Pyridoxine for severe metabolic acidosis and seizures due to isoniazid [INH] overdose

Isoniazid [INH] overdose can be effectively treated, only if, suspected. Seizures and coma are due to INH unless proved otherwise in patients with access to the drug. Acute INH intoxication is characterized by a clinical triad consisting of metabolic acidosis resistant to treatment with sodium bicarbonate, seizure which may be fatal and refractory to standard anticonvulsant therapy, and coma. Pyridoxine is the specific antidote for INH overdose. We report a case of a 25-yr-old lady, who in a suicidal attempt ingested a toxic dose of INH resulting in status epilepticus and was successfully treated with pyridoxine [Vit B6]