Ethambutol + Isoniazid + Pyrazinamide + Rifampicin

Medicine details

Image
Name	Rimstar FDC 4
Dosage	Tablet
Generic Name	Ethambutol + Isoniazid + Pyrazinamide + Rifampicin
Classes	Antiinfective Agent Antibiotic Respiratory Agent Antibiotic Combination Antituberculosis
Diseases	Infectious Disease Lung Tuberculosis
Company	Novartis (Bangladesh) Ltd.

Drug Package Details

Strength	275 mg + 75 mg + 400 mg + 150 mg
Storage Condition
Origin Country	Bangladesh
Commercial Pack	50
Price per pack	৳ 605.00
Cost per pack	৳ 532.40
Package unit	10 tabs strip
Price per unit	৳ 12.10
Cost per unit	৳ 10.65
Discount	0
Coupon
Remarks

Ethambutol + Isoniazid + Pyrazinamide + Rifampicin

The combination drug of Ethambutol, Isoniazid, Pyrazinamide, and Rifampicin is classified as an antitubercular medication. Each component of the combination drug has its mechanism of action that targets various stages of the Mycobacterium tuberculosis cell cycle, leading to its eradication.

Ethambutol inhibits the synthesis of the mycobacterial cell wall by preventing the incorporation of mycolic acid, a critical component of the cell wall. Isoniazid inhibits the synthesis of mycolic acid by blocking the action of the enzyme responsible for its production. Pyrazinamide is converted to an active form within the mycobacterium, which then disrupts the membrane potential of the cell, leading to its death. Rifampicin inhibits the RNA polymerase of the mycobacterium, thereby preventing its ability to synthesize RNA and protein synthesis.

Indication and Usage

This combination drug is indicated for the treatment of active pulmonary tuberculosis caused by Mycobacterium tuberculosis.

TB (Tuberculosis)

Dosage & Administration (How to take this medication)

The dosage of the combination drug depends on the patient's weight and age. The usual adult dosage for the combination drug is one tablet containing 150mg of Ethambutol, 75mg of Isoniazid, 400mg of Pyrazinamide, and 225mg of Rifampicin, taken once daily for two months, followed by a dosage of one tablet containing 75mg of Isoniazid and 450mg of Rifampicin taken daily for an additional four months.
For children weighing less than 15kg, the dosage is determined by the child's weight, and for children weighing more than 15kg, the dosage is determined by the child's weight or body surface area.

Side effect

The following adverse reactions have been reported with the use of this combination drug:

Gastrointestinal disturbances, such as nausea, vomiting, and abdominal pain
Hepatic toxicity, including elevated liver enzyme levels, hepatitis, and jaundice
Cutaneous reactions, such as rash and pruritus
Neurological toxicity, such as peripheral neuropathy, optic neuritis, and convulsions
Hematological disturbances, such as anemia, leukopenia, and thrombocytopenia
Hypersensitivity reactions, such as fever, urticaria, and angioedema
Arthralgia and myalgia

Nausea	Hepatic dysfunction	Jaundice
Rash	Anemia	Myalgia

Precaution/Good to know

Liver function should be monitored regularly during treatment with this combination drug, as it can cause hepatic toxicity.
Patients with a history of liver disease should be monitored closely during treatment with this combination drug.
Patients should be advised to report any signs of hypersensitivity reactions immediately.
This combination drug may cause visual impairment, and patients should be advised to report any changes in vision immediately.
Patients with renal impairment should be monitored closely during treatment with this combination drug.
This combination drug may cause hematological disturbances, and patients should be advised to report any signs of bleeding or bruising.
This combination drug may cause dizziness, and patients should be advised to avoid driving or operating heavy machinery if they experience this side effect.