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Rifater (isoniazid / pyrazinamide / rifampin) and Alcohol / Food Interactions

There are 2 alcohol/food/lifestyle interactions with Rifater (isoniazid / pyrazinamide / rifampin) which include:

Major

rifAMPin ↔ Alcohol (Ethanol)

Major Drug Interaction

Using isoniazid together with rifampin can cause serious side effects that may affect your liver. Call your doctor immediately if you experience a fever, chills, joint pain or swelling, excessive tiredness or weakness, unusual bleeding or bruising, skin rash or itching, loss of appetite, nausea, vomiting, or yellowing of the skin or the whites of your eyes. If your doctor does prescribe these medications together, you may need a dose adjustment or special tests to safely take both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Major

rifAMPin ↔ Alcohol (Ethanol)

Major Drug Interaction

Ask your doctor before using rifampin together with pyrazinamide. This can cause damage to the liver. Liver function and drug levels in the blood may be monitored with blood tests during treatment. Call your doctor if you experience fever, rash, loss of appetite, nausea, vomiting, fatigue, right upper abdominal pain, dark urine, and jaundice. You may need a dose adjustment or special tests to safely take both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Moderate

isoniazid ↔ Alcohol (Ethanol)

Moderate Drug Interaction

Isoniazid may cause liver problems, and taking it with alcohol can increase the risk. You should avoid or limit the use of alcohol while being treated with isoniazid. Call your doctor immediately if you have fever, chills, joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, abdominal pain, dark urine, pale stools, and/or yellowing of the skin or eyes, as these may be signs and symptoms of liver damage. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Moderate

isoniazid ↔ food

Moderate Food Interaction

Consumer information for this interaction is not currently available.

ADJUST DOSING INTERVAL: Administration with food significantly reduces isoniazid absorption, increasing the risk of therapeutic failure or resistance. The mechanism is unknown. In addition, the ingestion of certain histamine-rich fish (e.g., tuna) and cheeses during isoniazid therapy may cause a flushing reaction in some patients. The proposed mechanism is inhibition of monoamine oxidase and histaminase by isoniazid, resulting in histamine intoxication.

MANAGEMENT: Isoniazid should be administered on an empty stomach, one hour before or two hours after meals. Patients who experience symptoms such as flushing, tachycardia, chills, headache, nausea, vomiting, diarrhea, burning sensations, sweating, or shortness of breath after eating certain foods should be advised to avoid them.

References

  1. "Product Information. INH (isoniazid)." Ciba Pharmaceuticals, Summit, NJ.
  2. Smith CK, Durack DT "Isoniazid and reaction to cheese." Ann Intern Med 88 (1978): 520-1
  3. Uragoda CG, Kottegoda SR "Adverse reactions to isoniazid on ingestion of fish with a high histamine content." Tubercle 58 (1977): 83-9

Rifater (isoniazid / pyrazinamide / rifampin) drug Interactions

There are 830 drug interactions with Rifater (isoniazid / pyrazinamide / rifampin)

Rifater (isoniazid / pyrazinamide / rifampin) disease Interactions

There are 17 disease interactions with Rifater (isoniazid / pyrazinamide / rifampin) which include:

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.

Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.

Do not stop taking any medications without consulting your healthcare provider.

Disclaimer: Every effort has been made to ensure that the information provided by Multum is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. Multum's information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill, knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective, or appropriate for any given patient. Multum Information Services, Inc. does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. Copyright 2000-2016 Multum Information Services, Inc. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse, or pharmacist.

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