cycloserine (Rx)

Brand and Other Names:Seromycin
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

capsule

  • 250mg

Active Tuberculosis

Initial: 250 mg PO q12hr for 14 days THEN

500 mg -1 g/day divided q12hr for 18-24 months; not to exceed 1 g/day

Monitor blood levels

UTI

Initial: 250 mg PO q12hr for first 14 days

Maintenance: 500 mg -1 g/day in divided doses; not to exceed 1 g/day

Monitor blood levels

Gaucher's Disease (Orphan)

Orphan indication sponsor

  • Lev, Meir M.D.; The City College, City University Of NY Medical Sc, Convent Avenue at 138 Street; New York, NY 10031

Renal Impairment

CrCl 50-80 mL/min: Administer q12-16hr

CrCl 10-49 mL/min: Administer q24-36hr

CrCl <10 mL/min: Administer q36-48hr

Administration

Part of multi-drug regimen; not first-line treatment

Dosage Forms & Strengths

capsule

  • 250mg

Active Tuberculosis

10-20 mg/kg/day PO in divided doses up to 1 g/day for 18-24 months  

Renal Impairment

CrCl 50-80 mL/min: Administer q12-16hr

CrCl 10-49 mL/min: Administer q24-36hr

CrCl <10 mL/min: Administer q36-48hr

Administration

Part of multi-drug regimen; not first-line treatment

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Interactions

Interaction Checker

and cycloserine

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

            All Interactions Sort By:
             activity indicator 

            Contraindicated (0)

              Serious - Use Alternative (0)

                Monitor Closely (3)

                • ethionamide

                  ethionamide, cycloserine. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Enhanced CNS toxicity; risk of seizure.

                • isoniazid

                  isoniazid increases toxicity of cycloserine by decreasing metabolism. Use Caution/Monitor. Enhanced CNS toxicity; risk of seizure.

                • sodium picosulfate/magnesium oxide/anhydrous citric acid

                  cycloserine decreases effects of sodium picosulfate/magnesium oxide/anhydrous citric acid by altering metabolism. Use Caution/Monitor. Coadministration with antibiotics decreases efficacy by altering colonic bacterial flora needed to convert sodium picosulfate to active drug.

                Minor (0)

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                  Adverse Effects

                  Frequency Not Defined

                  Confusion

                  Restlessness

                  Drowsiness

                  Vertigo

                  Cardiac arrhythmia

                  Folate deficiency

                  Hyperreflexia

                  Dysarthria

                  Dizziness

                  Headache

                  Coma

                  Liver enzymes increased

                  Somnolence

                  Paresis

                  Seizure

                  Heart failure

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                  Warnings

                  Contraindications

                  Hypersensitivity

                  Alcohol use

                  Renal dysfunction, severe

                  History of seizure disorder, mental depression, severe anxiety or psychosis

                  Cautions

                  Caution in patients with history of alcoholism (may increase seizures), anemia, impaired hepatic/renal function

                  CNS toxicity (depression, seizures, psychosis) may occur

                  Prolonged use may result in fungal or bacterial superinfection (C. difficile-associated diarrhea)

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                  Pregnancy & Lactation

                  Pregnancy Category: C

                  Lactation: enters breast milk; safe

                  Pregnancy Categories

                  A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

                  B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

                  C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

                  D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

                  X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

                  NA: Information not available.

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                  Pharmacology

                  Mechanism of Action

                  Bacteriostatic or bactericidal

                  Inhibits cell wall synthesis

                  Pharmacokinetics

                  Absorption: 70-90%

                  Metabolism: Hepatic

                  Half-life: 10 hr (normal renal function)

                  Peak plasma serum: 4-8 hr

                  Excretion: Urine (60 to 70%)

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                  Images

                  BRAND FORM. UNIT PRICE PILL IMAGE
                  cycloserine oral
                  -
                  250 mg capsule
                  cycloserine oral
                  -
                  250 mg capsule
                  cycloserine oral
                  -
                  250 mg capsule

                  Copyright © 2010 First DataBank, Inc.

