Speculation that fast acetylators of isoniazid could be at increased risk of hepatotoxicity due to production of a hepatotoxic hydrazine metabolite has not been supported; in fact, slow acetylators have generally been found to have a higher risk than fast acetylators.
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mild hepatic dysfunction, evidenced by mild and transient elevation of serum transaminase levels occurs in 10 to 20 percent of patients taking isoniazid.
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for persons 35 and older, in addition to monthly symptom reviews, hepatic enzymes specifically, ast and alt formerly sgot and sgpt, respectively should be measured prior to starting dom-isoniazid therapy and periodically throughout treatment.
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ivabradine is primarily metabolized by cyp3a4; isoniazid, inh inhibits cyp3a4.
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