Rifampicin+Ethambutol+Pyrazinamide+Vitamin B6 / Pyridoxine+Isoniazid

Uses	Tuberculosis
Therapy	Antitubercular
Side Effects	Dizziness, stomach upset, drowsiness, itching, fever, jaundice, loss of appetite, salivation, excess sputum, blurred vision, joint swelling, joint pain, severe abdominal pain, increased liver enzymes, nausea, vomiting, change in colour of urine, weight loss, bleeding or bruising.

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Molecule Description

Rifampicin+Ethambutol+Pyrazinamide+Vitamin B6 / Pyridoxine+Isoniazid aids in treating and preventing tuberculosis (TB). It consists of five active ingredients: Isoniazid, rifampicin, pyrazinamide, ethambutol, and pyridoxine. All of them, except pyridoxine, are anti-tuberculosis (anti-TB) medicines. The mode of action of Rifampicin+Ethambutol+Pyrazinamide+Vitamin B6 / Pyridoxine+Isoniazid is to kill the bacteria, and each active ingredient does it differently.

Uses

As per CDSCO, Rifampicin+Ethambutol+Pyrazinamide+Vitamin B6 / Pyridoxine+Isoniazid is used to treat pulmonary tuberculosis (infection of the lungs).

Contraindications

When should one not use Rifampicin+Ethambutol+Pyrazinamide+Vitamin B6 / Pyridoxine+Isoniazid

If you have any known allergy to any of the components of Rifampicin+Ethambutol+Pyrazinamide+Vitamin B6 / Pyridoxine+Isoniazid
If you are diagnosed with any vision disorders like optic neuritis, this medicine can worsen the condition
If you have severe liver disease or drink alcohol regularly, this medicine can cause severe liver damage
If you have acute liver illness
If you have been diagnosed with gout due to high uric acid levels in the body

Side effects

Common side effects of this drug are:

Joint pains
Blurred or loss of vision
Nausea or vomiting
Change in the color of urine
Weight loss
Bleeding or bruising
Yellowing of eyes and skin (jaundice)

Precautions and Warnings

Pregnancy

Yes. If you are diagnosed with TB infection while you are pregnant, take Rifampicin+Ethambutol+Pyrazinamide+Vitamin B6 / Pyridoxine+Isoniazid in the precise way advised by the doctor. It is usual to have concerns about the unborn child's health, but not taking anti-TB medicines can cause further more severe infection and even death. Rifampicin+Ethambutol+Pyrazinamide+Vitamin B6 / Pyridoxine+Isoniazid medicine may reach the baby, but studies have not shown any development problems.

Breast Feeding

It is important to breastfeed the baby, even if you are taking Rifampicin+Ethambutol+Pyrazinamide+Vitamin B6 / Pyridoxine+Isoniazid or any other anti-tuberculosis medications. A small amount of Rifampicin+Ethambutol+Pyrazinamide+Vitamin B6 / Pyridoxine+Isoniazid medicine may pass into the breast milk, but the amount is too little to cause any harm. Please consult your doctor to know more.

Driving

No, Rifampicin+Ethambutol+Pyrazinamide+Vitamin B6 / Pyridoxine+Isoniazid may cause side effects that can be dangerous while driving, such as dizziness or blurred vision. If you notice having any such effects, do not drive.

Alcohol

No, do not consume alcohol with Rifampicin+Ethambutol+Pyrazinamide+Vitamin B6 / Pyridoxine+Isoniazid. It can increase the side effects and cause dizziness and drowsiness, affecting your ability to drive. It will also increase the risk of hepatitis (liver inflammation).

Other General Warnings

Talk to your doctor if

You persistently have any of the side effects.
You have already used Rifampicin+Ethambutol+Pyrazinamide+Vitamin B6 / Pyridoxine+Isoniazid before to treat tuberculosis; inform your doctor
You have stopped using Rifampicin+Ethambutol+Pyrazinamide+Vitamin B6 / Pyridoxine+Isoniazid in the middle of the course. In such cases, the TB infection can return with increased severity and resistance to antibiotics, and it will become harder to treat the infection
You are on oral contraceptive pills, use other contraceptive methods like condoms, diaphragm, etc.
You have a disorder known as peripheral neuropathy. Even though Rifampicin+Ethambutol+Pyrazinamide+Vitamin B6 / Pyridoxine+Isoniazid has added vitamin B6, this medicine should be used with caution

Mode of Action

How Does It Work?

