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Isoniazid + Rifampicin + Ethambutol + Pyrazinamide

Information about Isoniazid + Rifampicin + Ethambutol + Pyrazinamide

Isoniazid + Rifampicin + Ethambutol + Pyrazinamide Uses

Isoniazid+Rifampicin+Ethambutol+Pyrazinamide is used in the treatment of tuberculosis.

How Isoniazid + Rifampicin + Ethambutol + Pyrazinamide works

Isoniazid + Rifampicin + Ethambutol + Pyrazinamide is a combination of four medicines: Isoniazid, rifampicin, ethambutol and pyrazinamide which treat tuberculosis. Isoniazid works by preventing the TB bacteria from forming their own protective covering, while rifampicin inactivates a bacterial enzyme (RNA-polymerase) which is required by TB bacteria to make essential proteins and to reproduce. Together, they kill the bacteria and eradicate the infection. Ethambutol and pyrazinamide on the other hand, work by slowing the growth of these bacteria.

Common side effects of Isoniazid + Rifampicin + Ethambutol + Pyrazinamide

Nausea, Vomiting, Peripheral neuropathy (tingling and numbness of feet and hand), Abdominal pain, Skin rash, Hepatitis (viral infection of liver), Lethargy, Low blood platelets, Joint pain, Thrombocytopenic purpura, Cutaneous reactions, Retrobulbar optic neuritis
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Written By
PhD (Pharmacology), PGDPRA
Reviewed By
MD (Pharmacology), MBBS
Last updated
12 May 2023 | 05:49 PM (UTC)

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Expert advice for Isoniazid + Rifampicin + Ethambutol + Pyrazinamide

  • You have been prescribed Isoniazid + Rifampicin + Ethambutol + Pyrazinamide for the treatment of tuberculosis.
  • Take it on an empty stomach and preferably at the same time everyday.
  • Try not to forget a dose, as this increases the risk of the bacteria becoming resistant to the medicine, and also increases the risk of getting side effects.
  • It may discolour your urine, sweat, saliva and tears a reddish/orange colour. This is normal and not harmful.
  • Your doctor may check your liver function before starting treatment and regularly thereafter. Inform your doctor if you notice yellowing of eyes or skin, dark urine, or stomach pain.
  • Avoid drinking alcohol while taking Isoniazid + Rifampicin + Ethambutol + Pyrazinamide as this may increase the risk of side effects on the liver.
  • It may cause vitamin B6 deficiency. Your doctor may prescribe vitamin B6 supplements to help avoid potential problems associated with its deficiency, such as inflammation of the nerves (neuritis). 
  • Use a reliable contraceptive method (such as condoms or a diaphragm) to prevent pregnancy while you are taking Isoniazid + Rifampicin + Ethambutol + Pyrazinamide as it may make hormonal contraceptives such as the pill less effective.
  • Do not take indigestion remedies (antacids)  within at least two hours of taking Isoniazid + Rifampicin + Ethambutol + Pyrazinamide.
  • Finish the full course of the medication, even if you feel better. Stopping the course early increases the risk of coming back of the infection.

Frequently asked questions for Isoniazid + Rifampicin + Ethambutol + Pyrazinamide

Isoniazid + Rifampicin + Ethambutol + Pyrazinamide

Q. How to take Isoniazid+Rifampicin+Ethambutol+Pyrazinamide?

Take Isoniazid+Rifampicin+Ethambutol+Pyrazinamide on an empty stomach which means at least one hour before and two hours after a meal and with full glass of water.

Q. Can I drink alcohol while taking Isoniazid+Rifampicin+Ethambutol+Pyrazinamide?

No, avoid drinking alcohol while taking Isoniazid+Rifampicin+Ethambutol+Pyrazinamide. Drinking alcohol will increase the risk of hepatitis caused by Isoniazid+Rifampicin+Ethambutol+Pyrazinamide because of isoniazid.

Q. Can the use of Isoniazid+Rifampicin+Ethambutol+Pyrazinamide cause discoloration of the urine?

Yes, Isoniazid+Rifampicin+Ethambutol+Pyrazinamide contains Rifampicin. It can cause temporary discoloration of your teeth, sweat, urine, saliva and tears (red, orange or brown color). This side effect is usually not harmful. However, discoloration of urine can be a sign of liver damage. Contact your doctor if you notice discoloration of urine accompanied with stomach pain, loss of appetite and jaundice (yellowing of your skin or eyes).

Q. Can Isoniazid+Rifampicin+Ethambutol+Pyrazinamide cause visual impairment?

Isoniazid+Rifampicin+Ethambutol+Pyrazinamide contains Ethambutol which may cause visual impairment. Inform the doctor immediately if you notice any changes in your eyesight.

Q. Can I discontinue Isoniazid+Rifampicin+Ethambutol+Pyrazinamide if I feel well?

No, do not discontinue Isoniazid+Rifampicin+Ethambutol+Pyrazinamide. Take the proper course of a drug that has been prescribed for you even if you begin to feel better. If you stop taking Isoniazid+Rifampicin+Ethambutol+Pyrazinamide then your infection may become worse, difficult to treat and it may result in drug-resistant TB (drugs you are taking may no longer work).

Q. Can I take oral contraceptive pills while taking Isoniazid+Rifampicin+Ethambutol+Pyrazinamide?

No, Isoniazid+Rifampicin+Ethambutol+Pyrazinamide can make birth control pills less effective. So, ask your doctor about using a birth control method which does not affect your hormone levels (such as a condom, diaphragm, spermicide).

Q. What are the instructions for storage and disposal of Isoniazid+Rifampicin+Ethambutol+Pyrazinamide?

Keep this medicine in the container it came in, tightly closed. Store it according to the instructions mentioned on the pack or label. Dispose of the unused medicine. Make sure it is not consumed by pets, children and other people.

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