Rifa 4 Plus 100 Tablets

The combination of Ethambutol, Isoniazid, Rifampicin, and Pyrazinamide works synergistically to treat tuberculosis (TB). Ethambutol inhibits the synthesis of arabinogalactan, a key component of the mycobacterial cell wall, disrupting its integrity. Isoniazid is a prodrug that inhibits the synthesis of mycolic acids, essential components of the mycobacterial cell wall, by interfering with the enzyme enoyl-acyl carrier protein reductase (InhA). Rifampicin binds to and inhibits the bacterial RNA polymerase, preventing RNA synthesis and subsequent protein synthesis. Pyrazinamide is active against the semi-dormant, metabolically inactive bacteria by interfering with the energy production and fatty acid synthesis within the mycobacterial cell. Together, these drugs target various pathways crucial for the survival and proliferation of Mycobacterium tuberculosis, effectively combating the infection.

Ethambutol, Isoniazid, Rifampicin, Pyrazinamide

Anti-tuberculosis

Tablet

The following are the uses of Ethambutol, Isoniazid, Rifampicin, Pyrazinamide Tablet:

• Used for treating active tuberculosis (TB) in combination with other anti-TB drugs.
• Used for stopping the growth of TB bacteria and preventing the spread of infection.
• Used for targeting specific stages of the TB bacteria's lifecycle.
• Used for reducing symptoms and improving lung function in TB patients.
• Used for shortening the overall treatment duration when combined with other medications.
• Used for managing drug-resistant TB cases under specialized care.
• Used for reducing the risk of TB transmission and relapse.
• Used for ensuring patient adherence to the full course of treatment.

To be used as per doctor's prescription

In the case of an overdose of Ethambutol, Isoniazid, Rifampicin, and Pyrazinamide Tablets, individuals may experience an array of symptoms. These can include gastrointestinal distress, such as nausea, vomiting, and abdominal pain, as well as neurological effects like dizziness, headache, and visual disturbances. Additionally, severe cases might lead to more critical complications, requiring immediate medical intervention and supportive care. It is crucial to seek professional assistance promptly to manage potential adverse effects effectively.

In the case of a missed dose of Ethambutol, Isoniazid, Rifampicin, and Pyrazinamide Tablet, it is important to take the missed dose as soon as possible. If it is close to the time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not double the dose to make up for a missed one. For Isoniazid, if more than 24 hours have passed since the missed dose, consult your doctor for further instructions.

To take the Ethambutol, Isoniazid, Rifampicin, and Pyrazinamide Tablet, swallow the tablet whole with a full glass of water, preferably on an empty stomach, following the dosage instructions provided by your healthcare professional.

Following are the conditions/situations when Ethambutol, Isoniazid, Rifampicin, Pyrazinamide Tablet should not be used:

• Not recommended for individuals with known allergy or hypersensitivity to any of the componentsEthambutol, Isoniazid, Rifampicin, or Pyrazinamide.
• Contraindicated in patients with severe liver disease or impaired liver function, as these drugs are primarily metabolized in the liver.
• Should be avoided in individuals with a history of severe renal impairment or kidney disease, as these drugs are excreted through the kidneys.
• Not suitable for patients with optic neuritis or any visual impairment, as Ethambutol can worsen these conditions.
• Should not be used in individuals with a history of severe mental health disorders, as Isoniazid can affect the central nervous system.
• Contraindicated in patients with a history of gastrointestinal bleeding or obstruction, as Rifampicin can affect the gastrointestinal tract.
• Should be used with caution in individuals with a history of gout, as Pyrazinamide can increase uric acid levels.
• Not recommended for pregnant or breastfeeding women, as these drugs can pass into breast milk and may cause harm to the fetus or infant.
• Should not be used in patients with a history of severe blood disorders, such as severe anemia or low white blood cell count.
• Contraindicated in individuals with a history of epilepsy or other seizure disorders, as some of these drugs may lower the seizure threshold.

The side effects of Ethambutol, Isoniazid, Rifampicin, and Pyrazinamide Tablet may include:

• Visual disturbances, such as blurred or changed color vision.
• Nausea, vomiting, and stomach pain.
• Loss of appetite and weight loss.
• Skin reactions, including rashes and itching.
• Darkened urine and pale-colored stools.
• Joint and muscle pain.
• Liver problems, including hepatitis (inflammation of the liver).
• Peripheral neuropathy (nerve damage) with symptoms like numbness, tingling, or weakness in the hands and feet.

