Rifampicin + Isoniazid + Pyrazinamide information from DrugsUpdate  

Pharmacodynamics

Pharmacokinetics

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Rifampicin + Isoniazid + Pyrazinamide Indications / Rifampicin + Isoniazid + Pyrazinamide Uses

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Rifampicin + Isoniazid + Pyrazinamide Adverse Reactions / Rifampicin + Isoniazid + Pyrazinamide Side Effects

GI Disturbances, pseudomembranous colitis (rare), abnormalities of liver function, fatalities in those with liver disorders, influenza like symptoms, skin reactions, eosinophilia, transient leucopenia, shock, drowsiness, headache, ataxia, visual disturbances, menstrual irregularities,. Reddish coloured urine and tears. Peripheral neuritis, optic neuritis, psychotic reactions, convulsions, fatigue, epigastric distress, fever, rash, pyrodoxine deficiency. Hepatotoxicity (hepatomegaly, splenomegaly and jaundice may develop and in rare case fulminating acute yellow atrophy and death). Anorexia, nausea, vomiting, arthralgia, malaise, fever, hyperuricaemia. Hepatitis (rare), fatalities following liver necrosis, hepatotoxicity.

Precautions

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Special Precautions

Impaired hepatic or renal function. Elderly, malnourished or very young patients. Alcoholic patients. Monitor blood counts and liver function regularly. Body fluids may colour orange-red. Discontinue use if thrombocytopaenia or purpura occurs. Convulsive disorders; history of psychosis; patients at risk of neuropathy or pyridoxine deficiency eg, diabetic, alcoholic, malnourished, uraemic, infected with HIV. Check liver function before treatment.

Other Drug Interactions

Liver enzyme induction affects metabolism of chloramphenicol, corticosteroids, clofibrate, ciclosporin, dapsone, digoxin, hexobarbitone, ketoconazole, quinidine and verapamil.
Antagonises hypoglycaemic action of insulin. Pyridoxine antagonises INH effects. Reduced oral absorption with aaluminium containing antacids; should be given 1hr before the antacid. After control of diabetes. Significantly reduces serum INH concentration.
Synergistic activity with clarithromycin. Blood levels lowered by phenobarb and phenytoin. Increase in blood levels with probenecid. Decreases effects of tolbutamide, clofibrate, coumarin anticoagulants, diazepam and oral contraceptives.
Reduces levels of metoprolol, norethisterone, quinidine. Rifampicin and INH reduces Vit D blood levels.
Reduced efficacy of corticosteroids in Addison's disease and induces an Addisonian crisis. Increases effect of toxicity with alcohol.

Dosage

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Food(before/after)

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Rifampicin + Isoniazid + Pyrazinamide and Lactation

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Rifampicin + Isoniazid + Pyrazinamide and Children

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Rifampicin + Isoniazid + Pyrazinamide and Geriatic

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Rifampicin + Isoniazid + Pyrazinamide and Other Contraindications

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Storage

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Lab interference

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