Rifampin, Isoniazid, and Pyrazinamide
Generic name: Rifampin, Isoniazid, and Pyrazinamide (rif AM pin, eye soe NYE a zid, & peer a ZIN a mide)
Brand name: Rifater
Drug class: Antituberculosis combinations
Medically reviewed by Drugs.com. Last updated on Sep 5, 2020.
- This medicine may cause very bad and sometimes deadly liver problems like hepatitis. Call your doctor right away if you have signs of liver problems like dark urine, feeling tired, not hungry, upset stomach or stomach pain, light-colored stools, throwing up, or yellow skin or eyes.
- The chance of liver problems is higher the older you are. The chance may also be raised by drinking alcohol every day, long-term liver problems, or injection drug use. The chance of liver problems may also be raised in women, mainly women who are black or Hispanic or who have just had a baby. Most of the time, liver problems caused by rifampin, isoniazid, and pyrazinamide happen within the first 3 months of care, but they can happen at any time. Most of the time, liver function has gone back to normal but sometimes it has not. Blood work will need to be done before starting this drug and while taking it. If you have questions, talk with the doctor.
- Have blood work checked as you have been told by the doctor. Talk with the doctor.
- If you have active liver disease, talk with your doctor. This medicine may not be right for you.
Uses of Rifampin, Isoniazid, and Pyrazinamide:
- It is used to treat TB (tuberculosis).
What do I need to tell my doctor BEFORE I take Rifampin, Isoniazid, and Pyrazinamide?
- If you are allergic to rifampin, isoniazid, and pyrazinamide; any part of rifampin, isoniazid, and pyrazinamide; or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had.
- If you have any of these health problems: Gout or liver problems.
- If you have had very bad side effects while taking isoniazid in the past, like liver problems, drug fever, chills, or arthritis.
- If you had liver problems while taking some other drug in the past.
- If you take any drugs (prescription or OTC, natural products, vitamins) that must not be taken with rifampin, isoniazid, and pyrazinamide, like certain drugs that are used for HIV, infections, or depression. There are many drugs that must not be taken with rifampin, isoniazid, and pyrazinamide. Your doctor or pharmacist can tell you if you are taking a drug that must not be taken with rifampin, isoniazid, and pyrazinamide.
This is not a list of all drugs or health problems that interact with rifampin, isoniazid, and pyrazinamide.
Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take rifampin, isoniazid, and pyrazinamide with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.
What are some things I need to know or do while I take Rifampin, Isoniazid, and Pyrazinamide?
- Tell all of your health care providers that you take rifampin, isoniazid, and pyrazinamide. This includes your doctors, nurses, pharmacists, and dentists.
- Have an eye exam as you have been told by your doctor.
- This medicine may affect certain lab tests. Tell all of your health care providers and lab workers that you take rifampin, isoniazid, and pyrazinamide.
- Talk with your doctor before you drink alcohol.
- If you have high blood sugar (diabetes), you will need to watch your blood sugar closely. Tell your doctor if you get signs of high blood sugar like confusion, feeling sleepy, more thirst, more hungry, passing urine more often, flushing, fast breathing, or breath that smells like fruit.
- Watch for gout attacks.
- Some foods and drinks, like cheese and red wine, may cause sudden, severe high blood pressure when you are taking rifampin, isoniazid, and pyrazinamide. This effect can be deadly. Talk with your doctor about your risk for this effect. Get a list of foods and drinks to avoid. Avoid these foods and drinks for as long as your doctor has told you after rifampin, isoniazid, and pyrazinamide is stopped.
- This medicine may stain contact lenses.
- A severe and sometimes deadly reaction has happened. Most of the time, this reaction has signs like fever, rash, or swollen glands with problems in body organs like the liver, kidney, blood, heart, muscles and joints, or lungs. If you have questions, talk with the doctor.
- Diarrhea is common with antibiotics. Rarely, a severe form called C diff–associated diarrhea (CDAD) may happen. Sometimes, this has led to a deadly bowel problem (colitis). CDAD may happen during or a few months after taking antibiotics. Call your doctor right away if you have stomach pain, cramps, or very loose, watery, or bloody stools. Check with your doctor before treating diarrhea.
