Drug Notes

Rifampin/isoniazid/pyrazinamide (By mouth)

Isoniazid (eye-soe-NYE-a-zid), Pyrazinamide (pir-a-ZIN-a-mide), Rifampin (rif-AM-pin)

Treats tuberculosis (TB).

Brand Name(s):

Rifater

When This Medicine Should Not Be Used:

How to Use This Medicine:

Tablet

• Your doctor will tell you how much medicine to use. Do not use more than directed.
• Take this medicine on an empty stomach, 1 hour before or 2 hours after a meal, and with a full glass of water. It is important to take this medicine on a regular schedule.
• Take all of the medicine in your prescription to clear up your infection, even if you feel better after the first few doses.
• Your doctor may also want you to take pyridoxine (vitamin B6) every day to help prevent or lessen some of the side effects of isoniazid.
• Missed dose: Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose.
• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Do not take this medicine if you also take medicine to treat HIV/AIDS, including ritonavir, saquinavir, atazanavir, darunavir, fosamprenavir, or tipranavir.
• There are many other drugs that interact with this medicine. Make sure your doctor knows all other medicines you are using. Some of the drugs of concern are phenytoin, digoxin, and blood thinners such as warfarin.
• If you use an antacid, take it at least 1 hour after you take rifampin/isoniazid/pyrazinamide.
• Birth control that uses hormones, such as birth control pills, may not work while you are using this medicine. Use a different kind of birth control, if needed.
• Avoid foods and drinks that are high in tyramine, because your blood pressure could get dangerously high. Your doctor should give you a complete list. In general, do not eat anything aged or fermented, such as most cheese, most alcohol, cured meat (such as salami), sauerkraut, and soy sauce. Check the expiration dates on packages. Tyramine levels get higher as food gets older or if it has not been refrigerated properly.
• You might need to avoid certain types of fish, such as tuna and skipjack, while you are taking this medicine, if eating them causes headaches, sweating, dizziness, or other side effects.

Warnings While Using This Medicine:

• Tell your doctor if you are pregnant or breastfeeding, or if you have liver disease, kidney disease, gout, diabetes, or porphyria (an enzyme problem).
• This medicine may cause the following problems:
  • Liver damage
  • High levels of uric acid, which causes symptoms of gout
• Tell your doctor if you drink alcohol. You could have a higher risk of liver problems.
• This medicine may turn your urine, bowel movements, saliva, sweat, and tears red. This is normal. This side effect could stain contact lenses.
• Call your doctor if your symptoms do not improve or if they get worse.
• Tell any doctor or dentist who treats you that you are using this medicine. This medicine may affect certain medical test results.
• Your doctor will check your progress and the effects of this medicine at regular visits. Keep all appointments.
• Keep all medicine out of the reach of children. Never share your medicine with anyone.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Blistering, peeling, or red skin rash
• Blurred vision, vision changes, trouble seeing
• Dark urine or pale stools, nausea, vomiting, loss of appetite, stomach pain, yellow skin or eyes
• Joint pain or swelling
• Numbness, tingling, or burning pain in your hands, arms, legs, or feet

If you notice these less serious side effects, talk with your doctor:

• Mild nausea, vomiting, diarrhea, or stomach pain

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088

Last Updated: 1/27/2017