Rifampicin + isoniazid + pyrazinamide - oral

Patient Medicine Information
Why do I need this medicine?
Rifampicin, Isoniazid and Pyrazinamide are combined in this medicine.

Rifampicin + Isoniazid + Pyrazinamide is an antibiotic. It is used to treat a lung infection known as tuberculosis (TB).
How do I take this medicine?
Take Rifampicin + Isoniazid + Pyrazinamide exactly as directed by your doctor or according to the instructions on the label. Do not take more or less than instructed by your doctor.

Take it on an empty stomach, at least 1 hour before or 2 hours after a meal. Try to take it at the same time each day.

Swallow the tablets whole with a glass of water.

Take Rifampicin + Isoniazid + Pyrazinamide at regular intervals. Do not skip any doses. You must complete the entire course of this medicine. If you don't, the infection will not be properly controlled.
What should I do if I have forgotten to take this medicine?
Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.

DO NOT double a dose under any circumstances.

If you often forget to take your medicine, let your doctor and pharmacist know.
When should I not use this medicine?
Do not take this medicine if you ever had an allergic reaction (e.g. rashes, breathlessness, swollen eyes) to Rifampicin, Isoniazid, and Pyrazinamide or similar medicines to Rifampicin, such as rifabutin.

Alert your doctor if you have the following conditions:
  • jaundice (yellowing of the skin and whites of the eyes with stomach pain, persistent tiredness, nausea or vomiting)
  • severe liver disease
  • acute gout (pain or swelling in the joints due to high uric acid level in the blood)
as this medicine may not be suitable for you.

Do not take Rifampicin + Isoniazid + Pyrazinamide with medicines for HIV infection, such as atazanavir, darunavir, fosamprenavir, saquinavir, saquinavir/ritonavir, or tipranavir, and praziquantel (medicine to treat parasitic or worm infection) unless instructed by your doctor.
What should I take note of while taking this medicine?
Inform your doctor if you have the following conditions:
  • diabetes
  • kidney disease
  • persistent or long-standing gout
  • epilepsy (fits or seizures)
  • mental illness
  • coughing up of blood
  • poor nutritional status e.g. malnourished, underweight
  • porphyria (an inherited disorder that causes skin or nervous system abnormalities)
  • neuropathy (nerve damage that causes tingling, numbness, and pain)
  • mild to moderate liver disease
Let your doctor know if you are pregnant or breastfeeding.

Notify your doctor if you consume large amounts of alcohol or if you are a frequent drinker.

Do not wear contact lenses during treatment as this medicine may permanently stain the contact lenses.

If you are going to have certain laboratory tests (e.g. urine or blood tests), inform your doctor that you are taking Rifampicin + Isoniazid + Pyrazinamide.

Individuals who are known as slow acetylators or inactivators of this medicine may experience enhanced side effects. If you know you have this gene type, inform your doctor.

Why is it important to keep my appointments with the doctor?

Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.
  • Routine tests (e.g. liver and kidney function, complete blood count, chest X-ray, eye examination) may be done before and during your treatment with this medicine. Your doctor will advise you about how often you will need to have these tests.
  • Regular monitoring for signs and symptoms of liver problems and skin reactions may also be needed.
What must I do to prevent spreading TB to other people?

TB is spread through the air, especially when you cough, sneeze or laugh. Always cover your mouth when you cough, sneeze or laugh. If you use tissue paper, seal it in a plastic bag before you throw it away. If you need to be around people for a long time, be sure to wear a mask that covers your mouth and nose to minimise the risk of passing the disease to other people.

You may still be able to infect others while undergoing treatment for TB. Your doctor may tell you to stay at home to avoid passing the disease to other people. You may need to sleep in a bedroom separate from your family members.

Be sure to finish the course of medication according to your doctor's instructions.
What side effects could I experience?
Rifampicin + Isoniazid + Pyrazinamide may cause dizziness with sensations of spinning and some problems with your eyesight. If affected, do not drive or take part in any activity in which you need to be alert or need to see clearly.

Your urine and faeces may look slightly yellow, orange, red or brown in colour. This is normal while you are being treated with this medicine. It may also cause discolouration of your saliva, teeth, tears, and sweat. This is harmless, do not be alarmed.

