Isoniazid Injection and alcohol

Isoniazid may cause liver problems, and taking it with alcohol can increase the risk. You should avoid or limit the use of alcohol while being treated with isoniazid. Call your doctor immediately if you have fever, chills, joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, abdominal pain, dark urine, pale stools, and/or yellowing of the skin or eyes, as these may be signs and symptoms of liver damage. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

GENERALLY AVOID: Alcoholic patients have been shown to have a higher incidence of isoniazid-induced hepatotoxicity. The mechanism has not been established.

MANAGEMENT: Patients should be counseled to avoid the combination of alcohol and isoniazid and clinicians should be aware of the risk for increased hepatotoxicity in these patients.

Food decreases the levels of isoniazid in your body. Take isoniazid on an empty stomach at least 1 hour before or 2 hours after a meal. This will make it easier for your body to absorb the medication. If nausea occurs, ask your doctor if you can take isoniazid with food. Avoid alcohol while taking isoniazid. Alcohol may increase the risk of damage to the liver during isoniazid treatment. Alcohol can also cause isoniazid side effects to get worse. Contact your doctor if you experience flushing, chills, headache, nausea, vomiting, and diarrhea.

ADJUST DOSING INTERVAL: Administration with food significantly reduces isoniazid absorption, increasing the risk of therapeutic failure or resistance. The mechanism is unknown.

GENERALLY AVOID: Concomitant administration of isoniazid with foods containing tyramine or histamine may decrease the metabolism of tyramine and histamine, increasing the risk of symptoms relating to tyramine- and/or histamine toxicity (e.g., headache, diaphoresis, flushing, diarrhea, nausea, vomiting, tachycardia, dyspnea, and hypotension). The proposed mechanism is isoniazid-mediated inhibition of monoamine oxidase (MAO) and diamine oxidase (DAO), enzymes responsible for the metabolism of tyramine and histamine, respectively.

MANAGEMENT: Isoniazid should be administered on an empty stomach, one hour before or two hours after meals. Patients should be advised to avoid foods containing tyramine (e.g., aged cheese, cured meats such as sausages and salami, fava beans, sauerkraut, soy sauce, beer, or red wine) or histamine (e.g., skipjack, tuna, mackerel, salmon) during treatment with isoniazid. Corticosteroids and antihistamines may be considered if histamine intoxication is suspected.