From the Guidelines
Both Rifampicin and Isoniazid do not require dose adjustment in patients with Impaired Renal Function.
Key Points
- Rifampicin and Isoniazid are metabolized by the liver, so conventional dosing may be used in the setting of renal insufficiency 1.
- The liver metabolism of these drugs means that their clearance is not significantly affected by renal function, allowing for standard dosing in patients with impaired renal function.
- In contrast, other antituberculosis medications such as pyrazinamide, ethambutol, and streptomycin require dose adjustments in patients with renal insufficiency due to their renal clearance 1.
- It is essential to note that while Rifampicin and Isoniazid do not require dose adjustment, monitoring of serum concentrations may be necessary to avoid toxicity in patients with severe renal impairment 1.
From the FDA Drug Label
Serum concentrations do not differ in patients with renal failure at a studied dose of 300 mg, and consequently, no dosage adjustment is required.
Rifampicin does not require dose adjustment in patients with Impaired Renal Function. 2
From the Research
Treatment of Tuberculosis with Impaired Renal Function
- The treatment of Tuberculosis (TB) involves the use of several drugs, including Rifampicin and Isoniazid.
- In patients with impaired renal function, the dosage of certain drugs may need to be adjusted to prevent adverse effects.
Dose Adjustment for Rifampicin and Isoniazid
- According to the provided studies, Rifampicin has been associated with nephrotoxicity and acute renal failure in some patients 3, 4.
- Isoniazid, on the other hand, does not appear to require dose adjustment in patients with impaired renal function, as its clearance is not significantly affected by renal impairment.
- However, it is essential to note that Isoniazid can still cause adverse effects, such as hepatotoxicity, and its use should be monitored closely in patients with pre-existing liver or renal disease 5, 6.
Renal Function and Antituberculous Drugs
- The use of antituberculous drugs, including Isoniazid and Rifampicin, can affect renal function and uric acid excretion 7.
- Patients with impaired renal function should be closely monitored for signs of adverse effects, such as hyperuricemia, arthralgia, and renal failure, when taking these drugs.
- The dosage of Rifampicin may need to be adjusted in patients with severe renal impairment to prevent adverse effects, while Isoniazid does not require dose adjustment in patients with impaired renal function 3, 4.