RIMCURE
RIFAMPICIN, ISONIAZID AND PYRAZINAMIDE · by NOVARTIS
Composition
Tab 120/75/400 mg: Rifampicin 120 mg, isoniazid (INH) 75 mg, pyrazinamide (PZA) 400 mg. Tab 120/80/250 mg: Rifampicin 120 mg, isoniazid 80 mg, pyrazinamide 250 mg. Tab 150/150/500 mg: Rifampicin 150 mg, isoniazid 150 mg, pyrazinamide 500 mg
Indications & Dosage
Initial treatment of tuberculosis: Adult (body-weight 30-39 kg): 2 tabs daily for 2 months (initial phase); (body-weight 40-54 kg): 3 tabs daily for 2 months (initial phase); (body-weight 55-69 kg): 4 tablets daily for 2 months (initial phase); (body-weight 70 kg and above): 5 tabs daily for 2 months (initial phase); doses to be taken one or two hr before a meal. Children: 1 tab/15 kg body-weight daily for 2 months (initial phase); doses to be taken one or two hr before a meal.
Contraindications
Liver disease, previous hypersensitivity to any rifamycin, patients with previous isoniazid associated hepatic injury or other severe adverse reactions with isoniazid.
Precautions
Patients with active chronic liver disease or severe renal dysfunction. Isoniazid crosses the placental barrier and passes into maternal breast milk, observe neonates, breast fed infants of isoniazid treated mothers for any evidence of adverse effects. Not recommended for intermittent therapy, caution patients against intentional or accidental interruption of daily dosage regimen, since rare renal hypersensitivity reactions have been reported when therapy is resumed. Urine, faeces, saliva, sputum, sweat and tears may be coloured red orange. Perform frequently liver function tests and blood uric acid determinations, history of gout or diabetes. Withdraw treatment if liver damage or hyperuricaemia accompanied by acute gouty arthritis occurs.
Interactions
The effectiveness of isoniazid may be decreased when administered with corticosteroid. The effects of benzodiazepines may be increased. The hepatic toxicity of both isoniazid and/or rifampicin may be increased when administered concomitantly. Rifampicin induces hepatic microsomal enzymes that metabolize a wide variety of drugs e.g. metoprolol, propranolol, quinidine, corticosteroids, contra-ceptives, oral anticoagulants, oral sulfonylureas probenecid, sulfinpyrazone, oral typhoid vaccine.
Pregnancy
Caution advised, use only if potential benefit outweighs risk
Lactation
Caution advised
Side Effects
Anaphylactoid reactions, heartburn, epigastric dis-tress, anorexia, nausea, vomiting, diarrhoea, sore mouth, rash, pruritus, urticaria, eosinophilia, thrombocytopenia, muscular weakness, pain in extremities, visual disturbances, haemoglobinuria, hematuria, menstrual disturbances, peripheral neuropathy, elevated SOOT, SGPT, SGOPT, hepatitis which can be minimized by dose adjustment