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1

SALT INFORMATION

Ethambutol(800mg)

TYPICAL USAGE

Ethambutol is used in the prevention, treatment and recurrence (second time treatment) of tuberculosis (a serious infection caused by bacteria that affects the lungs and in certain cases other parts of the body). It is always given in combination with other antituberculosis drugs. 

SIDE EFFECTS

* Uncommon: Optic neuritis (inflammation of nerve fibers that transmit visual information from your eye to the brain) symptoms include decreased clearness of vision, loss of vision, scotoma (disturbed vision due to blind spots), color blindness, visual disturbance, visual field defect, eye pain; high blood levels of uric acid (hyperuricemia) * Rare: Peripheral neuropathy (weakness, numbness and pain in hands and feet due to nerve damage), numbness, paresthesia of the extremities (tingling, numbness, pricking, burning sensation in hands and feet);rash, itching of skin (pruritus), pale red raised itchy skin rashes (urticaria),  * The following side effects have been noted in patients receiving multi drug (including ethambutol) treatment for tuberculosis: Loss of appetite (anorexia), urge to vomit (nausea), vomiting, abdominal pain and diarrhea, inflammation of liver (hepatitis), abnormal liver function causing yellowing of skin and eyes (jaundice), abnormal liver function tests (blood tests to assess health of liver) and very rarely liver failure. 

DRUG INTERACTION

* Aluminum hydroxide containing antacids may interact with ethambutol; therefore there should be a gap of at least 4 hours following ethambutol administration. * Please inform your doctor about all the medications, herbal and dietary supplements you are currently taking to avoid interactions that may reduce effectiveness of any treatment or aggravate side effects. * Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.

MECHANISM OF ACTION

Ethambutol belongs to a class of anti-tuberculosis drugs. It suppresses the growth of tuberculosis causing bacteria (Mycobacterium tuberculosis). Ethambutol enters the growing bacteria and kills the bacteria by inhibiting an important enzyme arabinosyl tranferases involved in the formation of the outer protective covering of the bacteria called cell wall.

DOSAGE

* Always follow the instructions of doctor regarding the dosage and duration * Adult                      -Given in combination with other antituberculosis drugs                      -Prevention and treatment of tuberculosis: 15 mg/kg body weight as a single                                dose                       -Second time treatment: 25 mg/kg body weight as a single dose for 2 months;                              thereafter dose reduced to 15 mg/kg bodyweight  * Children: Same as for adult. Not recommended for use in children aged below 3 years * Elderly: Same as adults, however, dose adjustments may be needed in elderly with kidney problems

DOs and DON'Ts

* Do consult your doctor before taking ethambutol if you have any eye problems such as cataracts (disturbed vision due to clouding of eye lenses) , recurrent inflammatory conditions of the eye, optic neuritis (inflammation of nerve fibers that transmit visual information from your eye to the brain), and diabetic retinopathy (a complication of eye due to diabetes). Ethambutol can cause serious eye damage. Regular eye checkups are recommended while on treatment with ethambutol. * Do consult your doctor before taking ethambutol,                        -If you have kidney problems                        -If you have liver problems                        -If you have gout (pain, swelling, redness and stiffness in joints due to                                          accumulation of uric acid) * Ethambutol is not recommended for use in children aged below 3 years. * Do consult your doctor before taking ethambutol if you are pregnant or planning to become pregnant. * Do consult your doctor before taking ethambutol if you are breastfeeding. * Do not stop taking ethambutol without consulting your doctor. * If you forget to take a dose of ethambutol, take it as soon as you remember. Do not double the dose to make up for the missed dose.

CONTRA INDICATIONS

* Patients who are allergic to ethambutol or any other ingredient in the medicine. * Patients who have optic neuritis (inflammation of nerve fibers that transmit visual information from your eye to the brain).  * Children below 5 years of age, who cannot report visual disturbances. * Patients who have severe kidney problems

