Rifampicin + Isoniazid brands and prices in Pakistan

About Rifampicin + Isoniazid

Rifampicin + isoniazid is a combination of two antibiotics that kill the germ that causes tuberculosis (TB). Putting both medicines in one tablet means fewer tablets to take. It is part of the standard TB treatment used around the world. TB treatment is started and followed up by a TB doctor, TB nurse or TB programme team, and health workers or trained volunteers often support people until they finish.

Who should not take it, or should take care

• Do not take it if you are allergic to rifampicin, isoniazid or any other ingredient.
• Do not take it if you have acute liver disease, jaundice or severe liver problems, or if these medicines have damaged your liver before.
• Do not take it if you had a serious reaction to isoniazid before, such as drug fever, chills or joint inflammation (arthritis).
• Do not take it with certain medicines, including voriconazole (antifungal), many HIV medicines (such as HIV protease inhibitors, nevirapine, rilpivirine, doravirine and etravirine), hepatitis C antiviral tablets and lurasidone. Your TB team will check all your medicines.
• Liver problems are more likely in older people, people who drink alcohol regularly or inject drugs, people with liver disease, HIV or poor nutrition, pregnant women and women who have recently had a baby. Liver blood tests are often done.
• Nerve problems are more likely in people with poor nutrition, alcohol dependence, HIV, kidney failure or diabetes, in pregnancy and when breastfeeding.
• Tell your doctor if you have kidney disease, diabetes (blood sugar may change), epilepsy or a past mental illness (psychosis), porphyria, an adrenal gland problem, or malaria.
• Pregnancy: it can be used in pregnancy for treatment or prevention, with close checks. Vitamin B6 is advised. Use near the time of birth may raise the risk of bleeding in the mother and baby, so tell your team if you are pregnant.
• Breastfeeding: small amounts pass into breast milk. Breastfeeding is not discouraged, but the baby should be watched, and mother and baby may need vitamin B6.
• The children's dispersible tablets contain aspartame (a source of phenylalanine, important for people with phenylketonuria) and a red colouring that can cause allergy in some people.

Medicines and drinks that can interact

• Hormonal contraception (the pill, and other hormonal methods) may not work. Use a barrier method such as condoms, or another non-hormonal method, and ask your doctor for advice.
• HIV medicines and hepatitis C medicines: many are affected and some must not be combined. Your doctor should check every HIV medicine you take.
• Voriconazole and lurasidone must not be taken with it.
• Blood thinners such as warfarin and clopidogrel
• Epilepsy medicines such as phenytoin, and disulfiram (used for alcohol problems)
• Steroid medicines, diabetes medicines (including sulfonylureas), cholesterol medicines and medicines that dampen the immune system
• Painkillers including paracetamol, morphine and codeine, and methadone
• Praziquantel (a worm medicine): a gap is needed after stopping rifampicin. Ask your doctor.
• Antacids containing aluminium can reduce absorption. Ask your pharmacist how to space them.
• Alcohol: avoid it, as it raises the risk of liver damage.
• Some foods high in tyramine or histamine, such as certain cheeses, some fish (such as tuna) and red wine, can cause flushing, headache or a racing heartbeat.
• Always tell your doctor or pharmacist about every medicine, herbal remedy and supplement you use, including ones bought without a prescription.

Always tell your doctor and pharmacist about every medicine, supplement and herbal product you take.

Using it safely

• Take it only when prescribed for you. Take every dose and finish the whole course exactly as your TB team tells you, even when you feel better. Missing doses or stopping early can make TB come back and become drug-resistant.
• It is usually taken on an empty stomach, because food can reduce how well it is absorbed. Follow your TB team's instructions on how to take it.
• Children's dispersible tablets are mixed in drinking water before swallowing, following the leaflet.
• If you miss a dose, check the leaflet or ask your TB team or pharmacist what to do. Never take two doses together.
• If you are sick (vomit) soon after a dose, ask your TB team whether to take it again.
• Do not run out. Contact your TB centre or nurse early if you are running low.
• Go to all check-ups and blood tests. Your TB team may also check the people you live with for TB.
• Wear glasses instead of soft contact lenses, which can be stained for good. Dentures can also be stained.
• Tell lab staff you take rifampicin before any urine drug test, as it can give a false result.
• Isoniazid can affect alertness, so take care with driving or machines if you feel dizzy or unwell.
• Store in the original pack in a cool, dry place, out of the reach and sight of children.

Common questions

Why is my urine orange?
Rifampicin colours body fluids such as urine, sweat, saliva and tears orange or red. This is harmless and expected, and it stops after treatment. Yellow skin or eyes, or dark brown urine with tiredness or sickness, are different: they can mean liver problems, so contact your TB team straight away.

Is TB treatment free in Pakistan?
Yes. A WHO research programme (TDR) reports that TB medicines are provided free in Pakistan under the national TB programme. Families can still face other costs, such as travel, special food and lost income, so ask your TB centre what support is available.

Why must I finish the whole course if I feel better?
Feeling better does not mean all the TB germs are gone. WHO says that if treatment is not fully completed, TB can become drug-resistant and spread to others, and drug-resistant TB needs longer and more complex treatment. Health workers or trained volunteers can support you to finish.

Will it stop my contraceptive pill working?
It can. Rifampicin can stop hormonal contraception from working properly. Use condoms or another non-hormonal method and ask your doctor or nurse which method is best during treatment.

Can I drink alcohol while taking it?
It is best not to. Alcohol raises the risk of liver damage from these medicines.

Prepared from the sources listed by the MedInfoBase team. General information, not medical advice: it gives no doses. Your doctor or pharmacist decides the medicine and dose for you.