Terizidone Research Articles

A Validated RP-HPLC Method for the Simultaneous Detection and Quantification of Pyridoxine and Terizidone in Pharmaceutical Formulations

Tuberculosis (TB) remains a life-threatening infection, and it is well-known that effective TB treatment is associated with multiple drugs administered to infected patients on a daily basis. Terizidone (TZD) is an anti-TB drug used in the treatment of multi-drug resistant and extensively drug-resistant TB but presents with polyneuropathic adverse effects in some patients. To counteract these adverse effects, TZD is typically prescribed with pyridoxine (PDX), well known as Vitamin B6. As part of a pre-formulation study investigating the potential to co-formulate these two compounds, it became necessary to have a simple and reliable reversed-phase high-performance liquid chromatography (RP-HPLC) method. Optimal, simultaneous separation and detection of TZD and PDX were obtained using an isocratic mobile phase setup, consisting of ultrapure water and acetonitrile (30:70% v/v), with 1 mL glacial acetic acid added to the mobile phase mixture. A Discovery® C18, 150 × 4.6 mm, 5 μm column maintained at ambient temperature was utilized, with a detection wavelength of 260 nm. The method was validated in terms of linearity, accuracy, precision, limit of detection (LOD), limit of quantification (LOQ), specificity, robustness, and solution stability. Validation proved this method to be acceptable and reliable for the simultaneous accurate detection and quantification of TZD and PDX.

Safety of cycloserine and terizidone for the treatment of drug-resistant tuberculosis: a meta-analysis [Review article

Although cycloserine (CS) is recommended by the World Health Organization as a second-line agent for the treatment of multidrug-resistant tuberculosis (MDR-TB), safety concerns have impeded its uptake by several national TB programmes. Terizidone (TRD), a structural analogue of cycloserine, may be better tolerated. To assess the safety of CS and TRD for TB treatment, a systematic review and meta-analysis were conducted. From articles published up to December 2011, 27 studies with 2164 patients were included in our review of CS use. The pooled estimate for the frequencies of any adverse drug reaction (ADR) from CS was 9.1% (95%CI 6.4-11.7); it was 5.7% (95%CI 3.7-7.6) for psychiatric ADRs, and 1.1% (95%CI 0.2-2.1) for central nervous system (CNS) related ADRs. TRD showed no better to moderately better safety than CS in a systematic review of the available literature. The published evidence suggests that CS is associated with a higher frequency of psychiatric and CNS-related ADRs than other second-line drugs. While data were limited, treatment discontinuation rates appeared to be manageable. There were no significant differences in tolerability by region, study period or combination. As countries review and revise their treatment programmes, CS, and potentially TRD, should be included in MDR-TB treatment regimens. Adequate information on possible ADRs should be provided to patients, their families and attending health care workers. Greater attention to MDR-TB patients' mental health and a significant increase in resources devoted to pharmacovigilance and treatment of MDR-TB are essential.