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1

SALT INFORMATION

Ethambutol Hydrochloride(275 mg)

TYPICAL USAGE

It is used in the treatment of tuberculosis.

SIDE EFFECTS

Vision impairment, stevens-Johnson syndrome, skin inflammation, redness of the skin, itching and joint pain, loss of appetite, nausea, vomiting, stomach upset and abdominal pain, fever, uneasiness, headache, dizziness, mental confusion, decrease in white blood cells and platelets.

DRUG INTERACTION

Ethambutol is known to interact with other drugs like aluminium hydroxide and oxide, bromazepam. These interactions are sometimes beneficial and sometimes may pose threats to life. 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 inhibits arabinosyl transferases which is involved in cell wall biosynthesis. By inhibiting this enzyme, the bacterial cell wall complex production is inhibited. This leads to an increase in cell wall permeability.

Isoniazid(75 mg)

TYPICAL USAGE

It is used for all forms of pulmonary and extra-pulmonary tuberculosis.

SIDE EFFECTS

Liver injury, nausea, vomiting, tachycardia, convulsions, coma, seizures, urinary retention, dizziness, hyperreflexia, slurred speech.

DRUG INTERACTION

Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor or pharmacist first.

MECHANISM OF ACTION

Isoniazid is a prodrug and must be activated by bacterial catalase. Specficially, activation is associated with reduction of the mycobacterial ferric KatG catalase-peroxidase by hydrazine and reaction with oxygen to form an oxyferrous enzyme complex. Once activated, isoniazid inhibits the synthesis of mycoloic acids, an essential component of the bacterial cell wall. At therapeutic levels isoniazid is bacteriocidal against actively growing intracellular and extracellular Mycobacterium tuberculosis organisms. Specifically isoniazid inhibits InhA, the enoyl reductase from Mycobacterium tuberculosis, by forming a covalent adduct with the NAD cofactor. It is the INH-NAD adduct that acts as a slow, tight-binding competitive inhibitor of InhA.

Pyrazinamide(400 mg)

TYPICAL USAGE

Tuberculosis.

SIDE EFFECTS

Anorexia, Fever, Malaise, Arthralgia, Nausea and vomiting.

DRUG INTERACTION

Excretion may be blocked by probenecid.

MECHANISM OF ACTION

Pyrazinamide has bactericidal action against M. tuberculosis in acid environment present in macrophages and inflammed tissue. Together with rifampicin provides greatest sterilising action with reduction in relapse rate. Reduces tubular secretion of uric acid.

Rifampicin(150 mg)

TYPICAL USAGE

Epilepsy (monotherapy), Iron-deficiency anaemia with chronic renal failure, Leprosy, Meningitis, Meningitis prophylaxis, Mycobacterial infection, Paget's disease of bone, Tuberculosis, Urinary tract infection

SIDE EFFECTS

Nausea, Vomiting, Anorexia, Abdominal discomfort, Orange coloration of secretions.

DRUG INTERACTION

Epilepsy (monotherapy), Iron-deficiency anaemia with chronic renal failure, Leprosy, Meningitis, Meningitis prophylaxis, Mycobacterial infection, Paget's disease of bone, Tuberculosis, Urinary tract infection

MECHANISM OF ACTION

Rifampicin acts via the inhibition of DNA-dependent RNA polymerase, leading to a suppression of RNA synthesis and cell death.

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INTERACTIONS

Can I take Rimstar (4) during pregnancy?

Experiences of drug use and evidence from studies in pregnant women have shown risk to fetus. 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 Rimstar (4) while breastfeeding/lactation?

Contraindicated: The drug should not be used by breastfeeding women, as evidences from studies have shown that there is a high risk of causing significant damage to infants.

Can I take Rimstar (4) 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.