Following are the precautions and warnings for Ethambutol, Isoniazid, Rifampicin, and Pyrazinamide Tablet:

• This medication should be used with caution in patients with visual impairment or a history of optic neuritis, as it can cause visual disturbances and optic nerve damage.
• Regular eye examinations are required to monitor for any adverse effects on vision.
• Patients with a history of liver or kidney disease should be closely monitored as these conditions can be aggravated by the medication.
• It is essential to ensure adequate fluid intake to reduce the risk of kidney stones, especially with Pyrazinamide.
• Rifampicin can reduce the effectiveness of hormonal contraceptives, so alternative contraceptive methods should be considered.
• Patients should be advised to avoid alcohol consumption as it may increase the risk of liver damage.
• This combination of drugs may cause dizziness and affect coordination; patients should avoid driving or operating heavy machinery until they know how the medication affects them.
• Women who are pregnant or planning to become pregnant should consult their doctor as these drugs may have potential risks for the fetus.

Following are the drug interactions for Ethambutol, Isoniazid, Rifampicin, and Pyrazinamide Tablet:

• Rifampicin induces the metabolism of various drugs, including antiretrovirals, hormonal contraceptives, and anticoagulants, potentially reducing their effectiveness.
• Pyrazinamide can increase the effects of anticoagulants, requiring close monitoring of INR values.
• Isoniazid may interact with anticonvulsants like phenytoin, leading to decreased efficacy of either drug.
• Ethambutol and Isoniazid can both affect the eyes, and their combined use may increase the risk of optic nerve damage.
• Rifampicin reduces the plasma concentrations of several antiretroviral drugs, potentially compromising their effectiveness.
• Alcohol consumption may increase the risk of liver-related side effects, especially with Isoniazid and Rifampicin.
• The use of other hepatotoxic drugs alongside Rifampicin, Isoniazid, and Pyrazinamide may increase the risk of liver damage.
• The combination of Rifampicin and Pyrazinamide may lead to increased plasma levels of Pyrazinamide, potentially requiring dosage adjustments.

Following are the food interactions for Ethambutol, Isoniazid, Rifampicin, and Pyrazinamide Tablet:

• Alcohol consumption should be avoided as it may increase the risk of liver damage, especially when combined with Isoniazid and Rifampicin, which are metabolized by the liver.
• Grapefruit and grapefruit juice should be consumed with caution as Rifampicin can affect its metabolism, potentially altering the levels of the medication.
• High-fat meals can increase the absorption of Rifampicin, so it is recommended to maintain a consistent diet pattern.
• Pyrazinamide levels can be affected by a high-protein diet, so a balanced diet is advised.
• Avoid excessive caffeine intake as it can interact with Isoniazid, potentially causing restlessness and insomnia.
• Ensure a consistent intake of Vitamin B6 (pyridoxine) as Isoniazid can deplete its levels, leading to potential side effects.
• Keep a balanced diet with adequate Vitamin D and calcium as Rifampicin may interfere with their metabolism.
• There are no specific food restrictions for Ethambutol, but maintaining a healthy diet is essential during treatment.

Ethambutol, Isoniazid, Rifampicin, and Pyrazinamide Tablets should be stored in a cool, dry place, preferably at room temperature between 68°F and 77°F (20°C and 25°C). Keep the tablets in their original container, tightly sealed, and away from direct sunlight, moisture, and heat. It is crucial to maintain a consistent storage environment to preserve the medication's effectiveness. Always check the expiration date before using the tablets, and never use them beyond this date. For proper disposal, do not flush the tablets down the toilet or pour them into a drain. Consult your pharmacist or healthcare professional for guidance on safe disposal methods to minimize environmental impact. Keep all medications out of the sight and reach of children to prevent accidental consumption.

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Following are the quick tips for Ethambutol, Isoniazid, Rifampicin, Pyrazinamide Tablet:

• Take the tablet as directed by your doctor; follow the prescription closely.
• Ensure you complete the full course of medication as prescribed.
• Swallow the tablet whole with a full glass of water; do not crush or chew.
• Take the tablet with food to minimize stomach irritation.
• Avoid alcohol consumption as it may interfere with the medication's effectiveness.
• Regularly monitor your liver function and vision during treatment.
• Store the medication in a cool, dry place, away from direct sunlight.