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
Medically reviewed on September 5, 2018
- 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. Talk with the doctor.
- You will be watched closely by your 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 have an allergy to rifampin, isoniazid, pyrazinamide, or any other part of rifampin, isoniazid, and pyrazinamide.
- If you are allergic to any drugs like this one, any other drugs, foods, or other substances. Tell your doctor about the allergy and what signs you had, like rash; hives; itching; shortness of breath; wheezing; cough; swelling of face, lips, tongue, or throat; or any other signs.
- 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 are taking any of these drugs: Atazanavir, darunavir, fosamprenavir, saquinavir, or tipranavir.
- If you are breast-feeding or plan to breast-feed.
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, when taken with rifampin, isoniazid, and pyrazinamide, may cause very risky effects such as sudden high blood pressure. To avoid these problems, get a list of foods to avoid.
- This medicine may affect how much of some other drugs are in your body. If you are taking other drugs, talk with your doctor. You may need to have your blood work checked more closely while taking rifampin, isoniazid, and pyrazinamide with your other drugs.
- This medicine may stain contact lenses.
- A very bad and sometimes deadly reaction has happened with rifampin, isoniazid, and pyrazinamide. 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. Talk with the doctor.
- It is common to have diarrhea when taking rifampin, isoniazid, and pyrazinamide. Rarely, a very bad form of diarrhea called Clostridium difficile (C diff)–associated diarrhea (CDAD) may occur. Sometimes, this has led to a deadly bowel problem (colitis). CDAD may happen while you are taking rifampin, isoniazid, and pyrazinamide or within a few months after you stop taking it. Call your doctor right away if you have stomach pain or cramps, very loose or watery stools, or bloody stools. Do not try to treat loose stools without first checking with your doctor.
- 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 or plan on getting pregnant. You will need to talk about the benefits and risks of using rifampin, isoniazid, and pyrazinamide while you are pregnant.
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.
- To gain the most benefit, do not miss doses.
- 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 of 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.
See also: Dosage Information (in more detail)
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.
- Chest pain or pressure.
- Coughing up blood.
- Fever or chills.
- Sore throat.
- 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.
- Any unexplained bruising or bleeding.
- Purple spots or redness of the skin.
- Feeling very tired or weak.
- Dizziness or passing out.
- A burning, numbness, or tingling feeling that is not normal.
- Feeling confused.
- Memory problems or loss.
- Change in eyesight, eye pain, or very bad eye irritation.
- Change in balance.
- Not able to focus.
- Change in how you act.
- 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.
- Loose stools (diarrhea).
- Feeling sleepy.
- Upset stomach or throwing up.
- Belly pain or heartburn.
- Stomach cramps.
- Not able to sleep.
- 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-FDA-1088. You may also report side effects at http://www.fda.gov/medwatch.
See also: Side effects (in more detail)
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.
- Keep a list of all your drugs (prescription, natural products, vitamins, OTC) with you. Give this list to your doctor.
- Talk with the doctor before starting any new drug, including prescription or OTC, natural products, or vitamins.
- 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.
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
More about isoniazid/pyrazinamide/rifampin
- Isoniazid/pyrazinamide/rifampin Side Effects
- During Pregnancy
- Dosage Information
- Drug Interactions
- Compare Alternatives
- En Español
- Drug class: antituberculosis combinations
Other brands: Rifater