Other side effects include any of the following: headache, cough, nausea, vomiting, diarrhoea, stomach discomfort, loss of appetite, joint and muscle pain, gout, and difficulty sleeping.

Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:
  • rashes, breathlessness, swelling of the face, eyes, lips, tongue or throat
  • yellowing of the skin or eyes, abdominal pain, dark coloured urine, swelling in the legs and ankles
  • severe watery diarrhoea accompanied by weakness and fever
  • flu-like symptoms e.g. fever, chills, general feeling of discomfort or illness
  • rashes with peeling of the skin or blistering of the lips, mouth or eyes accompanied by fever
This medicine may cause the level of your red blood cells, white blood cells and platelets to drop.

Red blood cells carry oxygen around your body. A fall in the level of red blood cells may make you feel tired and worn out.

White blood cells help your body to fight infections. A fall in the level of your white blood cells may put you at higher risk for infections, such as coughs, colds and flu, which may lead to more serious infections. Avoid crowded places and people who are sick. Inform your doctor if you have a fever or a cough or flu that does not go away.

Platelets help your blood to clot when there is a cut in the skin. A fall in the level of your platelets may put you at risk of bleeding more than usual. Do not take part in activities where you may fall or get injured, such as contact sports. Inform your doctor if you get any unusual bruising (large bruises or several bruises, especially if the bruises appeared on their own) or bleeding that takes a long time to stop (for example, too much bleeding when you floss or brush your teeth).

Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Can I take this with other medicines?
Do not take Rifampicin + Isoniazid + Pyrazinamide with medicines for HIV infection, such as atazanavir, darunavir, fosamprenavir, saquinavir, saquinavir/ritonavir, or tipranavir, and praziquantel (medicine to treat parasitic or worm infection) unless instructed by your doctor.

Inform your doctor and pharmacist if you are taking or using any of these medicines:
  • medicines for epilepsy (fits or seizures) e.g. phenytoin, carbamazepine, valproic acid
  • medicines to treat fungal infection e.g. itraconazole, ketoconazole, fluconazole
  • medicines for mood disorders e.g. haloperidol, aripiprazole, clozapine
  • medicines to treat depression e.g. amitriptyline, nortriptyline
  • medicines for cancer e.g. tamoxifen, irinotecan, imatinib
  • medicines for irregular heartbeat e.g. disopyramide, quinidine, propafenone, mexiletine
  • medicines for high blood pressure e.g. enalapril, bisoprolol, diltiazem, nifedipine
  • medicines for gout (high uric acid level in the blood) e.g. sulfinpyrazone, probenecid
  • medicines used in organ transplant or certain immune disorders e.g. ciclosporin, tacrolimus
  • medicines for diabetes e.g. glipizide, rosiglitazone
  • warfarin (blood-thinning medicine)
  • theophylline (medicine for asthma)
This list does not include all medicines that may interact with Rifampicin + Isoniazid + Pyrazinamide.

This medicine should not be taken with antacids as antacids could reduce the absorption of Rifampicin + Isoniazid + Pyrazinamide. If you must take antacids, take it at least 1 hour after you have taken this medicine.

Alert your doctor if you are taking birth control pills or other types of hormonal birth control. You may need to consider alternative non-hormonal birth control measures.

Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements and medicines that you buy without a prescription.
What special dietary instructions should I follow?
Avoid alcohol and other drinks that contain tyramine such as red wine and beer.

Avoid foods that are rich in tyramine, such as cheese, sausages, soya beans, fava beans, broad beans, and pickled foods like sauerkraut. Ask your doctor or dietitian about the types of food you should avoid.
How should I store this medicine?
Store in a cool, dry place away from the reach of children. Protect from excessive humidity.

Medicines must not be used past the expiry date.
This information is independently developed by MIMS based on rifampicin + isoniazid + pyrazinamide - oral and is provided for your reference only. It is not a replacement for and should only be used in conjunction with full consultation with a licensed healthcare professional, the information provided by your pharmacist and/or the manufacturer of the medication. It may not contain all the available information you require and cannot substitute professional medical care, nor does it take into account all individual circumstances. Although great effort has been made to ensure content accuracy, we shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2022 MIMS. All rights reserved. Powered by MIMS.com
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