FAQ

Q.Does ethambutol cause blindness?Optic neuritis (inflammation of nerve fibers that transmit visual information from your eye to the brain) is one of the side effects of ethambutol which causes several forms of eye defect. Although these conditions are reversible upon discontinuation of the drug, rare cases of irreversible blindness have also been reported. Please contact your doctor immediately if you notice any of these symptoms: decreased clearness of vision, loss of vision, disturbed vision due to blind spots, color blindness, visual field defect and eye pain.Q.Does ethambutol induce hyperuricemia/how does ethambutol induce hyperuricemia?Yes. Increase in blood levels of uric acid is a side effect of ethambutol. It increases the retention of uric acid in the body by decreasing the excretion of urates (uric acid) by the kidneys. Q.How does ethambutol work in the body?Ethambutol is an antibiotic effective against tuberculosis causing bacteria. It suppresses the growth of the bacteria by interfering with the formation of the outer protective covering (cell wall) of the bacteria, thereby weakening the bacteria.Q.What is ethambutol toxicity/How does ethambutol cause optic neuritis/how does ethambutol affect vision?Ethambutol toxicity involves toxic effects on the eyes (optic neuritis/optic neuropathy) which are related to the dose and duration of ethambutol treatment. It causes optic neuritis (inflammation of nerve fibers in the eye) by interfering with important cellular activities (mitochondrial toxicity) in the nerve cells and inducing nerve damage (neuropathy) thereby affecting the transmission of visual information from the eye to brain. The symptoms of ethambutol induced optic neuritis include: decreased clearness of vision, loss of vision, disturbed vision due to blind spots, color blindness, visual field defect and eye pain.Q.What does ethambutol treat?Ethambutol is an antibiotic effective against tuberculosis causing bacteria. It is used in the prevention, treatment and second time treatment of tuberculosis (a serious infection caused by bacteria that affects the lungs and in certain cases other parts of the body).Q.Is ethambutol bacteriostatic or bactericidal?Ethambutol is both a bacteriostatic and a bactericidal antibiotic. It suppresses the growth of bacteria (bacteriostatic) by interfering with the formation of the outer protective covering (cell wall) of the bacteria, thereby weakening it and causing cell death in certain cases (bactericidal).Q.Is ethambutol safe in pregnancy?There are no adequate studies on ethambutol in pregnant women. There are few reports of eye problems in infants born to mothers on multi drug therapy for tuberculosis during pregnancy. Ethambutol should be used during pregnancy only if the potential benefit outweighs the potential risk to the fetus. Please follow the advice of the doctor regarding its use.Q.Is ethambutol hepatotoxic?Liver toxicities are among the known side effects of ethambutol. Inflammation of liver (hepatitis), abnormal liver function causing yellowing of skin and eyes (jaundice), abnormal liver function tests (blood tests to assess health of liver) and very rarely liver failure have been noted in patients receiving multi drug  (including ethambutol) treatment for tuberculosis. Please contact your doctor before taking ethambutol if you have any liver problems.Q.Is ethambutol toxicity reversible?In most cases ethambutol toxicities are related to dose (depends upon the quantity of ethambutol you take) and duration of treatment and are reversible upon discontinuation. However, serious irreversible damage to eye and liver has been reported in rare cases.Q.Is ethambutol chemotherapy?Ethambutol is an antibiotic used in the treatment of tuberculosis. Do not confuse it with chemotherapy or chemo drugs used for the treatment of cancer.Q.Ethambutol is effective against?Ethambutol is effective against most tuberculosis causing bacteria belonging to Mycobacterium family (M. tuberculosis, M. avium complex, M. kansasii, M. marinum).

FURTHER INFORMATION

1.Prescribing information. http://www.accessdata.fda.gov/drugsatfda_docs/label/2003/16320slr057_Myambutol_lbl.pdf 2.Summary of product characteristics. http://www.medicines.org.uk/emc/medicine/287023.Patient information leaflet, http://www.medicines.org.uk/emc/PIL.28924.latest.pdf 4.http://www.nlm.nih.gov/medlineplus/druginfo/meds/a682550.html5.http://www.drugs.com/mtm/ethambutol.html

Isoniazid(300mg)

TYPICAL USAGE

Isoniazid is used in the prevention and treatment of tuberculosis (TB -a serious infection caused by bacteria that affects the lungs and in certain cases other parts of the body). It is always given in combination with other antituberculosis drugs. 

