Four weeks after starting isoniazid preventive therapy, a woman develops anorexia, nausea and right-upper-quadrant discomfort. ALT is four times the

Question

Four weeks after starting isoniazid preventive therapy, a woman develops anorexia, nausea and right-upper-quadrant discomfort. ALT is four times the upper limit of normal and bilirubin is rising. What is the most appropriate immediate action?

Accepted Answer

Withhold isoniazid now and urgently assess drug-induced liver injury

Answer

Reduce isoniazid to alternate-day dosing while symptoms settle

Answer

Add pyridoxine and continue the unchanged isoniazid dose

Answer

Replace isoniazid immediately with rifampicin before further assessment

Answer

Continue isoniazid and repeat liver tests after completing therapy

Isoniazid hepatotoxicity — DTM&H MCQ

Four weeks after starting isoniazid preventive therapy, a woman develops anorexia, nausea and right-upper-quadrant discomfort. ALT is four times the upper limit of normal and bilirubin is rising. What is the most appropriate immediate action?