[stephjoel99]

We started Isoniazid today to treat Amelia for TB. I got the list of "forbidden foods". Wow is that a list.

But my question is, the bottle says to give on an empty stomach 1-2 hours before or after eating - she's ALWAYS eating so how hard and fast a rule is this? It does say that you can give it with food if the medicine upsets their stomach.

I was curious how everyone handled this. She's starving and I have 30 minutes until I can feed her according to this - I remember someone saying they gave their child the pill form with applesauce so I'd love to know how others did it. 9 months is a loooooooong time to remember all the rules of this stuff.

Edited to add: Also her pulmonologist wants to do a liver panel every month to check and see how she's tolerating it - I am curious how everyone else's dr. did it. Thanks!

[Mindybeth6]

I never did that. My DR told me to give it to her with food as it would upset her stomach. Mikayla couldn't tolerate it early in the day, she got very grumpy on it, and so we gave it to her before bed mixed in with her cereal (she started it at 9 months old I believe) and we had the liquid. I know LOTS of other people who have had to give their children INH too and most all of them mixed it with food. HTH.

[CurlysGirly]

I gave it to her around 4pm, after her nap and about an hour and a half before dinner. We used the pill and crushed it. I tried to switch up the base with applesauce, pears, YoYo baby, etc. I only used about 2 little spoons worth of base. I first tried doing it in between breakfast and the 1st nap (she used to do 2 naps). I quit that because it made her so gassy and gumpy that early.

Funny thing about the food interactions. My ped had NO idea about that. Another thing that I read that she was not privvy to was that Tylenol should be avoided and Motrin only in moderation. Kind of stunk going through the teething phase and we mostly used chamomile.....nice and earthy but nearly as good as Motrin

[DeeVee]

The food restrictions are new to me, and I asked three specialists lots and lots of questions, including an infectious disease doc.

I crushed Carolina's pill and gave it to her in applesauce or yogurt with no problem. Our ped did a liver panel twice during the course of treatment, and she was fine. I think INH is more likely to have a side effect on the liver in adults than in young children, so that is why he chose not to do the liver panel every month. I forgot about the tylenol thing at some point along the way (bad mommy), and I did give it to her a couple times while she was on the INH, again with no ill effects (thiankfully).

I hope this helps! Feel free to PM me too.

[dovelu]

Okay--

-- I gave it crushed in food (mostly yogurt) usually first thing in the morning. But sometimes later, if I forgot or had something to do first thing etc. (I have 2 other kids.) We didn't avoid food before or after.

-- I didn't know about avoiding pain-relievers. We used Tylenol on rare occasions (as needed). I don't think that I used Motrin, but only because I only use it for very high fevers.

-- I didn't know about avoiding certain foods. We didn't avoid any.

-- We didn't do any liver panels/checks, etc.

So, I guess we did everything wrong . But we hung in there like champs and gave the stuff religiously for 9 mos.... just finished a few weeks ago. Much harder than any grad. class I ever took. I give us an "A" despite our errors .

-- Amy

[Howdy]

I don't know about infants but I was on INH last year (for chronic infection related to chronic Lyme) and my impression at the time was the 'don't eat before and after' was the easiest way to avoid foods that can have bad interactions. It sounds like you already have a list of foods to avoid with it, but here is a quote from a website about it:

"Use caution with the foods listed below. They can interact with isoniazid and cause a reaction that includes a severe headache, large pupils, neck stiffness, nausea, vomiting, diarrhea, flushing, sweating, itching, irregular heartbeats, and chest pain. A reaction will not necessarily occur, but eat these foods with caution until you know if you will react to them. Call your doctor immediately if you experience any of these symptoms.

Eat the following foods with caution:

cheeses, including American, Blue, Boursault, Brick, Brie, Camembert, Cheddar, Emmenthaler, Gruyere, Mozzarella, Parmesan, Romano, Roquefort, Stilton, and Swiss;
sour cream and yogurt;
beef or chicken liver, fish, meats prepared with tenderizer, bologna, pepperoni, salami, summer sausage, game meat, meat extracts, caviar, dried fish, herring, shrimp paste, and tuna;
avocados, bananas, figs, raisins, and sauerkraut;
soy sauce, miso soup, bean curd, and fava beans;
yeast extracts;
ginseng;
chocolate;
caffeine (coffee, tea, cola, etc.); and
beer (alcoholic and nonalcoholic), red wine (especially Chianti), sherry, vermouth, and other distilled spirits. "

That website didn't mention them, but I think greenbeans also have potential interactions.