SIDE EFFECTS

* Peripheral neuropathy (weakness, numbness and pain in hands and feet due to nerve damage); other neurotoxic effects include – fits (convulsions), abnormal brain function due to drug toxicity (toxic encephalopathy), optic neuritis (inflammation of nerve fibers that transmit visual information from your eye to the brain), memory problems, toxic psychosis (abnormal mental condition in which a person gets thoughts that are not real) * Severe and sometimes fatal inflammation of liver (hepatitis) may occur during and in some cases after many months of treatment. The symptoms include- loss of appetite (anorexia), urge to vomit (nausea), vomiting, unusual tiredness (fatigue), feeling of discomfort (malaise), and weakness.  * Eosinophilia (abnormal increase in a type of white blood cell called eosinophil), agranulocytosis (abnormal decrease in white blood cell count) , thrombocytopenia (abnormally low blood platelet count) and anemia (low hemoglobin or red blood cells), aplastic anemia (a rare form of anemia in which the bone marrow does not make enough red blood cells), hemolytic anemia (abnormally low hemoglobin due to breakdown of red blood cells) * Systemic lupus erythematosus -like syndrome (a disease in which your body’s immune system attacks your tissues and organs causing inflammation that affects your joints, skin and other major organs) and rheumatic syndrome (inflammatory disorder that typically affects joints) * Severe skin reactions (rash, acne, Stevens-Johnson syndrome, exfoliative dermatitis, pemphigus) * Inflammation of pancreas (pancreatitis), difficulty passing stool (constipation), dry mouth, urge to vomit (nausea), vomiting, discomfort in the upper part of abdomen below the ribs (epigastric distress) * High blood sugar levels (hyperglycemia), development of breasts in men (gynecomastia) and anti-nuclear antibodies and pellagra (deficiency of a B-complex vitamin, niacin) have also been reported with isoniazid therapy.

DRUG INTERACTION

* Antiepileptic drugs (e.g. carbamazepine, phenytoin, pimidone, valproicacid), benzodiazepines (diazepam), haloperidol, ketoconazole, theophylline,warfarin, para-aminosalicylic acid may increase blood levels of these drugs * Stavudine increases risk of nerve relateddisorder (distal sensory neuropathy) * Use with anti-HIV drug zalcitabine doubles the elimination of isoniazidfrom the body thereby drastically decreasing blood levels of isoniazid * Prednisone may drastically decrease blood levels of isoniazid byincreasing its elimination from the body * Always consult your physician forthe change of dose regimen or an alternative drug of choice that may strictlybe required.

MECHANISM OF ACTION

Isoniazid belongs to a class of antituberculosis drugs. It suppresses the growth of tuberculosis causing bacteria (Mycobacterium tuberculosis). It interferes with the formation of the outer protective covering (cell wall) of the bacteria by inhibiting the synthesis of a chemical called mycolic acid an essential component of cell wall.

DOSAGE

Always follow the instructions of doctor regarding the dosage andduration Isoniazid is used as a part of multi-drug regimen containing rifampicin,pyrazinamide, and ethambutolAdult * Active TB: 3 to 5 mg/kg body weight orally once daily (max.dose 300 mg/day) * Latent TB:10-20 mg/kg bodyweight orally once daily (max.dose300 mg/day)Children:  * 10 to 15 mg/kg body weight orally once daily(max. dose 300 mg/day)

DOs and DON'Ts

* Do not take isoniazid if you have severe liver problemsor if you have taken isoniazid in the past and it caused liver problems, fever, chills, joint pain, or severe allergic reaction. * Contact your doctor immediately if you experience symptoms such unusual tiredness (fatigue), weakness, feeling of discomfort (malaise), loss of appetite (anorexia), urge to vomit (nausea) or vomiting while taking isoniazid. It indicates that you are progressing towards liver damage. * Do consult your doctor before taking isoniazid if you are aged above 35 years. The frequency of isoniazid related inflammation of liver (hepatitis) is higher in individuals older than 35 years of age. The doctor may advice measurement of blood levels of enzyme transferases before starting treatment with isoniazid. * Avoid drinking alcohol. It may increase your risk of liver damage while you are taking isoniazid. * Do consult your doctor before taking isoniazid if you are pregnant or planning to become pregnant or are breastfeeding * Isoniazid interacts with many drugs. Please inform your doctor about all the medication you are currently taking to avoid interactions that may reduce effectiveness of any treatment or aggravate side effects. * Do not stop taking isoniazid without consulting your doctor * If you forget to take a dose of Isoniazid, take it as soon as you remember. Do not double the dose to make up for the missed dose.