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                  Patient Handout

                  Patient Education
                  cycloserine oral

                  CYCLOSERINE - ORAL

                  (sye-klo-SER-een)

                  COMMON BRAND NAME(S): Seromycin

                  USES: This medication is used with other medications to treat tuberculosis (TB). In some cases, it may also be used to treat urinary tract infections (UTIs). It works by stopping the growth of bacteria.This antibiotic treats only bacterial infections. It will not work for viral infections (such as common cold, flu). Using any antibiotic when it is not needed can cause it to not work for future infections.

                  HOW TO USE: Take this medication by mouth with or without food, usually twice daily (every 12 hours) or as directed by your doctor.The dosage is based on your weight, medical condition, cycloserine blood levels, and response to treatment. Do not take more than 1000 mg per day.For the best effect, take this antibiotic at evenly spaced times. To help you remember, take this medication at the same time(s) every day.Continue to take this medication (and other TB medications) until the full prescribed amount is finished, even if symptoms disappear. Stopping the medication too early or skipping doses may allow the bacteria to continue to grow, which may result in a return of the infection and cause the infection to be more difficult to treat (resistant).Your doctor may also direct you to take vitamin B6 (pyridoxine) to help prevent certain side effects from cycloserine. Follow your doctor's instructions carefully.Tell your doctor if your condition persists or worsens.

                  SIDE EFFECTS: Headache, drowsiness, dizziness, or shaking (tremor) may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if any of these unlikely but serious side effects occur: weakness, mental/mood changes (such as confusion, agitation, hallucination, depression, thoughts of suicide), numb/tingling skin, seizures.Tell your doctor right away if any of these rare but serious side effects occur: irregular heartbeat, symptoms of heart failure (such as shortness of breath, swelling ankles/feet, unusual tiredness, unusual/sudden weight gain), pale skin.A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

                  PRECAUTIONS: Before taking cycloserine, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: seizures, mental/mood disorders (such as depression, anxiety, psychosis), kidney disease, liver disease, alcohol use.This drug may make you dizzy or drowsy. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Avoid alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).Cycloserine may cause live bacterial vaccines (such as typhoid vaccine) to not work as well. Do not have any immunizations/vaccinations while using this medication unless your doctor tells you to.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.This medication passes into breast milk but is unlikely to harm a nursing infant. Consult your doctor before breast-feeding.

                  DRUG INTERACTIONS: The effects of some drugs can change if you take other drugs or herbal products at the same time. This can increase your risk for serious side effects or may cause your medications not to work correctly. These drug interactions are possible, but do not always occur. Your doctor or pharmacist can often prevent or manage interactions by changing how you use your medications or by close monitoring.To help your doctor and pharmacist give you the best care, be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products) before starting treatment with this product. While using this product, do not start, stop, or change the dosage of any other medicines you are using without your doctor's approval.Tell your doctor or pharmacist if you are taking other products that cause drowsiness including alcohol, marijuana (cannabis), antihistamines (such as cetirizine, diphenhydramine), drugs for sleep or anxiety (such as alprazolam, diazepam, zolpidem), muscle relaxants, and opioid pain relievers (such as codeine).Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely.This document does not contain all possible drug interactions. Keep a list of all the products you use. Share this list with your doctor and pharmacist to lessen your risk for serious medication problems.

                  OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: numb/tingling skin, confusion, agitation, hallucinations, seizures.

                  NOTES: Do not share this medication with others.Laboratory and/or medical tests (such as sputum test, cycloserine blood levels, kidney/liver function, complete blood count) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.

                  MISSED DOSE: It is important to take each dose of this medication as scheduled. If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

                  STORAGE: Store at room temperature between 68-77 degrees F (20-25 degrees C) away from light and moisture. Do not store in the bathroom. Keep all medicines away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

                  Information last revised August 2021. Copyright(c) 2021 First Databank, Inc.

                  IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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                  Formulary

                  FormularyPatient Discounts

                  Adding plans allows you to compare formulary status to other drugs in the same class.

                  To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

                  Adding plans allows you to:

                  • View the formulary and any restrictions for each plan.
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                  • Compare formulary status to other drugs in the same class.
                  • Access your plan list on any device – mobile or desktop.

                  The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

                  Tier Description
                  1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
                  2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
                  3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
                  4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                  5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                  6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                  NC NOT COVERED – Drugs that are not covered by the plan.
                  Code Definition
                  PA Prior Authorization
                  Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
                  QL Quantity Limits
                  Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
                  ST Step Therapy
                  Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
                  OR Other Restrictions
                  Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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                  Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.