title: Rifampicin and isoniazid plasma concentrations in relation to adverse reactions in tuberculosis patients: a retrospective analysis.
abstract: OBJECTIVE
  High concentrations of antituberculosis (anti-TB) drugs can be associated with many adverse drug reactions (ADRs). The objective of this study was to examine the plasma concentrations of rifampicin (RMP) and isoniazid (INH) in patients with and without ADRs.
  
  
  METHODS
  Concentration monitoring data of patients treated with anti-TB drugs were retrospectively analyzed from 2009 to 2011. RMP and INH plasma concentrations were measured 2 and 3 h after drug administration respectively using high-performance liquid chromatography.
  
  
  RESULTS
  A total of 54 out of 120 patients have experienced ADRs to anti-TB drugs. The median concentrations [interquartile range (IQR)] obtained in patients with and without ADRs were 6.7 mg/l (3.7-9.9) and 5.6 mg/l (2.9-8.6) (p= 0.56) for RMP and 4.3 mg/l (2.3-5.3) and 3.1 mg/l (1.7-4.8) (p= 0.04) for INH, respectively. Related median doses (IQR) were 8.7 mg/kg (8.0-10.0) and 8.6 mg/kg (6.5-9.9) (p= 0.42) for RMP and 4.8 mg/kg (4.3-5.0) and 4.0 mg/kg (2.8-5) (p< 0.01) for INH, respectively. Concentrations above the expected range in patients with and without ADRs were not reached for RMP, but were 76% and 65% for INH, respectively. Correlation between concentrations and doses has not been established for RMP or INH. In addition, high INH concentrations showed no association with sex, age, liver injury or renal or diabetes.
  
  
  CONCLUSIONS
  High INH concentrations were common in patients with and without ADRs whereas RMP concentrations were low or within the normal range in most patients. Further studies are required to assess the association between high INH concentrations and the occurrence of ADRs.
authors.affiliation: Department of Pharmacovigilance, Moroccan Poison Control and Pharmacovigilance Center-Rue Lamfedel Cherkaoui, Rabat-Institut, Madinat Al Irfan, BP: 6671, Rabat, Morocco.
authors.forename: L
authors.initials: L
authors.lastname: Aït Moussa
authors.affiliation: Laboratory of Toxicology and Pharmacology, Moroccan Poison Control and Pharmacovigilance Center, Rue Lamfedel Cherkaoui, Rabat-Institut, Madinat Al Irfan, BP: 6671, Rabat, Morocco.
authors.forename: O
authors.initials: O
authors.lastname: El Bouazzi
authors.affiliation: Laboratory of Pharmacology and Toxicology, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco.
authors.forename: S
authors.initials: S
authors.lastname: Serragui
authors.affiliation: Department of Pharmacology, Faculty of Medicine and Pharmacy, University of Abdelmalek Essaadi, Tanger, Morocco.
authors.forename: D
authors.initials: D
authors.lastname: Soussi Tanani
authors.affiliation: Laboratory of Genetics & Biometry, Faculty of Sciences, Ibn Tofail University, Kénitra, Morocco.
authors.forename: A
authors.initials: A
authors.lastname: Soulaymani
authors.affiliation: Moroccan Poison Control and Pharmacovigilance Center-Rue Lamfedel Cherkaoui, Rabat-Institut, Madinat Al Irfan, BP: 6671, Rabat, Morocco.
authors.forename: R
authors.initials: R
authors.lastname: Soulaymani
keywords: adverse drug reactions; drug concentrations; isoniazid; rifampicin