CONTRA INDICATIONS

* Patients allergic to isoniazid or any other ingredient in the medicine * Patients with a history of severe side effects to isoniazid- fever, chills and inflammatory disorder of joints (arthritis) * Patients having serious liver damage or any active liver disease * Patients having have gout (pain, swelling, redness and stiffness in joints due to accumulation of uric acid).

FAQ

Q. Is isoniazid an antibiotic?Isoniazid is an antibiotic used in the prevention and treatment of tuberculosis or TB (a serious infection caused by bacteria that affects the lungs and in certain cases other parts of the body).Q. Is isoniazid safe in pregnancy? Does isoniazid affect pregnancy?There are no adequate studies of isoniazid in pregnant women. Studies of isoniazid in pregnant in animals have indicated risk to fetus. Isoniazid may be used in pregnant women only if the potential benefit to the mother outweighs the potential risk to fetus. Patients should follow the advice of the doctor regarding its use. Please consult your doctor before taking isoniazid if you are pregnant or planning to become pregnant.Q. Is isoniazid chemotherapy/chemotherapy drug?Isoniazid is a primary antibiotic used for treatment of tuberculosis. Do not confuse it with chemotherapy or chemo drugs used for the treatment of cancer.Q. Is isoniazid bacteriostatic or bactericidal?Isoniazid is a bacteriostatic antibiotic. It stops or suppresses growth of tuberculosis causing bacteria by interfering with the formation of protective outer covering (cell wall) which is essential for their growth.Q. Is isoniazid safe?Yes. Isoniazid is safe if used at prescribed doses for the prescribed duration as advised by your doctor.Q. Is isoniazid a MAOI? Isoniazid has very weak inhibitory activity on enzymes monoamine oxidases (MAO); however it is not used as a monoamine oxidase inhibitor (MAOI).Q. Is isoniazid a sulfa drug?No. The chemical structure and mechanism of action of isoniazid is different from sulfa drugs.Q. Is isoniazid an inducer or inhibitor?Isoniazid is an inhibitor (decreases activity) of an important liver enzyme system that is responsible for the final processing and elimination of several drugs from the body. Q. Can I take isoniazid with food or milk?Taking isoniazid with food is known to delay its absorption (process by which the active drug reaches the affected site in the body via blood circulation) thereby, hampering its effectiveness. Multidrug therapy (combination of antituberculosis drugs) for tuberculosis should preferably be taken in the morning before breakfast. Q. Can I take isoniazid with ibuprofen/Benadryl/Nyquil/Aleve/Mucinex/amoxicillin?There no known serious drug interactions of isoniazid with ibuprofen, paracetamol (trade name: Tylenol), naproxen (trade name: Aleve), amoxicillin or any active drug present in Nyquil or Mucinex. Please inform your doctor about all the medication you are currently taking to avoid interactions that may reduce effectiveness of any treatment or aggravate side effects.Q. Does isoniazid cause weight loss/weight gain/hair loss/diarrhea/affect menstruation?Changes in body weight (gain/loss), hair loss, diarrhea or changes in menstruation are not among the known side effects of isoniazid. You may experience few of these side effects while on multi drug (including isoniazid) treatment for tuberculosis.Q. Does isoniazid cause acne/make you tired/cause constipation?You may experience unusual tiredness, constipation or acne while on treatment with isoniazid. Please inform your doctor about all the medication you are currently taking to avoid interactions that may reduce effectiveness of any treatment or aggravate side effects.Q. Does isoniazid affect birth control?Isoniazid has no known interaction with commonly used oral contraceptives (birth control pills). However, multidrug treatment for tuberculosis contains active drug rifampin that decreases the effectiveness of oral contraceptives and hampers birth control.