Rifampicin+Ethambutol+Pyrazinamide+Vitamin B6 / Pyridoxine+Isoniazid has a combination of five active ingredients: Isoniazid, rifampicin, pyrazinamide, ethambutol, and pyridoxine.

Interactions

Interactions with other medicines

If you are taking oral contraceptives, blood thinners (warfarin), certain diabetic medicines(sulfonylureas), and methadone, Rifampicin+Ethambutol+Pyrazinamide+Vitamin B6 / Pyridoxine+Isoniazid can decrease the level and effectiveness of these medications in the blood
If you are using phenytoin (anti-seizure medicines) or disulfiram (treatment for alcohol abuse), Rifampicin+Ethambutol+Pyrazinamide+Vitamin B6 / Pyridoxine+Isoniazid will raise the level of these medicines in the blood and cause adverse effects
Consult your doctor before using medicines such as blood thinners or Antiplatelets (medicines that increase bleeding), as Rifampicin+Ethambutol+Pyrazinamide+Vitamin B6 / Pyridoxine+Isoniazid can increase the risk of unusual bleeding
Rifampicin+Ethambutol+Pyrazinamide+Vitamin B6 / Pyridoxine+Isoniazid can also react with other medicines like antacids, heart medication, etc
Rifampicin, an ingredient of Rifampicin+Ethambutol+Pyrazinamide+Vitamin B6 / Pyridoxine+Isoniazid, is contraindicated in HIV-positive patients who use antivirals like protease inhibitors

Dosage

Overdose

Overdose of Rifampicin+Ethambutol+Pyrazinamide+Vitamin B6 / Pyridoxine+Isoniazid causes symptoms like nausea, vomiting, stomach pain, irritation, slurred speech, low heart rate, rash, joint pain and tenderness, liver problems (yellowing of skin and eyes), retention of urine, lack of consciousness, and dark-colored skin, urine, saliva, and stools. If you have Rifampicin+Ethambutol+Pyrazinamide+Vitamin B6 / Pyridoxine+Isoniazid's overdose symptoms, contact your doctor and seek medical treatment at a hospital close to you.

Missed a Dose

It is essential not to miss Rifampicin+Ethambutol+Pyrazinamide+Vitamin B6 / Pyridoxine+Isoniazid dose. If you missed it and it is the same day, take the missed dose. If you recall missing a dose the next day, skip the missed dose and continue the treatment from that day. Do not take both doses of this medicine on the same day. Inform your doctor immediately if you missed a few doses consecutively.

Frequently Asked Questions (FAQs)

Yes. This color change of the tears is normal due to rifampicin, a component of this medicine. It is not harmful. However, it is not advisable to wear contact lenses while on Rifampicin+Ethambutol+Pyrazinamide+Vitamin B6 / Pyridoxine+Isoniazid as the color of the lens can be permanently changed. Rifampicin+Ethambutol+Pyrazinamide+Vitamin B6 / Pyridoxine+Isoniazid can also change the color of your eyes, urine, saliva, etc., to orange. But, it is not permanent.

Rifampicin+Ethambutol+Pyrazinamide+Vitamin B6 / Pyridoxine+Isoniazid should be consumed one to two hours before eating the food. Take it on an empty stomach, as food decreases its absorption. If you are experiencing severe stomach problems due to this medicine, you can take it with food. Please consult your doctor.

No, it is not recommended to use both of them simultaneously. Do not take antacids within two hours of taking Rifampicin+Ethambutol+Pyrazinamide+Vitamin B6 / Pyridoxine+Isoniazid. Consult your doctor if you are feeling persistent stomach upset and have other stomach problems.

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References:

Isoniazid: Medlineplus drug information [Internet]. MedlinePlus. U.S. National Library of Medicine; [cited 2026 Jun 15]. Available from:

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