Isoniazid is a potent antibiotic primarily used in the treatment and prevention of tuberculosis (TB). It works by inhibiting the synthesis of mycolic acids, essential components of the mycobacterial cell wall, thereby exerting its bactericidal effects against actively dividing Mycobacterium tuberculosis.

As a first-line agent in TB therapy, isoniazid is often included in combination regimens to enhance efficacy and prevent the development of drug resistance. Its role in latent TB infection treatment is crucial, as it significantly reduces the risk of progression to active disease.

Prescribers should be aware of isoniazid's potential side effects, including hepatotoxicity and peripheral neuropathy, which necessitate regular monitoring of liver function and the possible co-administration of pyridoxine (vitamin B6) to mitigate neuropathic effects. Isoniazid's pharmacokinetics can be influenced by genetic factors, such as acetylator status, which may affect dosing and risk of adverse effects.

In compounding formulations, isoniazid can be tailored to meet specific patient needs, offering flexibility in dosing and administration routes. This customization is particularly beneficial for patients with unique therapeutic requirements or those who experience difficulties with standard treatment regimens.