- A very bad skin reaction (Stevens-Johnson syndrome/toxic epidermal necrolysis) may happen. It can cause very bad health problems that may not go away, and sometimes death. Get medical help right away if you have signs like red, swollen, blistered, or peeling skin (with or without fever); red or irritated eyes; or sores in your mouth, throat, nose, or eyes.
- If you are 65 or older, use rifampin, isoniazid, and pyrazinamide with care. You could have more side effects.
- Birth control pills and other hormone-based birth control may not work as well to prevent pregnancy. Use some other kind of birth control also like a condom when taking rifampin, isoniazid, and pyrazinamide.
- Tell your doctor if you are pregnant, plan on getting pregnant, or are breast-feeding. You will need to talk about the benefits and risks to you and the baby.
How is this medicine (Rifampin, Isoniazid, and Pyrazinamide) best taken?
Use rifampin, isoniazid, and pyrazinamide as ordered by your doctor. Read all information given to you. Follow all instructions closely.
- Take on an empty stomach. Take 1 hour before or 2 hours after meals.
- Take with a full glass of water.
- Keep taking rifampin, isoniazid, and pyrazinamide as you have been told by your doctor or other health care provider, even if you feel well.
- Do not take antacids within 1 hour before or 1 hour after taking rifampin, isoniazid, and pyrazinamide.
What do I do if I miss a dose?
- Take a missed dose as soon as you think about it.
- If it is close to the time for your next dose, skip the missed dose and go back to your normal time.
- Do not take 2 doses at the same time or extra doses.
What are some side effects that I need to call my doctor about right away?
WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:
- Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
- Signs of lupus like a rash on the cheeks or other body parts, sunburn easy, muscle or joint pain, chest pain or shortness of breath, or swelling in the arms or legs.
- Signs of a pancreas problem (pancreatitis) like very bad stomach pain, very bad back pain, or very bad upset stomach or throwing up.
- Signs of too much acid in the blood (acidosis) like confusion; fast breathing; fast heartbeat; a heartbeat that does not feel normal; very bad stomach pain, upset stomach, or throwing up; feeling very sleepy; shortness of breath; or feeling very tired or weak.
- Signs of kidney problems like unable to pass urine, change in how much urine is passed, blood in the urine, or a big weight gain.
- Chest pain or pressure.
- Coughing up blood.
- Fever, chills, or sore throat; any unexplained bruising or bleeding; or feeling very tired or weak.
- Flu-like signs.
- A heartbeat that does not feel normal.
- Swollen gland.
- Joint pain or swelling.
- Period (menstrual) changes.
- Ringing in ears.
- Muscle pain or weakness.
- Shortness of breath.
- Sweating a lot.
- Swelling in the arms or legs.
- Purple spots or redness of the skin.
- Dizziness or passing out.
- A burning, numbness, or tingling feeling that is not normal.
- Memory problems or loss.
- Change in eyesight, eye pain, or very bad eye irritation.
- Change in balance.
- Feeling confused, not able to focus, or change in behavior.
- Change in tooth color. These changes may be long-lasting.
What are some other side effects of Rifampin, Isoniazid, and Pyrazinamide?
All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:
- Change in color of body fluids to orange or red.
- Feeling sleepy.
- Upset stomach or throwing up.
- Stomach pain or cramps.
- Trouble sleeping.
- Not hungry.
These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.
You may report side effects to the FDA at 1-800-332-1088. You may also report side effects at https://www.fda.gov/medwatch.
If OVERDOSE is suspected:
If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.
How do I store and/or throw out Rifampin, Isoniazid, and Pyrazinamide?
- Store at room temperature.
- Store in a dry place. Do not store in a bathroom.
- Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
- Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.
Consumer information use
- If your symptoms or health problems do not get better or if they become worse, call your doctor.
- Do not share your drugs with others and do not take anyone else's drugs.
- Some drugs may have another patient information leaflet. Check with your pharmacist. If you have any questions about rifampin, isoniazid, and pyrazinamide, please talk with your doctor, nurse, pharmacist, or other health care provider.
- If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.
More about isoniazid / pyrazinamide / rifampin
- Side Effects
- During Pregnancy
- Dosage Information
- Drug Interactions
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- Drug class: antituberculosis combinations
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