Tuberculosis 

Liver damage, hyperuricaemia, Acute gout, arthalgia, arthritis, Neuropathies, convulsions, Cutaneous syndrome, Flushing,itching and rash.

Hypersensitivity to isoniazid -skin rash, fever, Lymphadenopathy, vasculitis, rarely SLE. Flu like syndrome with rifampicin during intermittant theapy. Photosensitisation and GI upsets with pyrazinamide.

Tuberculosis

Dosage-

2 tabs daily as a single dose either 1 hour before or 2 hours after meals

1. Allergies- tell your doctor if you have ever had any unusual or allergic reaction to rifampicin, isoniazid or pyrazinamide. Also tell your doctor if you are allergic to any other substances, such as foods, presevatives or dyes.

2.Pregnancy - pregnant women with tuberculosis should be treated with TB medicines including rifampicin, isoniazid and pyrazinamide. Rifampicin , isoniazid and pyrazinamide combination has not been shown to cause birth defects or other problems.

3.Breast feeding- rifampicin, isoniazid and pyrazinamide pass into the breast milk. However it has not been reported cause problems in nursing babies

4.Children- this combinaton may not be appropriate for use in children.

5. Elderly- liver problems are more likely to occur in patients over 50 years of age.

6. Other medicines - Acetoaminophen or Amiodarone or Anabolic stroids or Androgens or Antithyroid agents or Carbamazepine or Carmustine or Chloroquine or Dantrolene or Daunorubicin or Dissulfram or Divalproex or Etretinate or Gold salts or Hydroxychloroquine Mercaptopurine or Methyldopa or Naltrexone or Other anti-infectives by mouth or Phenothiazines or Pilcamycin or Valproic acid - these medicines may increase the chance of liver damage if taken with this combination Anticoagulants or Aminophylline or Antidiabetics or Chloramphenicol or Corticosteroids or Digitalis glycosides or Disopyramide or Estrmustine or Fluconazole or Itraconazole or Ketoconazole or Methadone or Methotrexate or Mexilitine or Oxytriphylline or Qunidine or Theophylline or Tocainide or Verapramil - this combination may decrease the effects of these medicines Disulfram or - this medicine may increase the chance of liver damage Estrogens or Oral contraceptives or Phenytoin - this combinatiuon may decrease the effects of these medicines.

If you are taking oral contraceptives this may increase the chance of pregnancy. May also increase the chance of liver damage if taken with this combinatiuon.

10. Other medical problems - Tell your doctor if you have any other medical problems especially - Alcohol abuse or Liver disease - there may be an increased chance of getting hepatitis if you take this medicine and drink alcohol daily. Convulsive disorders- may increase the frequency of convulsions Gout - this combination may worsen the goiout attack. Kidney disease- increased chance of side efects.

11. Missed dose - If you miss a dose of this medicine, take it as soon as possible. however, if it is almost time for the next dose, skip the missed dose. Do not double doses.

12. Storage - Keep out of reach of children. Store away from heat or direct sunlight. Do not store the capsule in bathroom, near the kitchen sink, or in other damp places.

13. Outdated medicines - Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of reach of children.

Pharmacokinetics:

An open cross over study was conducted on healthy subjects with normal liver and kidney function, to evaluate the pharmacokinetic profile of rifampicin, isoniazid, and pyrazinamide, given as a combination. They were treated free and fixed triple dose combination at interval of one week. The pharmacokinetic properties were compared based on blood concentration up to 12 hrs with proportions of the dose of the drugs and their metabolites in the urine. No negative pharmacokinetic interaction could be observed in either situation. The results of these studies show the pharmacokinetic proifiles of rifampicin, isoniazid,and pyrazinamide assessed individually and in fixed triple dose are comparable.

Food reduces the absorption of isoniazid.