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Cycloserine Dosage

Medically reviewed by Drugs.com. Last updated on Aug 10, 2023.

Applies to the following strengths: 250 mg

Usual Adult Dose for Tuberculosis - Extrapulmonary

Initial dose: 250 mg orally every 12 hours for the first 2 weeks
Maintenance dose: 500 to 1000 mg orally per day, given in divided doses
Maximum dose: 1000 mg/day

Comments:


Uses:

American Thoracic Society (ATS), US Centers for Disease Control and Prevention (US CDC), and Infectious Diseases Society of America (IDSA) Recommendations:
10 to 15 mg/kg orally, given in divided doses 1 to 2 times a day

Comments:

Use: Second-line treatment of tuberculosis caused by known/suspected drug-susceptible organisms

ATS, US CDC, US Department of Health and Human Services (US HHS), and IDSA Recommendations:
10 to 15 mg/kg orally once to 2 times a day

Comments:

Uses:

US HHS, National Institutes of Health (NIH), Health Resources and Services Administration (HRSA), and US CDC Recommendations:
Initial dose: 250 mg orally once a day
Maintenance dose: 250 to 1000 mg orally per day, given once a day or in divided doses
Maximum dose: 1000 mg/day

Comments:

Use: Second-line adjunctive treatment of drug-resistant tuberculosis in patients with HIV

Usual Adult Dose for Tuberculosis - HIV Positive

Initial dose: 250 mg orally every 12 hours for the first 2 weeks
Maintenance dose: 500 to 1000 mg orally per day, given in divided doses
Maximum dose: 1000 mg/day

Comments:


Uses:

American Thoracic Society (ATS), US Centers for Disease Control and Prevention (US CDC), and Infectious Diseases Society of America (IDSA) Recommendations:
10 to 15 mg/kg orally, given in divided doses 1 to 2 times a day

Comments:

Use: Second-line treatment of tuberculosis caused by known/suspected drug-susceptible organisms

ATS, US CDC, US Department of Health and Human Services (US HHS), and IDSA Recommendations:
10 to 15 mg/kg orally once to 2 times a day

Comments:

Uses:

US HHS, National Institutes of Health (NIH), Health Resources and Services Administration (HRSA), and US CDC Recommendations:
Initial dose: 250 mg orally once a day
Maintenance dose: 250 to 1000 mg orally per day, given once a day or in divided doses
Maximum dose: 1000 mg/day

Comments:

Use: Second-line adjunctive treatment of drug-resistant tuberculosis in patients with HIV

Usual Adult Dose for Tuberculosis - Resistant

Initial dose: 250 mg orally every 12 hours for the first 2 weeks
Maintenance dose: 500 to 1000 mg orally per day, given in divided doses
Maximum dose: 1000 mg/day

Comments:


Uses:

American Thoracic Society (ATS), US Centers for Disease Control and Prevention (US CDC), and Infectious Diseases Society of America (IDSA) Recommendations:
10 to 15 mg/kg orally, given in divided doses 1 to 2 times a day

Comments:

Use: Second-line treatment of tuberculosis caused by known/suspected drug-susceptible organisms

ATS, US CDC, US Department of Health and Human Services (US HHS), and IDSA Recommendations:
10 to 15 mg/kg orally once to 2 times a day

Comments:

Uses:

US HHS, National Institutes of Health (NIH), Health Resources and Services Administration (HRSA), and US CDC Recommendations:
Initial dose: 250 mg orally once a day
Maintenance dose: 250 to 1000 mg orally per day, given once a day or in divided doses
Maximum dose: 1000 mg/day

Comments:

Use: Second-line adjunctive treatment of drug-resistant tuberculosis in patients with HIV

Usual Adult Dose for Tuberculosis - Active

Initial dose: 250 mg orally every 12 hours for the first 2 weeks
Maintenance dose: 500 to 1000 mg orally per day, given in divided doses
Maximum dose: 1000 mg/day

Comments:


Uses:

