title: Protective effect of N-acetylcysteine on antituberculosis drug-induced hepatotoxicity.
abstract: BACKGROUND
  Isoniazid, rifampicin, and pyrazinamide, the first-line antituberculosis (anti-TB) drugs, are associated with hepatotoxicity.
  
  
  OBJECTIVE
  To study the hepatoprotective effect of N-acetylcysteine (NAC) on liver injury induced by anti-TB drugs.
  
  
  METHODS
  A randomized clinical trial was conducted on 60 new TB patients who were aged 60 years or more. Patients were randomized into two groups. In group I (n=32), drug regimen included daily doses of isoniazid, rifampicin, pyrazinamide, and ethambutol. Patients in group II (n=28) were treated with the same regimen and NAC. The patients were followed up for 2 weeks. Liver enzymes and bilirubins were measured at baseline, after 1 and 2 weeks of treatment, and whenever the patients presented with clinical symptoms of hepatotoxicity.
  
  
  RESULTS
  The mean+/-SD values of aspartate aminotransferase and alanine aminotransferase were significantly higher in group I than in group II after 1 and 2 weeks of treatment. Hepatotoxicity occurred in 12 patients with (37.5%) group I and none in group II. The mean duration of treatment before the onset of hepatotoxicity was 4.67+/-4.58 days.
  
  
  CONCLUSIONS
  NAC protects against anti-TB drug-induced hepatotoxicity.
authors.affiliation: Pharmaceutical Care Department, Virology Research Center, School of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
authors.forename: Shadi
authors.initials: S
authors.lastname: Baniasadi
authors.forename: Parivash
authors.initials: P
authors.lastname: Eftekhari
authors.forename: Payam
authors.initials: P
authors.lastname: Tabarsi
authors.forename: Fanak
authors.initials: F
authors.lastname: Fahimi
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Raoufy
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Masjedi
authors.forename: Ali Akbar
authors.initials: AA
authors.lastname: Velayati
mesh_terms: D000111:Acetylcysteine / Q000008:administration & dosage*; D000368:Aged; D000369:Aged, 80 and over; D000995:Antitubercular Agents / Q000009:adverse effects*; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology / Q000517:prevention & control*; D004347:Drug Interactions; D004359:Drug Therapy, Combination; D004977:Ethambutol / Q000009:adverse effects; D005260:Female; D016166:Free Radical Scavengers / Q000008:administration & dosage*; D006801:Humans; D007538:Isoniazid / Q000009:adverse effects*; D008099:Liver / Q000187:drug effects; D008297:Male; D011718:Pyrazinamide / Q000009:adverse effects; D012293:Rifampin / Q000009:adverse effects; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy*
chemical_list: D000995:Antitubercular Agents; D016166:Free Radical Scavengers; D011718:Pyrazinamide; D004977:Ethambutol; D007538:Isoniazid; D012293:Rifampin; D000111:Acetylcysteine