Last update Nov. 6, 2024

Cycloserine

Likely Compatibility

Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.

Antibiotic used to treat tuberculosis as part of a multidrug regimen when resistance to the primary drugs has developed. Also used in some types of urinary tract infections. Oral administration in two daily doses.

Its pharmacokinetic data (low molecular weight and low protein binding) explain the moderate-high milk excretion (RD > 10%), which could be clinically significant since the dose received by the infant can be 20-40% of the pediatric dose (10-20 mg/kg/day).

At least 6 infants exposed to cycloserine through breast milk had no clinical or developmental problems. (Drobac 2005)

May cause neurological and psychiatric side effects.

Authorized use in Pediatrics.

Children of mothers treated with isoniazid, cycloserine or ethionamide/prothionamide who receive maternal lactation should receive maternal lactation.

mothers receiving maternal lactation should receive pyridoxine (Vitamin B6) supplementation. (Baquero 2015, Arbex 2010)

If used during lactation it is advisable to monitor the infant clinically and analytically (levels).

The American Academy of Pediatrics considers it generally compatible with breastfeeding. (AAP 2001)

Alternatives

  • Clofazimine (Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.)
  • Imipenem + Cilastatin (Safe product and/or breastfeeding is the best option.)
  • Linezolid (Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.)

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

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Other names

Cycloserine in other languages or writings:

Group

Cycloserine belongs to this group or family:

Tradenames

Main tradenames from several countries containing Cycloserine in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 70 - 90 %
Molecular weight 102 daltons
Protein Binding 0 %
pKa 4.21 -
Tmax 3 - 4 hours
T½ 10 - 12 hours
M/P ratio 1 -
Theoretical Dose 2 - 2.85 mg/Kg/d
Relative Dose 12 - 17 %
Ped.Relat.Dose 20 - 40 %

References

  1. Baquero-Artigao F, Mellado Peña MJ, del Rosal Rabes T, Noguera Julián A, Goncé Mellgren A, de la Calle Fernández-Miranda M, Navarro Gómez ML; Working Group on gestational, congenital, and postnatal tuberculosis, Spanish Society of Pediatric Infectious Diseases (PFIC). Guía de la Sociedad Española de Infectología Pediátrica sobre tuberculosis en la embarazada y el recién nacido (ii): profilaxis y tratamiento. [Spanish Society for Pediatric Infectious Diseases guidelines on tuberculosis in pregnant women and neonates (ii): Prophylaxis and treatment]. An Pediatr (Barc). 2015 Abstract Full text (link to original source) Full text (in our servers)
  2. Arbex MA, Varella Mde C, Siqueira HR, Mello FA. Antituberculosis drugs: drug interactions, adverse effects, and use in special situations. Part 2: second line drugs. J Bras Pneumol. 2010 Sep-Oct;36(5):641-56. Abstract Full text (link to original source) Full text (in our servers)
  3. Drobac PC, del Castillo H, Sweetland A, Anca G, Joseph JK, Furin J, Shin S. Treatment of multidrug-resistant tuberculosis during pregnancy: long-term follow-up of 6 children with intrauterine exposure to second-line agents. Clin Infect Dis. 2005 Jun 1;40(11):1689-92. Epub 2005 Apr 18. Abstract Full text (link to original source) Full text (in our servers)
  4. AAP - American Academy of Pediatrics Committee on Drugs. Transfer of drugs and other chemicals into human milk. Pediatrics. 2001 Sep;108(3):776-89. Abstract Full text (link to original source) Full text (in our servers)
  5. Tran JH, Montakantikul P. The safety of antituberculosis medications during breastfeeding. J Hum Lact. 1998 Dec;14(4):337-40. Review. Abstract
  6. CHARLES E, MCKENNA MH, MORTON RF. Studies on the absorption, diffusion, and excretion of cycloserine. Antibiot Annu. 1955-1956;3:169-72. No abstract available. Abstract

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