Ethambutol+Isoniazid+Pyrazinamide+Rifampicin

Uses	Tuberculosis (TB)
Therapy	Anti-Tubercular
Side Effects	Nausea, Vomiting, Rash, Fever, Dark-coloured urine, Sweating, Increased sputum production, Salivation, Watery eyes, Peripheral neuropathy (tingling and numbness of feet and hands), Increased liver enzymes, Jaundice, Increased uric acid level in blood, Visual impairment

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Molecule Description

Ethambutol+Isoniazid+Pyrazinamide+Rifampicin helps in treating tuberculosis. It prevents the growth of tuberculosis causing bacteria. Tuberculosis is a disease that mainly affects the lungs but can affect other parts of the body as well, such as the kidneys, brain, spinal cord and bone marrow.

Uses

As per CDSCO, the medicine has usage in Tuberculosis (TB).

Contraindications

When should one not use Ethambutol+Isoniazid+Pyrazinamide+Rifampicin

If you have colitis - inflammation in the lining of the colon

Side effects

Common side effects of this drug are:

Nausea
Vomiting
Rash
Fever
Dark-coloured urine
Sweating
Increased sputum production
Salivation
Watery eyes
Peripheral neuropathy - tingling and numbness of feet and hand
Increased liver enzymes
Jaundice
Increased uric acid level in blood
Visual impairment

Precautions and Warnings

Pregnancy

Ethambutol+Isoniazid+Pyrazinamide+Rifampicin is not recommended during pregnancy as there is limited or no data from its use in pregnant women. Studies on animals, which look at reproductive toxicity, are insufficient. Pregnant women must seek medical advice before consuming this medicine.

Breast Feeding

It is not recommended to take Ethambutol+Isoniazid+Pyrazinamide+Rifampicin while you are breastfeeding as there is no sufficient data about it. Hence, you should always consult your doctor before you take Ethambutol+Isoniazid+Pyrazinamide+Rifampicin, as a small amount of the medicine passes through the milk to the infant.

Driving

It is not apparent that Ethambutol+Isoniazid+Pyrazinamide+Rifampicin would adversely affect the ability to drive or operate machinery. If you experience any drowsiness or dizziness during your course of treatment, you should not handle any machinery and be cautious.

Alcohol

It is not safe to consume alcohol with Ethambutol+Isoniazid+Pyrazinamide+Rifampicin as it causes some adverse effects like increased heartbeat, fainting and heartburn.

Other General Warnings

Talk to your doctor if

You experience any side effects.
Ethambutol+Isoniazid+Pyrazinamide+Rifampicin is not meant to be used in children below 12 years of age.
If you suffer from liver disease or kidney disease, then consult your doctor before taking Ethambutol+Isoniazid+Pyrazinamide+Rifampicin.

Mode of Action

How Does It Work?

Ethambutol+Isoniazid+Pyrazinamide+Rifampicin is composed of four anti-tuberculosis medications, namely rifampicin, isoniazid, pyrazinamide and ethambutol. Isoniazid prevents the Mycobacterium tuberculosis from forming a protective covering and rifampicin inactivates the bacterial enzyme responsible for the reproduction of essential proteins. Ethambutol and pyrazinamide together slow the growth of the bacteria. All these medicines work in combination to eliminate the infection and kill the bacteria.

Interactions

Interactions with other medicines

Antibiotic - erythromycin
Painkiller - acetaminophen
Anti-diabetic - insulin isophane
Anti-HIV - saquinavir, ritonavir
Proton pump inhibitor - omeprazole

Interactions with food items

Avoid foods and drinks that contain histamine or tyramine, such as cured meat, matured cheese, soya, tuna, salmon, mackerel, wine and beer.

Dosage

Overdose

Symptoms of an overdose include drowsiness, confusion, problems with coordination and loss of consciousness. In case of an overdose, medical help should be sought as soon as possible.

Missed a Dose

If you have missed your dose of Ethambutol+Isoniazid+Pyrazinamide+Rifampicin, take it as soon as you remember. If it is time for the next dose, do not take the missed dose as it will lead to a double dose.

Frequently Asked Questions (FAQs)

Take the medication as directed by your doctor. Do not stop taking Ethambutol+Isoniazid+Pyrazinamide+Rifampicin even if you feel better. Your infection might worsen, become harder to manage and you might develop medicine-resistant tuberculosis if you stop taking Ethambutol+Isoniazid+Pyrazinamide+Rifampicin.

When taking Ethambutol+Isoniazid+Pyrazinamide+Rifampicin test results for some tests such as folate, vitamin B12 and liver functions may be affected. Inform the person conducting your test that you are on Ethambutol+Isoniazid+Pyrazinamide+Rifampicin.

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