Comparative Pharmacology
Head-to-head clinical analysis: CAPREOMYCIN SULFATE versus INH.
Peer-Reviewed Evidence
Head-to-head clinical analysis: CAPREOMYCIN SULFATE versus INH.
CAPREOMYCIN SULFATE vs INH
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Inhibits bacterial protein synthesis by binding to the 30S ribosomal subunit, causing misreading of mRNA and inhibiting translation initiation. Also alters membrane permeability.
INH inhibits InhA, an enoyl-acyl carrier protein reductase involved in mycolic acid synthesis, essential for the mycobacterial cell wall. It also disrupts NAD and NADH metabolism via the KatG-activated isonicotinoyl-NAD adduct.
15 mg/kg (up to 1 g) intramuscularly or intravenously once daily for 60 days, then 15 mg/kg (up to 1 g) 2-3 times weekly for 12-18 months in combination with other antituberculosis agents.
300 mg orally once daily (or 15 mg/kg orally once daily, up to 300 mg total) for active tuberculosis; for latent tuberculosis, 300 mg orally once daily or 900 mg orally twice weekly under directly observed therapy.
None Documented
None Documented
Terminal elimination half-life: 24-40 hours (prolonged in renal impairment; anuria may extend to 96-120 hours).
Fast acetylators: 0.5-1.5 hours; slow acetylators: 2-4 hours. Clinically, slow acetylators have higher risk of peripheral neuropathy and hepatotoxicity.
Primarily renal (80-90% as unchanged drug via glomerular filtration). Biliary/fecal elimination: <1%.
Renal: 75-95% as unchanged drug and metabolites (including acetylisoniazid, isonicotinic acid). Biliary/fecal: minor (<5%).
Category C
Category C
Antitubercular Agent
Antitubercular Agent