American Thoracic Society (ATS), US Centers for Disease Control and Prevention (US CDC), and Infectious Diseases Society of America (IDSA) Recommendations:
10 to 15 mg/kg orally, given in divided doses 1 to 2 times a day

Comments:

Use: Second-line treatment of tuberculosis caused by known/suspected drug-susceptible organisms

ATS, US CDC, US Department of Health and Human Services (US HHS), and IDSA Recommendations:
10 to 15 mg/kg orally once to 2 times a day

Comments:

Uses:

US HHS, National Institutes of Health (NIH), Health Resources and Services Administration (HRSA), and US CDC Recommendations:
Initial dose: 250 mg orally once a day
Maintenance dose: 250 to 1000 mg orally per day, given once a day or in divided doses
Maximum dose: 1000 mg/day

Comments:

Use: Second-line adjunctive treatment of drug-resistant tuberculosis in patients with HIV

Usual Adult Dose for Urinary Tract Infection

Initial dose: 250 mg orally every 12 hours for the first 2 weeks
Maintenance dose: 500 to 1000 mg orally per day, given in divided doses
Maximum dose: 1000 mg/day

Comments:


Uses:

American Thoracic Society (ATS), US Centers for Disease Control and Prevention (US CDC), and Infectious Diseases Society of America (IDSA) Recommendations:
10 to 15 mg/kg orally, given in divided doses 1 to 2 times a day

Comments:

Use: Second-line treatment of tuberculosis caused by known/suspected drug-susceptible organisms

ATS, US CDC, US Department of Health and Human Services (US HHS), and IDSA Recommendations:
10 to 15 mg/kg orally once to 2 times a day

Comments:

Uses:

US HHS, National Institutes of Health (NIH), Health Resources and Services Administration (HRSA), and US CDC Recommendations:
Initial dose: 250 mg orally once a day
Maintenance dose: 250 to 1000 mg orally per day, given once a day or in divided doses
Maximum dose: 1000 mg/day

Comments:

Use: Second-line adjunctive treatment of drug-resistant tuberculosis in patients with HIV

Usual Adult Dose for Mycobacterium avium-intracellulare - Treatment

US HHS, NIH, HRSA, and US CDC Recommendations:
5 mg/kg orally 2 times per day


Comments:

Use: Second-line adjunct therapy (with azithromycin/clarithromycin and other drugs as salvage therapy) in the treatment of Mycobacterium avium intracellulare complex (MAC) in patients with HIV

Usual Pediatric Dose for Tuberculosis - Extrapulmonary

American Academy of Pediatrics (AAP) Recommendations:
Infants, children, and adolescents: 10 to 20 mg/kg orally per day, given in 2 divided doses


Use: Adjunctive treatment of drug-resistant tuberculosis

ATS, US CDC, and IDSA Recommendations:
Children: 15 to 20 mg/kg orally, given in divided doses 1 to 2 times a day

Comment: Maintenance doses should be titrated and based on serum levels.

Use: Second-line treatment of tuberculosis caused by known/suspected drug-susceptible organisms

ATS, US CDC, US HHS, and IDSA Recommendations:
Children: 10 to 15 mg/kg orally once a day

Comment: Maintenance doses should be titrated and based on serum levels.

Uses:

US HHS, NIH, HRSA, and US CDC Recommendations:
Children: 10 to 20 mg/kg orally once a day

Comments:

Use: Second-line adjunctive treatment of drug-resistant tuberculosis in patients with HIV

Usual Pediatric Dose for Tuberculosis - HIV Positive

American Academy of Pediatrics (AAP) Recommendations:
Infants, children, and adolescents: 10 to 20 mg/kg orally per day, given in 2 divided doses


Use: Adjunctive treatment of drug-resistant tuberculosis

ATS, US CDC, and IDSA Recommendations:
Children: 15 to 20 mg/kg orally, given in divided doses 1 to 2 times a day

Comment: Maintenance doses should be titrated and based on serum levels.

