Overdosing occurs when cycloserine plasma concentrations of 25-30 mg / ml as a result of receiving high doses of cycloserine and / or renal clearance violations. Acute poisoning can occur with ingestion of more than 1 g / day. Symptoms of chronic intoxication during chronic administration in a dose of 500 mg / day: headache, dizziness, confusion, irritability, paresthesia, psychosis, dysarthria, paresis, seizures, coma. Treatment: symptomatic, activated charcoal, antiepileptics primobolan. To prevent neurotoxic effects of pyridoxine is administered at a dose of 200-300 mg / day, anticonvulsants and sedative drugs.
Interaction with other drugs
increases the rate of excretion by the kidneys of pyridoxine (can cause anemia and peripheral neuritis, require an increase in dose pyridoxine). Ethanol increases the risk of seizures, especially in people who suffer from chronic alcoholism.
Ethionamide increases the risk of side effects from the central nervous system, especially of seizures.
Isoniazid increases the incidence of dizziness, sleepiness.
Before starting therapy should be allocated primobolan cycloserine cultures of microorganisms and to determine the sensitivity of the strains to the drug. In the case of infection is necessary to determine the strain sensitivity to other anti-TB drugs.
Cycloserine treatment should be abolished or should reduce the dose if the patient has developed allergic dermatitis or symptoms of central nervous system, namely: headache, dizziness, drowsiness, confusion, tremors, peripheral paresis, dysarthria, seizures and psychosis. In view of the low therapeutic index of cycloserine danger of seizures is increased in patients with chronic alcoholism.
Poisoning usually occurs at concentrations of drug in the blood of more than 30 mg / l, which may be the result of an overdose or impaired renal clearance. Before the drug should be controlled hematologic, renal function (blood concentration of creatinine and BUN) concentration of drug in the blood and liver function.
In patients with reduced renal function, receiving a daily dose of 500 mg, and in which presumably show signs and symptoms overdose, drug levels in the blood must be controlled at least once a week. The dose must be adjusted so as to maintain the drug level in the blood is below primobolan. For prevention of symptoms of central nervous system, in particular, convulsions or tremors excitation state may use anticonvulsant or sedative drugs. Patients receiving 500 mg of cycloserine per day, must be under the direct supervision of a physician because of the possible development of similar symptoms. Prevent or reduce the toxic effect of cycloserine can assigning during treatment glutamic acid, 500 mg of 3 – 4 times daily (before food), and the daily / m administration of sodium salt (1 ml of 1% solution), and pyridoxine dose 200-300 mg / day. For the prevention of adverse effects of neurotoxic prescribed psychotropic medication benzodiazepine diazepam (5 mg) or Phenazepamum (1 mg) overnight and piracetam 800 mg 2 times a day. In some cases, the use of cycloserine can cause the development of vitamin B 12 and / or folic acid megaloblastic and sideroblastic anemia. In case primobolan of anemia during treatment is necessary to conduct an appropriate examination and treatment of the patient.
It should limit the mental stress of patients and prevent possible overheating of the factors (bareheaded sun exposure, hot shower). With the rapid development of resistance is recommended that its combination with other anti-TB drugs in monotherapy cycloserine. Influence receiving cycloserine on driving ability and use of machinery is not established.