FURTHER INFORMATION

1. Prescribing information.     http://www.accessdata.fda.gov/drugsatfda_docs/label/2010/050705s007lbl.pdf2. Summary of product characteristics.     http://www.medicines.org.uk/emc/medicine/8467 3. http://www.drugs.com/mtm/isoniazid.html 4. http://www.nlm.nih.gov/medlineplus/druginfo/meds/a682401.html 

Rifampicin(450mg)

TYPICAL USAGE

* Rifampin is used for: * Rifampin is used in combination with other drugs  to treat or prevent tuberculosis (TB). * Rifampin may also be used to reduce certain bacteria in your nose and throat that could cause meningitis or other infections. Rifampin prevents spread of these bacteria to other people, but this medicine will not treat an active meningitis infection. It is also used  in combination with other antibiotics for the  treatment of leprosy

SIDE EFFECTS

* Allergic skin reactions including itching and flushing (sudden reddening of skin) with or without rash; pale red, raised, itchy skin rash (urticaria); severe allergic reactions (Exfoliate dermatitis, pemphigoid reaction, erythema multiforme including Stevens-Johnson syndrome, Lyells syndrome and vasculitis) occur rarely * Loss of appetite (anorexia), urge to vomit (nausea), vomiting, gas, loose motions (diarrhea), abdominal discomfort; a condition called pseudomembranous colitis (inflammation of the large intestine typically following the use of antibiotics) * Inflammation of liver (hepatitis) and other liver problems characterized by increased blood levels of liver enzymes (e.g., elevations in serum bilirubin, BSP, alkaline phosphatase, serum transaminases) * Headache, fever, drowsiness, unusual tiredness, unsteady movements ( ataxia), dizziness, inability to concentrate, mental confusion, behavioral changes, muscular weakness, pain in hands and legs, and generalized numbness; psychoses (abnormal mental condition in which a person gets thoughts that are not real) is rare * Low count of platelets in blood (thrombocytopenia) affecting bleeding and clotting time of blood; low white blood cell count (leukopenia), low hemoglobin or red blood cells (hemolytic anemia) * Swelling of face, hands and feet * Flu syndrome (such as episodes of fever, chills, headache, dizziness, and bone pain) * Shortness of breath and wheezing (high-pitched whistling sound during breathing) * Decrease in blood pressure and shock * Visual disturbance * Disturbances in menstrual cycle * Intake of rifampin produces brownish-red or orange coloration of the urine, sweat, sputum and tears. This effect is not harmful.

DRUG INTERACTION

* Rifampin may decrease activity of the following drugs if taken together: Antiarrhythmics (e.g.disopyramide, mexiletine, quinidine, propafenone, tocainide); Antiepileptics (e.g. phenytoin); Hormone antagonist (antiestrogens e.g. tamoxifen, toremifene, gestinone); Antipsychotics (e.g. haloperidol, aripiprazole); Anticoagulants (e.g. coumarins); Antifungals (e.g. fluconazole, itraconazole, ketoconazole, voriconazole); Antivirals (e.g. saquinavir, indinavir, efavirenz, amprenavir, nelfinavir, atazanavir, lopinavir, nevirapine); Barbiturates; Beta-blockers (e.g. bisoprolol, propanolol); Anxiolytics and hypnotics (e.g. diazepam, benzodiazepines, zolpicolone, zolpidem); Calcium channel blockers (e.g. diltiazem, nifedipine, verapamil, nimodipine, isradipine, nicardipine, nisoldipine); Antibacterials (e.g. chloramphenicol, clarithromycin, dapsone, doxycycline, fluoroquinolones, telithromycin); Corticosteroids; Cardiac glycosides (digitoxin, digoxin);Clofibrate, Systemic hormonal contraceptives; Oestrogen; Antidiabetic (e.g. chlorpropamide, tolbutamide, sulfonylureas, rosiglitazone); Immunosuppressive agents (e.g. ciclosporin, sirolimus, tacrolimus), Irinotecan; Thyroid hormone (e.g. levothyroxine); Losartan; Analgestics (e.g. methadone, narcotic analgesics); Praziquantel; Progestogens; Quinine; Riluzole; Selective 5-HT3 receptor antagonists (e.g. ondansetron); Statins metabolised by CYP 3A4 (e.g. simvastatin); Theophylline; Tricclic antidepressants (e.g. amitriptyline, nortriptyline); Cytotoxics (e.g. imatinib); Diuretics (e.g. eplerenone). It may be necessary to adjust the dosages of these drugs if they are given concurrently with rifampin. * Concomitant use with drugs saquinavir, ritonavir, halothane or isoniazid may cause severe liver damage (hepatotoxicity) * Concomitant use with probenecid and cotrimoxazole may increase the blood level of rifampin * Ensure to maintain a gap of at least 8 hours between intake of rifampin and p-aminosalicylic acid * Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.

