Therapeutic Category: Broad spectrum antibiotic
Composition: Each hard gelatin capsule contains
                         Cycloserine USP 250 mg

Pharmacology: Cycloserine is a broad spectrum antibiotic that may be bactericidal or bacteriostatic in action, depending upon its concentration at the site of infection and the susceptibility of the infecting organism. It inhibits cell wall synthesis in susceptible organism by competitive inhibition of enzymes that are responsible for incorporating D-alanine into the bacterial cell wall.

Indications: Cycloserine is indicated in the treatment of active pulmonary and extra-pulmonary tuberculosis including renal disease when the organisms are susceptible to this drug and after failure of adequate treatment with the primary medications such as streptomycin, isoniazid, rifampicin and ethambutol. Like all anti-tuberculous drugs, cycloserine should be administered in conjunction with other effective chemotherapy and not as the sole therapeutic agent.

Cycloserine may also be indicated for the treatment of acute urinary tract infections caused by susceptible strains of Gram-positive and Gram-negative bacteria, especially Klebsiella/Enterobacter species and Escherichia coli. It is generally no more and may be less effective than other antimicrobial agents in the treatment of urinary tract infections caused by bacteria other than mycobacteria. Use of cycloserine in these infections should be considered only when the more conventional therapy has failed and when the organism has been demonstrated to be sensitive to the drug.

Dosage : Adults and teenagers- The initial adult dosage is 250 mg twice a day at interval of 12 hours. The usual dosage is 250 mg three or four times a day, monitored by blood level determinations. The daily dosage should not exceed 1g.

Children- The usual starting dose is 10 to 20 mg per kg (4.5 to 9.1 mg per pound) of body weight per day, then adjusted according to obtained blood levels and therapeutic response.

Elderly- As for adults but reduce dosage if renal function is impaired.

The patient should be advised, not to miss a dose. In case of missing a dose, he/she should take it as soon as possible. This will help in maintaining the constant concentration of cycloserine in the blood. However, if it is almost time for the next dose, better skip the missed dose and go back to regular dosing schedule. In any case duplication of the dose should be avided.

Contraindications: Cycloserine is contra-indicated in patients with severe renal impairment and in patients with a history of epilepsy, mental depression, severe anxiety, or psychosis. The use of cycloserine is also contradicted in frequent alcohol users and in patients hypersensitive to cycloserine.

Adverse Effects: Most of the side effects during treatment with cycloserine is related to the nervous system or are due to hypersensitivity.

Commonly observed side effects are anxiety, confusion, dizziness, drowsiness, increased irritability, increased restlessness, mental depression, muscle twitching or trembling, nervousness, nightmares, other mood or mental changes, speech problems, thought of suicide and headache.

Other reported side-effects include convulsion (seizures), numbness, tingling, burning pain, or weakness in the hands or feet, skin rash etc.

Presentation :
Strips of 1 x 10 and 10 x 10 capsules packed in unit carton.
Bulk pack of 1000 capsules in 100 strips of 10 capsules are also available.

Precautions: Do not drive or engage in hazardous work until the effect of medicine has been determined. Avoid alcohol while on this drug. Before taking cycloserine, inform your doctor, if you are depressed or have severe anxiety. Persons with a seizure disorder should not take cycloserine.

Storage: Store at a temperature up to 30^oC, in a dry place, protected from light and moisture.
Keep away from the reach of children.