Isoniazid Pyridoxine HCL (Coxiform) 200mg/20mg per 5ml Syrup 120ml

Product Description:

Isoniazid Pyridoxine HCl (Coxiform) is a combination syrup containing 200mg of Isoniazid and 20mg of Pyridoxine Hydrochloride (Vitamin B6) per 5ml of the syrup. It is primarily used in the treatment of tuberculosis (TB), particularly pulmonary TB. Isoniazid is an antibiotic that specifically targets Mycobacterium tuberculosis, the bacteria responsible for tuberculosis, while Pyridoxine (Vitamin B6) is included to prevent the development of peripheral neuropathy, a side effect commonly associated with Isoniazid therapy.

Indications:

Isoniazid Pyridoxine HCl (Coxiform) is indicated for:

1. Treatment of Active Tuberculosis (TB):

   • It is used as part of a multidrug regimen for the treatment of active pulmonary tuberculosis caused by Mycobacterium tuberculosis in both adults and children.

2. Prophylaxis of Tuberculosis:

   • For latent TB infection (when the TB bacteria are present in the body but not causing active disease), Isoniazid is used to reduce the risk of developing active TB.

3. Prevention of Isoniazid-Induced Peripheral Neuropathy:

   • The inclusion of Pyridoxine helps to prevent neuropathy, which can occur as a side effect of Isoniazid, especially in patients who are malnourished, elderly, or those with diabetes.

Dosage and Administration:

For Adults:

• Treatment of Active Tuberculosis:

  • Isoniazid: 5 mg/kg body weight daily, up to 300 mg per day.

  • Pyridoxine: Typically 10 mg/day, which may be adjusted depending on individual requirements and risk factors.

• For Latent TB:

  • Isoniazid: 300 mg daily for 6-9 months, or as prescribed by the healthcare provider.

• For Children:

  • Treatment of Active Tuberculosis: 10 mg/kg body weight, not exceeding 300 mg per day.

  • Prophylaxis: 10 mg/kg body weight, up to 300 mg.

Administration:

• The syrup should be taken once daily, with or without food.

• The dose should be measured using a proper measuring device for liquid medications.

Side Effects:

Common side effects of Isoniazid Pyridoxine HCl (Coxiform) may include:

1. Gastrointestinal:

   • Nausea, vomiting, abdominal discomfort, loss of appetite.

2. Nervous System:

   • Dizziness, headache, and peripheral neuropathy (despite the presence of Pyridoxine).

3. Hepatotoxicity:

   • Isoniazid can cause liver damage, leading to symptoms such as fatigue, jaundice, and dark urine. Liver function should be monitored regularly during treatment.

4. Skin Reactions:

   • Rash, itching, or flushing.

5. Pyridoxine (Vitamin B6) Related:

   • High doses of Pyridoxine may cause sensory neuropathy, though this is rare at standard doses.

Serious side effects (rare but possible):

1. Hepatitis: Severe liver inflammation.

2. Peripheral Neuropathy: Though Pyridoxine is included to prevent this, high doses of Isoniazid may still cause nerve damage in rare cases.

3. Severe Allergic Reactions: Including swelling, difficulty breathing, and anaphylaxis (rare).

Contraindications:

Isoniazid Pyridoxine HCl (Coxiform) should not be used in the following conditions:

1. Hypersensitivity to Isoniazid or Pyridoxine:

   • If the patient has a known allergy or hypersensitivity to either Isoniazid or Pyridoxine, this medication should be avoided.

2. Severe Liver Disease:

   • Isoniazid can cause liver toxicity. It should not be used in patients with active liver disease or a history of liver dysfunction related to prior use of Isoniazid.

3. Acute Alcoholism:

   • Patients with acute alcohol intoxication or those with a history of chronic alcoholism should avoid this combination due to an increased risk of liver toxicity.

4. Peripheral Neuropathy:

   • Patients with pre-existing neuropathy or certain metabolic conditions, such as diabetes, may be at higher risk of developing neurological side effects from Isoniazid therapy.

5. Pregnancy (Category C):

   • Isoniazid should be used in pregnancy only if the potential benefits outweigh the risks. Pyridoxine is generally considered safe in pregnancy, but close monitoring is advised.

6. Breastfeeding:

   • Isoniazid is excreted into breast milk, but at standard doses, the amount is typically low. Pyridoxine is considered safe. However, a healthcare provider should be consulted before using this combination while breastfeeding.

Precautions:

1. Liver Monitoring:

   • Regular liver function tests are required throughout treatment, especially for those with pre-existing liver conditions or those using other medications that may impact the liver.

2. Alcohol Consumption:

   • Alcohol should be avoided during treatment, as it increases the risk of hepatotoxicity.

3. Pyridoxine Deficiency:

   • Patients at risk of Vitamin B6 deficiency, such as those with malnutrition, may require higher doses of Pyridoxine.

4. Drug Interactions:

   • Isoniazid may interact with several medications, including phenytoin, warfarin, and alcohol, so caution is required when combining with other drugs.

Conclusion:

Isoniazid Pyridoxine HCl (Coxiform) is a combination therapy used for the treatment and prevention of tuberculosis (TB). It is beneficial in managing active TB and preventing the development of TB in individuals with latent infection. The addition of Pyridoxine (Vitamin B6) helps prevent the neuropathy often associated with Isoniazid. However, it requires careful monitoring for potential liver toxicity, particularly in vulnerable patients. Regular follow-up with healthcare providers is essential to ensure the safe and effective use of this medication.