MECHANISM OF ACTION

* Rifampin is an antibiotic and kills a wide range of infection causing bacteria (broad spectrum). It acts by blocking the activity of a bacterial enzyme called DNA-dependent RNA polymerase which is essential for important life processes in the bacteria, thereby killing the bacteria.

DOSAGE

* Always follow the instructions of doctor regarding the dosage and duration * Adult. * Tuberculosis: 450 mg (patients weighing less than 50 kg to 600 mg (patients weighing 50 kg or more) once daily * Leprosy : 600 mg once per month Or 450 mg to 600 mg once daily * Other infections (Brucellosis, Legionnaires disease or serious staphylococcal infections): 600 to 1200 mg given in 2 to 4 divided doses daily * Prevention of meningococcal meningitis: 600 mg twice daily for 2 days * Prevention of Haemophilus influenzae infections: 20 mg/kg once daily (maximum daily dose 600 mg) for 4 days. * Children * Tuberculosis: 10-20 mg/kg body weight daily * Prevention of meningococcal meningitis * 1 to 12 years: 10 mg/kg twice daily for 2 days * 3 months to 1 year: 5 mg/kg twice daily for 2 days * Prevention of Haemophilus influenzae infections * Children: 20 mg/kg once daily (maximum daily dose 600 mg) for 4 days * Neonates (aged 1month): 10 mg/kg daily for 4 days

DOs and DON'Ts

* Rifampin interacts with many drugs. Please inform your doctor about all the medication you are currently taking to avoid interactions that may reduce effectiveness of any treatment or aggravate side effects. * Do consult your doctor before taking rifampin if you wear contact lenses. Using rifampin may permanently stain your contact lenses * Taking rifampin may produce a brownish-red coloration of the urine, sweat, sputum and tears. This is not a harmful effect. * Do consult your doctor before taking rifampin if you are pregnant or planning to become pregnant * Do consult your doctor if you are taking oral contraceptive medications for birth control. Your doctor may ask you to use other means of birth control (eg. condom, diaphragm with spermicide) to prevent pregnancy while taking rifampin. * Do consult your doctor before taking rifampin if you are breast-feeding * Do consult your doctor before taking rifampin if you are aged 65 years or above * If you take rifampin irregularly or if daily administration is resumed after a drug free interval, you may experience ‘flu syndrome’ (includes episodes of fever, chills, headache, dizziness, and bone pain). * Rifampin should preferably be taken in the morning before breakfast. Taking rifampin with food is known to delay its absorption (process by which the active drug reaches the affected site in the body via blood circulation) thereby, hampering its effectiveness. * Do not stop taking rifampin without consulting your doctor.

CONTRA INDICATIONS

* Do not take or use rifampin if you are allergic to rifampin or any other ingredient in the medicine * Do not take rifampin if you have jaundice (abnormal liver function that may cause yellowing of skin and eyes) * Do not take rifampin if you are currently taking saquinavir or ritonavir to avoid severe liver damage * Do not take rifampin if you are currently taking atazanavir, darunavir, fosamprenavir, saquinavir, or tipranavir. Rifampin substantially decreases the blood levels of these antiviral drugs, which may result in loss of antiviral activity or development of resistance to these drugs.

