dizziness, convulsions, depression, lack of sleep, confusion, weakness, slurred speech, fearful feelings, and thoughts
• Skin: Rashes, skin allergies, lichenoid eruptions and Stevens Johnson Syndrome
• Usage of high doses such as more than 1g a day is not recommended because of the occurrence of liver disease, congestive cardiac failure, convulsions, and coma.
• Not known.
• Store at room temperature below 25°C and keep away from excess temperature.
• Keep out of the reach of the children.
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