Drug Index


Mechanism :

Cycloserine is an analog of the amino acid D-alanine. It interferes with an early step in bacterial cell wall synthesis in the cytoplasm by competitive inhibition of two enzymes, L-alanine racemase, which forms D-alanine from L-alanine, and D-alanylalanine synthetase, which incorporates D-alanine into the pentapeptide necessary for peptidoglycan formation and bacterial cell wall synthesis.

Indication :

  • Mycobacterium avium complex (MAC)
  • Multi-drug resistant tuberculosis (TB).

Contraindications :

Hypersensitivity; Alcohol use; Renal dysfunction, severe; History of seizure disorder, mental depression, severe anxiety or psychosis.

Dosing :

15-20 mg/kg/day (Oral) in divided doses upto 1 g/day for a period of 18-24 months.

Adverse Effect :

Confusion, dizziness, headache, somnolence, seizure, vertigo, arrhythmias and heart failure.

Interaction :

Ethanol: May increase risk of cycloserine-assoc. CNS toxicity, seizures (additive toxicity).

Renal Dose :

Dose in Renal Impairment GFR (mL/min)
20-50250–500 mg every 12–24 hours. Monitor blood levels weekly
10-20250–500 mg every 12–24 hours. Monitor blood levels weekly
<10250–500 mg every 24 hours. Monitor blood levels weekly

Dose in Patients undergoing Renal Replacement Therapies
CAPDUnknown dialysability. Dose as in GFR<10 mL/min
HDDialysed. Dose as in GFR<10 mL/ min
HDF/High fluxDialysed. Dose as in GFR<10 mL/ min
CAV/VVHDLikely dialysability. Dose as in GFR=10–20 mL/min

Hepatic Dose :

No dosage adjustments are recommended.
02/16/2024 19:00:30 Cycloserine
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