[CurlysGirly]

That food list is longer than the one I had. I basically followed what was written on the patient information leaflet that came from the pharmacy.

[stephjoel99]

Our instructions from the pharmacist were to "avoid any foods high in tyramine" and it gives the list of tyramine foods - some of the foods mentioned above and many more. I'm thinking "that's pretty much her diet!" I'm going to do my best, but 9 months is a long time for a girl to give up her bananas and cheese sticks, ya know? It says those foods can cause "severe high blood pressure" which requires "immediate medical attention". I have a list so long - it's spooky long. I spent like $250 today at Whole Foods just buying stuff that would not basically kill her. I am sure I'll get less freaky about this as time goes on, but can I say I'm just FAH-REAKED right now?!

Okay, so I'm feeling better about letting her eat close to her meds though - I gave her dinner about 45 minutes after her dose tonight - we are doing 5 ml twice per day (liquid, morning and night). If she starts showing any whacky symptoms I'll adjust that.

Thanks everybody for your help!!!

[Mariais5]

We only have about a month left on our INH meds.. We didn't avoid any foods.. Sofie takes the liquid form mixed in with a little milk.. I give it to her at all times of the day ~ whenever I think of it.. I talked with our DR and the health dept.. Both said that liver damage in an infant/toddler is very rare because their liver is still growing..

[Mindybeth6]

I wanted to add that my Dr is VERY awesome and never told me to avoid a single food. We didn't have any interactions at all. Mikayla is on a VERY limited diet due to her extreme milk allergies though. So she only eats the same 10 foods over and over. But most of them were on that list. We had liver panels done every months for Mikayla. All were fine. I have heard that taking it WITH milk can cause them to get sick, but I never had to worry about this obviously with a milk allegy.

OH....I wanted to add that the fist several weeks she was cranky on it as she adjusted and get ready for gas. It was NON-STOP gas the entire time she was on it and most kids I know got that way...also some nasty diapers. Kayla took all hers at one time. We went to an infectious disease specialist who does ONLY these kinds of things (Akron Children's Hospitla) and he said not to worry about the food thing....that it HIGHY over-rated...as most side-effects on medications are. JMO of course. But I am very particular about my kids' health, I put off starting her on the meds for a few months until I felt secure about them.

[cjrogers]

We mash ours up and it goes in the 3pm bottle. Doc never said to avoid any foods. We are on our 1st month.

No reactions here.

[guatamama2]

We had to switch to the pill (crushed in applesauce) right before bed. The liquid was a nightmare and I could never get the timing right. IMO I don't even know why the Dr.'s bother prescribing the liquid (2 doses verses one and it is so much easier disguised in pill form!)

Ask your doc about the pill - it was much easier for us!

Good Luck

[swjp]

Thanks for the thread and all the info since we have to start it because of a + skin test. She doesn't have the disease, but I guess we have to treat just in case.

[Ms.Judi]

We too also have one more month to go. I was not given any food restristions and i would give it to Elaina crushed up in her cup of milk before bed. That way I knew she was taking it. Our first doc had us to blood tests every month and then switched to a doc at Childrens Mercy in the infectious disease and he doesn't do the blood tests. We will have one last check with that doc in June for a final check up. Elaina tolerated the meds very well. Good Luck it is not as bad as it first seems.

[tricecm]

Our pediatrician never gave us a list of foods to avoid. But that is because I don't think he knew much about it anyway.

Since you asked what we did, here's what we did....we took the medicine for about a week, then I went back to the pediatrician with more questions, which he refused to answer. I told him that I would not subject my kid to such strong medicine without those answers. Instead he sent me to an infectious disease specialist.

I asked my questions of the infectious disease specialist, who had to admit that he knew none of my answers. He asked me to wait while he called a colleague and asked. They weren't hard questions; one was "why not wait until the bcg scab heals and re-check the mantoux?" and "have there been any studies on how several months of such strong medication will affect a child years from now?"

He came back and said that he wanted to re-check the mantoux. When I came back to get the mantoux checked, he would have answers to the rest of my questions.

The second mantoux was negative, so my questions were no longer relevant.

The bcg scab will not heal while on INH. If a person waits until the bcg scab heals (and it takes a long time), then re-checks the mantoux, it will very likely be negative. I would strongly urge folks to try that before using medicine so strong that kids livers need to be checked.

If you've already done that, sorry to repeat it.