Regimen-level interaction: Isoniazid + Moxifloxacin + Rifamycin

The Regimen-level interaction: Isoniazid + Moxifloxacin + Rifamycin refers to a pharmacological combination used in the treatment of tuberculosis (TB) rather than a single molecular target. This specific combination has been evaluated in clinical trials, such as the REMoxTB study, to determine if fluoroquinolones like moxifloxacin can shorten the standard six-month TB treatment duration (Gillespie et al., 2014, NEJM). Isoniazid acts by inhibiting the InhA enzyme to disrupt mycolic acid synthesis in the bacterial cell wall, while moxifloxacin inhibits DNA gyrase and topoisomerase IV to prevent bacterial DNA replication (StatPearls, 2023). Rifamycins, including rifampin and rifapentine, bind to the beta-subunit of bacterial DNA-dependent RNA polymerase, effectively halting transcription (StatPearls, 2023). The interaction between these drugs is clinically significant due to the potent induction of cytochrome P450 enzymes by rifamycins, which can alter the pharmacokinetics of co-administered agents. Furthermore, the combination carries a cumulative risk of hepatotoxicity and potential cardiac rhythm disturbances, specifically QTc prolongation associated with moxifloxacin. Because this entry describes a therapeutic regimen and its associated interactions, it does not constitute a discrete biological receptor or protein target.

Other names

INH-MXF-RIF regimenMoxifloxacin-containing tuberculosis therapyREMoxTB regimen componentIsoniazid-Moxifloxacin-Rifamycin combination

This entry describes a multi-drug regimen where Isoniazid inhibits enoyl-acyl carrier protein reductase (InhA), Moxifloxacin inhibits DNA gyrase and topoisomerase IV, and Rifamycins inhibit DNA-dependent RNA polymerase.