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Generic

Isoniazid + Pyrazinamide + Rifampicin

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At a glance

Isoniazid + Pyrazinamide + Rifampicin combination is used in the treatment of tuberculosis (TB).

Description

Isoniazid + Pyrazinamide + Rifampicin is a combination of three antitubercular drugs. Isoniazid prevents the TB bacteria from forming their own protective covering, Rifampicin inactivates a bacterial enzyme (RNA-polymerase) required by bacteria to make essential proteins and reproduce, and Pyrazinamide slows the growth of these bacteria. Together, they kill the bacteria and eradicate the infection.

Indications
  • Tuberculosis (TB)
Therapeutic class

Anti-tubercular antibiotics

Pharmacological class

Antimycobacterial (Combination)

Pharmacology

Isoniazid prevents TB bacteria from forming their own protective covering. Rifampicin inactivates bacterial enzyme (RNA-polymerase) which is required by bacteria to make essential proteins and to reproduce. Pyrazinamide slows the growth of these bacteria. Together, they kill the bacteria and eradicate the infection.

Mechanism of action

Isoniazid prevents bacterial protective covering formation; Rifampicin inactivates RNA-polymerase; Pyrazinamide slows bacterial growth.

Dosage

Adult Dose (Oral):

  • Take as part of TB treatment regimen as prescribed
  • Take on empty stomach

Child Dose: Dose determined by physician based on weight

Administration

Take on empty stomach; swallow whole; do not chew, crush or break; take at the same time every day; avoid tyramine-rich foods (cheese, smoked fish, meats, some beers).

Missed dose

If you miss a dose, take it as soon as possible; if it is almost time for your next dose, skip the missed dose and go back to regular schedule; do not double the dose.

Side effects

Common Side Effects:

  • Nausea
  • Vomiting
  • Fever
  • Rash
  • Dark colored urine
  • Sweating
  • Increased salivation
  • Peripheral neuropathy (tingling and numbness of feet and hand)
  • Increased liver enzymes
  • Jaundice
  • Increased uric acid level in blood
  • Gout
Precautions & warnings

Precautions:

  • Isoniazid + Pyrazinamide + Rifampicin may affect your ability to drive (dizziness, vision problems)
  • Regular monitoring of liver function tests advised
  • Avoid alcohol (may cause disulfiram reaction)
  • Caution in kidney and liver disease
  • Caution in pregnancy and lactation
Contraindications

Contraindications:

  • Hypersensitivity to any components
  • Acute liver disease
Drug interactions

Drug Interactions:

  • Rifampicin reduces effectiveness of hormonal contraceptives
  • Reduced absorption with antacids
  • Interactions with anticoagulants, anticonvulsants, corticosteroids, digoxin, oral hypoglycemic agents
Food interactions

Food Interactions: Consuming alcohol while taking this medicine may cause flushing, increased heart beat, nausea, thirst, chest pain and low blood pressure (Disulfiram reaction); avoid tyramine-rich foods.

Use in pregnancy

Use in Pregnancy: May be unsafe; animal studies have shown harmful effects; doctor will weigh benefits and risks.

Pregnancy Category: C — always consult a doctor before taking during pregnancy.

Use in lactation

Use in Lactation: Probably safe; limited human data suggests drug does not represent significant risk to baby.

Pediatric use

Pediatric dose determined by physician based on weight.

Geriatric use

No specific data for elderly; however caution advised.

Renal / hepatic impairment

Renal Impairment: Caution in kidney disease; dose adjustment may be needed.

Hepatic Impairment: Caution in liver disease; dose adjustment may be needed; regular monitoring of liver function tests advised.

Overdose effects

Overdose: Nausea, vomiting, abdominal pain, dizziness, confusion, liver toxicity; seek emergency medical attention; gastric lavage and activated charcoal; symptomatic treatment.

Storage conditions

Keep below 30°C temperature, away from light & moisture; keep out of reach of children.

Chemical structure

Isoniazid + Pyrazinamide + Rifampicin

Common questions

What is this medicine used for?
It is used for the treatment of tuberculosis (TB).
How to take it?
Take on empty stomach, swallow whole; follow the prescribed dose.
What are the side effects?
Nausea, vomiting, dark urine, increased liver enzymes, jaundice.
⚠️ This information is for educational purposes only — not a substitute for medical advice. Consult a registered physician before taking any medicine.