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ANTIINFECTIVES FOR SYSTEMIC USE › ANTIMYCOBACTERIALS › DRUGS FOR TREATMENT OF TUBERCULOSIS › Thiocarbamide derivatives
protionamide
J04AD01
Adult Dosing
- Tuberculosis: 15 to 20 mg/kg/day orally in divided doses (usually 12 to 18 mg/kg/day)
- Maximum daily dose: 1 g
- Administer with pyridoxine (vitamin B6) to prevent neurotoxicity
Pediatric Dosing
- Tuberculosis: 10 to 20 mg/kg/day orally in divided doses
- Maximum daily dose: 750 mg to 1 g/day
- Co-administer with pyridoxine
Indications
- Treatment of active tuberculosis caused by Mycobacterium tuberculosis (typically multidrug-resistant strains as a second-line agent)
- Used in combination with other anti-tuberculosis medications
Mechanism of Action
- Thioamide derivative structurally related to ethionamide
- Inhibits mycolic acid synthesis in mycobacterial cell walls, leading to bacterial cell death
Contraindications
- Hypersensitivity to protionamide, ethionamide, or any component of the formulation
- Severe hepatic impairment
- Acute hepatic disease
Adverse Reactions
- Gastrointestinal: nausea, vomiting, anorexia, diarrhea, abdominal pain, metallic taste
- Neurological: peripheral neuropathy, headache, dizziness, depression, psychosis, drowsiness
- Hepatotoxicity: elevated transaminases, jaundice, hepatitis
- Endocrine: hypothyroidism, gynecomastia, impotence, menstrual irregularities
- Hematological: thrombocytopenia, purpura
Drug Interactions
- Isoniazid: increased risk of neurotoxicity and hepatotoxicity
- Cycloserine: increased risk of central nervous system toxicity (convulsions, psychosis)
- Alcohol: increased risk of psychiatric disturbances and severe adverse effects
- Anticoagulants: may potentiate the effects of oral anticoagulants
Curated Content: Needs Vetting Before Put to Clinical Use