Introduction
Rimactazid 150 is a combination medicine used in the treatment of tuberculosis. It prevents the growth of the microorganisms that cause the infection.
Rimactazid 150 is a prescription medicine and it is to be taken as suggested by the doctor. It should be taken in an empty stomach and take it at a fixed time to ensure better efficacy. Do not consume more than the recommended dose, as this may have harmful effects on your body. If you miss a dose, take it as soon as you remember. The course of the treatment must be completed even if you feel better. Sudden discontinuation of the treatment may affect the potency of the medicine. The medicine may take some to show its effects on the symptoms. However, it is advised to consult the doctor if you feel an aggravation of the condition or if your condition does not improve.
Some common side effects of this medicine are nausea, vomiting, fever, dark-colored urine, sweating, increased saliva, etc. To cope up with the side effects, you should drink plenty of water. If any of the side effects get aggravated, you must consult your doctor immediately. Generally, serious side effects are rare. If you experience any allergic reaction (rashes, itching, swelling, shortness of breath, etc.), you must seek immediate medical help.
Before taking this medicine, you should tell your doctor if you are taking any medicines for any health condition. Patients with liver and kidney ailments must take this medicine with proper consultation and caution. Pregnant or breastfeeding women should also consult with the doctor before taking it. Avoid drinking alcohol as it can cause excessive drowsiness with this medicine. It usually does not impair your ability to drive, but you should not drive if it makes you feel sleepy or dizzy. During the treatment, you must take adequate rest and eat a healthy diet for a faster recovery. While on the medication, your doctor may ask for a few laboratory and diagnostic tests to know the effects of the medicine on your body.
Side effects of Rimactazid 150
Common
- Dark colored urine
- Rash
- Vomiting
- Jaundice
- Fever
- Increased liver enzymes
- Nausea
- Peripheral neuropathy (tingling and numbness of feet and hand)
How to use Rimactazid 150
Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Rimactazid 150 is to be taken empty stomach.
Avoid Rimactazid 150 with tyramine-rich food such as cheese, smoked fish, meats and some types of beer.
How Rimactazid 150 works
Rimactazid 150 is a combination of two antibiotics: Rifampicin and Isoniazid, which treats tuberculosis (TB). Rifampicin works by inactivating a bacterial enzyme (RNA-polymerase) which is required by TB bacteria to make essential proteins and to reproduce. Isoniazid prevents these bacteria from forming their own protective covering. Together, they kill the bacteria and eradicate the infection.
Adult Dose
Oral
Tuberculosis
Adult: Each tab contains rifampicin and isoniazid (mg):
<50 kg: 3 tab of 150/100 once daily;
>50 kg: 2 tab of 300/150 once daily.
Hepatic impairment: Max: 8 mg/kg daily.
Contraindication
Known or suspected hypersensitivity to rifamycins and/or to INH, and/or to any of the excipients including a history of drug-induced hepatitis; acute liver diseases, regardless of their origin; peripheral neuritis.
Mode of Action
Rifampicin and isoniazid are active bactericidal anti-TB drugs which are particularly active against the rapidly growing extracellular organisms and also have bactericidal activity intracellularly. Rifampicin inhibits DNA-dependent RNA polymerase activity in susceptible cells. Specifically, it interacts w/ bacterial RNA polymerase but does not inhibit the mammalian enzyme. Cross-resistance to rifampicin has only been shown w/ other rifamycins. It has activity against slow- and intermittently-growing M. tuberculosis. Isoniazid acts against actively growing tubercle bacilli.
Precaution
Use of isoniazid should be carefully monitored in the following:
Daily users of alcohol. Daily ingestion of alcohol may be associated with a higher incidence of isoniazid hepatitis.
Patients with active chronic liver disease or severe renal dysfunction.
Age > 35.
Concurrent use of any chronically administered medication.
History of previous discontinuation of isoniazid.
Existence of peripheral neuropathy or conditions predisposing to neuropathy.
Pregnancy.
Injection drug use.
Women belonging to minority groups, particularly in the post-partum period.
HIV seropositive patients.
Side Effect
Unwanted effects which may occur during continuous daily or intermittent therapy: Rifampicin: Rifampicin may cause reddish discolouration of body fluids and occasionally other body secretions eg, urine, sputum, lacrimal fluid, faeces, saliva and sweat. It may permanently discolour soft contact lenses.
Hepatic Effects: Very common (>10%) is an asymptomatic increase in liver enzymes; severe life-threatening hepatic reactions eg, hepatic failure and acute fulminant hepatitis are uncommon (>0.1% and <1%). In isolated cases (<0.01%), a fatal outcome was observed.
Renal Effects: Elevations of BUN and serum uric acid, haemolysis, haematuria, interstitial nephritis, renal insufficiency. Gastrointestinal Effects: Nausea, abdominal pains, vomiting or diarrhoea, pseudomembranous colitis.
Central and Peripheral Nervous System Effects: Tiredness, drowsiness, headache, dizziness, ataxia, mental confusion, muscular weakness, visual disturbances. Haematological Changes: Leucopenia, eosinophilia, thrombocytopenia and thrombocytopenic purpura. Effects on Skin and Appendages: Flushing, itching with or without skin rash, urticaria, reddening of the eyes, exudative conjunctivitis or generalised hypersensitivity reactions involving the skin eg, exfoliative dermatitis, Lyell's syndrome and pemphigoid reactions. Endocrine Effects: Disturbances in the menstrual cycle, induction of crisis in Addison patients. Unwanted effects chiefly occurring during intermittent therapy or upon resumption of treatment after temporary interruption:
Interaction
May reduce effectivity of hormonal contraceptives. Reduced absorption w/ antacids. May decrease plasma concentrations of antivirals (e.g. atazanavir, darunavir, fosamprenavir), atovaquone w/ rifampicin. Rifampicin may reduce serum levels of anticonvulsants (e.g. phenytoin), antiarrhythmics (e.g. disopyramide), oral anticoagulants, antifungals (e.g. ketoconazole), barbiturates, ?-blockers, Ca channel blockers (e.g. diltiazem), chloramphenicol, clarithromycin, corticosteroids, ciclosporin, cardiac glycosides, clofibrate, dapsone, diazepam, doxycycline, fluoroquinolones (e.g. ciprofloxacin), haloperidol, oral hypoglycemic agents (sulfonylureas), levothyroxine, methadone, narcotic analgesics, progestins, quinine, tacrolimus, theophylline, TCAs (e.g. amitriptyline, nortriptyline) and zidovudine. Increased risk of hepatotoxicity w/ halothane.
Isoniazid may inhibit the metabolism of anticonvulsants (e.g. carbamazepine, phenytoin), benzodiazepines (e.g. diazepam), haloperidol, ketoconazole, theophylline, and warfarin. May enhance the CNS effects of meperidine, cycloserine, and disulfiram w/ isoniazid. Loss of glucose control in patients on oral hypoglycaemics w/ isoniazid.
Potentially Fatal: Concurrent treatment w/ saquinavir/ritonavir combination may result to severe hepatoxicity.