Dosing
CrCl > 80: 250 - 500 mg po bid, usually the lower dose.
CrCl 80-50:
CrCl 50-10:
CrCl < 10:
Hemodialysis:
Peritoneal dialysis:
Important side effects
Mostly neurologic including absence seizures, catatonia, coma, confusion, dysarthria, headache, hyperreflexia, irritability, nervousness, paranoia, paresis, psychosis, somnolence, tonic-clonic seizures, tremor, twitching, vertigo, visual disturbances.
Important drug interactions
Concomitant use of cycloserine and ethionamide or cycloserine and isoniazid can increase CNS toxicity.
Rants and Screeds
Pearls
Treatment of choice
Second-line for tuberculosis.
And consider cycloserine for resistant E. coli UTI's. Yes, it's a TB drug, but it is effective against some gram-negative rods like E. coli (PubMed).
Use for
Don't use for
Class
A cyclic analog of D-alanine, it acts against two enzymes in peptidoglycan synthesis: alanine racemase and D-alanine:D-alanine ligase.
Last Update: 10/07/19.