Cycloserine
| Evidence Level: L5 | Predicted Indications: 7 |
Table of Contents
Cycloserine: From Pulmonary Tuberculosis to Irritable Bowel Syndrome
One-Sentence Summary
Cycloserine is a second-line antibiotic originally used to treat pulmonary tuberculosis. The TxGNN model predicts it may be effective for irritable bowel syndrome, but no clinical trials and no supporting publications are currently available for this indication. This is a computational prediction only and should be treated as a hypothesis.
Quick Overview
| Item | Content |
|---|---|
| Original Indication | Pulmonary tuberculosis |
| Predicted New Indication | Irritable bowel syndrome |
| TxGNN Prediction Score | 0.9995 |
| Evidence Level | L5 |
| India Market Status | Listed in a compiled Indian medicine price dataset (10 of 10) – CDSCO approval status is not included in this data |
| Number of Listed Products | 10 (valid: 10) |
| Recommended Decision | Hold |
Why is This Prediction Reasonable?
Currently, detailed mechanism of action data is not available. Based on known information, cycloserine is a D-alanine analogue that inhibits bacterial cell wall synthesis, and its efficacy in drug-resistant tuberculosis is established. It is also known to act as a partial agonist at the glycine site of the NMDA receptor.
A link between this pharmacology and irritable bowel syndrome (for example through the gut-brain axis or visceral hypersensitivity) is speculative. No data compiled for this report supports it. The high TxGNN score (rank 1382) comes from the TxGNN model (deep learning) and may reflect similarities the model learned between related diseases, not biological evidence or demonstrated efficacy.
Other predicted indications were also reviewed (acne, gastroparesis, conjunctivitis, insomnia, pharyngitis, nasal cavity disease). None has clinical trial support. For insomnia, the available literature points to cycloserine causing insomnia and psychosis, which is a safety signal against that use.
Clinical Trial Evidence
Currently no related clinical trials registered.
Literature Evidence
Currently no related literature available for irritable bowel syndrome.
India Market Information
| Authorization Number | Product Name | Dosage Form | Approved Indication |
|---|---|---|---|
| 35423 | Coxerin Capsule (Macleods) | Strip of 10 capsules | Not stated |
| 38907 | Cyclotec 250mg Capsule (United Biotech) | Strip of 10 capsules | Not stated |
| 39619 | Cyclorine Capsule (Lupin) | Strip of 6 capsules | Not stated |
| 142498 | MD Serine 250mg Tablet (Maneesh) | Strip of 4 tablets | Not stated |
| 142006 | Mycotuf C 250mg Tablet (Cadila) | Strip of 10 tablets | Not stated |
All 10 registrations are valid single-ingredient oral products; the table lists 5 of them.
Safety Considerations
- Contraindications (from the knowledge graph, not label text): epilepsy, anxiety disorder, neurotic disorder, dysthymic disorder, kidney disease, pyoureter, psychotic disorder, schizophreniform disorder, mental disorder, schizoaffective disorder, substance abuse/dependence, vitamin B12 deficiency, megaloblastic anemia, sideroblastic anemia.
- Neuropsychiatric effects: A published case report describes cycloserine-induced insomnia and psychosis in a patient with multidrug-resistant tuberculosis.
- Drug Interactions (11 recorded):
- Major: bupropion, ethanol, iohexol, iopamidol.
- Moderate: picosulfuric acid, polyethylene glycol (3350 with electrolytes), sodium sulfate, caffeine, dicoumarol, warfarin, lindane.
Please refer to the package insert for the full warnings, as label-level information was not available for this report.
Conclusion and Next Steps
Decision: Hold
Rationale: The prediction rests only on a model score, with no clinical trials or relevant publications for irritable bowel syndrome. Cycloserine also carries significant neuropsychiatric and other contraindication concerns, which are hard to justify for a non-life-threatening functional bowel disorder.
To proceed, the following is needed:
- Mechanism of action data and a plausible biological link to irritable bowel syndrome
- Preclinical or early clinical evidence in irritable bowel syndrome
- Package insert warnings and contraindications from the India regulatory source
- A risk-benefit assessment of the neuropsychiatric and renal safety concerns in this population
Disclaimer
This content is for research purposes only and does not constitute medical advice. Clinical validation is required before any clinical application.