Use: Second-line treatment of tuberculosis caused by known/suspected drug-susceptible organisms

ATS, US CDC, US HHS, and IDSA Recommendations:
Children: 10 to 15 mg/kg orally once a day

Comment: Maintenance doses should be titrated and based on serum levels.

Uses:

US HHS, NIH, HRSA, and US CDC Recommendations:
Children: 10 to 20 mg/kg orally once a day

Comments:

Use: Second-line adjunctive treatment of drug-resistant tuberculosis in patients with HIV

Usual Pediatric Dose for Tuberculosis - Resistant

American Academy of Pediatrics (AAP) Recommendations:
Infants, children, and adolescents: 10 to 20 mg/kg orally per day, given in 2 divided doses


Use: Adjunctive treatment of drug-resistant tuberculosis

ATS, US CDC, and IDSA Recommendations:
Children: 15 to 20 mg/kg orally, given in divided doses 1 to 2 times a day

Comment: Maintenance doses should be titrated and based on serum levels.

Use: Second-line treatment of tuberculosis caused by known/suspected drug-susceptible organisms

ATS, US CDC, US HHS, and IDSA Recommendations:
Children: 10 to 15 mg/kg orally once a day

Comment: Maintenance doses should be titrated and based on serum levels.

Uses:

US HHS, NIH, HRSA, and US CDC Recommendations:
Children: 10 to 20 mg/kg orally once a day

Comments:

Use: Second-line adjunctive treatment of drug-resistant tuberculosis in patients with HIV

Usual Pediatric Dose for Tuberculosis - Active

American Academy of Pediatrics (AAP) Recommendations:
Infants, children, and adolescents: 10 to 20 mg/kg orally per day, given in 2 divided doses


Use: Adjunctive treatment of drug-resistant tuberculosis

ATS, US CDC, and IDSA Recommendations:
Children: 15 to 20 mg/kg orally, given in divided doses 1 to 2 times a day

Comment: Maintenance doses should be titrated and based on serum levels.

Use: Second-line treatment of tuberculosis caused by known/suspected drug-susceptible organisms

ATS, US CDC, US HHS, and IDSA Recommendations:
Children: 10 to 15 mg/kg orally once a day

Comment: Maintenance doses should be titrated and based on serum levels.

Uses:

US HHS, NIH, HRSA, and US CDC Recommendations:
Children: 10 to 20 mg/kg orally once a day

Comments:

Use: Second-line adjunctive treatment of drug-resistant tuberculosis in patients with HIV

Renal Dose Adjustments

Children and adults:


Older patients:

ATS, US CDC, US HHS, and IDSA Recommendations:
Adults:

Comment: Serum levels and monitoring for neurotoxicity should be performed.

Uses:

Some experts recommend:
Adults:

US HHS, NIH, HRSA, and US CDC Recommendations:
Adults:

Liver Dose Adjustments

Frequent liver function monitoring recommended.

ATS, US CDC, and IDSA Recommendations:
Adults:
Severe, unstable liver disease: 250 mg orally once a day OR 500 mg orally 3 times a week and rifabutin, PLUS a fluoroquinolone and/or second-line injectable agent


Comments:

Use: Second-line treatment of drug-susceptible tuberculosis caused by susceptible organisms in patients with advanced liver dysfunction

Dose Adjustments

Allergic dermatitis or signs/symptoms of central nervous system (CNS) toxicity: Administration should be discontinued OR the dosage should be reduced

Anemia, folic acid deficiency, and/or vitamin B12: Further investigation and appropriate treatment should be started.

Hematological studies should be regularly assessed.

Therapeutic drug monitoring/range: Blood concentrations should be below 30 mcg/mL


Monitoring should be conducted at least once a week in:

Precautions

CONTRAINDICATIONS:


Safety and efficacy have not been established in pediatric patients.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

ATS, US CDC, and IDSA Recommendations:
Adults:
Hemodialysis: 250 mg orally once a day OR 500 mg orally 3 times a week

Comments:


Use: Second-line treatment of drug-susceptible tuberculosis caused by susceptible organisms

Other Comments

Storage requirements:


Monitoring:

Patient advice:

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.