FAQ

Q. Is rifampin and rifampicin same?Yes. Rifampin (nomenclature in the United States) and rifampicin (nomenclature in Britain) is the same antibiotic commonly used in the treatment of tuberculosis and leprosy.Q.Is rifampin a penicillin/amoxicillin/sulfa drug?No. Rifampin is an antibiotic commonly used in the treatment of tuberculosis and leprosy. It has a structure and mechanism of action different from penicillin or amoxicillin (amoxicillin belongs to the class of penicillin antibiotics). The chemical structure and mechanism of action of rifampin is different from sulfa drugs.Q. Is rifampin bacteriostatic or bactericidal?Rifampin is a bactericidal drug. It acts by blocking the activity of a bacterial enzyme called DNA-dependent RNA polymerase which essential for important life processes in the bacteria, thereby killing the bacteria.Q. Is rifampin an inducer or inhibitor?Rifampin is an inducer (increases activity) of an important liver enzyme system that is responsible for the final processing and elimination of several drugs from the body.Q. What is R-cin 600 used for?R-cin 600 is a trade name for active drug rifampin 600 mg. Rifampin is an antibiotic commonly used in the treatment of tuberculosis and leprosy. It is also used in the prevention of meningococcal meningitis and Haemophilus influenza infections. It may also be used in combination with other drugs to treat infections - Brucellosis, Legionnaires disease or serious staphylococcal infections.Q. What is R-cinex/Macox plus/R-cinex 600?R-cinex and Macox plus are trade names for a combination of active drugs rifampin and isoniazid. It is used in the treatment of tuberculosis. R-cinex 600 and Macox plus contains 600 mg of active drug rifampin and 300 mg of active drug isoniazid.Can I take rifampin with ibuprofen/acetaminophen (Tylenol)?Rifampin has no known serious drug interaction with ibuprofen or acetaminophen (trade name: Tylenol). Inform your doctor about all the medication you are currently taking to avoid interactions that may reduce effectiveness of any treatment or aggravate side effects.Q. Does rifampin cause weight gain/weight loss/hair loss/constipation/ yeast infection?No. Changes in body weight, hair loss or triggering constipation are not among the known side effects of rifampin. Rifampin is an antibiotic commonly used in the treatment of tuberculosis and leprosy. It has no known effect on causing yeast infectionsQ. Does rifampin cause headaches?Yes. Headache is a possible side effect of rifampin.Q. Does rifampin change urine color/turn urine orange?Yes. Taking rifampin may change the color of your urine (skin, sweat, saliva, tears and feces) to brownish-red or orange. This effect is not harmful.Q. Does rifampin affect birth control?Yes. Rifampin decreases the effectiveness of oral contraceptives (birth control pills). You may have to use other means of birth control (eg. condom, diaphragm with spermicide) to prevent pregnancy while taking rifampin. Inform your doctor about all the medication you are currently taking to avoid interactions that may reduce effectiveness of any treatment or aggravate side effects.Q. Can I take rifampin with food?Taking rifampin with food is known to delay its absorption (process by which the active drug reaches the affected site in the body via blood circulation) thereby, hampering its effectiveness. Rifampin should preferably be taken in the morning before breakfast.Q. Does rifampin cause liver damage?Rifampin is safe when used at prescribed doses for the prescribed duration. Constant monitoring of liver function is important while on treatment with rifampin. Taking drugs like saquinavir, ritonavir with rifampin can cause severe liver damage. Do consult your doctor if you have any liver problem before taking rifampin.

FURTHER INFORMATION

* Prescribing information. http://www.accessdata.fda.gov/drugsatfda_docs/label/2010/050420s073,050627s012lbl.pdf * Summary of product characteristics. http://www.medicines.org.uk/emc/medicine/21223 * Patient Information Leaflet, http://www.medicines.org.uk/emc/PIL.4846.latest.pdf * http://www.nlm.nih.gov/medlineplus/druginfo/meds/a682403.html * http://www.drugs.com/mtm/rifampin.html

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INTERACTIONS

Can I take Akt Fd during pregnancy?

Studies in animals have shown risk to fetus, however there are no sufficient studies in humans. This drug may be used in pregnant women if benefit outweighs the risk. Patients should follow the advice of the doctor regarding its use.

Can I take Akt Fd while breastfeeding/lactation?

Possibly unsafe: Evidence from studies in breastfeeding women show that there is a definite risk of side effects to the breastfed infants. However, use of the drug in breastfeeding women is acceptable in spite of the risk to the infants, if the drug is needed in a life-threatening situation or for a serious disease for which safer drugs cannot be used or are ineffective. Patients should follow the advice of the doctor regarding its use.

Can I take Akt Fd with alcohol?

Since there is some doubt about the results of concurrent use in this interaction, it is advised to give some guidance to the patient about its possible adverse effects and/or consider close monitoring.