Isoniazid + Rifampicin
Find more information about this combination medication at the webpages for Isoniazid and Rifampicin
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Advisory
- This medicine contains a combination of 2 drugs: Isoniazid and Rifampicin.
- Based on evidence, Isoniazid and Rifampicin are more effective when taken together.
Drug Status
Government Approvals
UK(BNF)
WHO Essential Medicine
YES
Known Teratogen
No
Pharmaceutical Class
None
Controlled Drug Substance
NO
Summary
Isoniazid and Rifampicin are primarily used to treat tuberculosis, which is a serious bacterial infection affecting the lungs. Isoniazid is also used as a preventive measure for those exposed to tuberculosis but not yet showing symptoms. Rifampicin can treat other bacterial infections like leprosy, which is a chronic disease affecting the skin and nerves. Both drugs are essential in the standard treatment regimen for tuberculosis, often used together to effectively combat the disease and prevent the development of drug-resistant strains.
Isoniazid works by inhibiting the synthesis of mycolic acids, which are essential components of the bacterial cell wall, thereby killing the bacteria. Rifampicin works by inhibiting RNA polymerase, which is an enzyme necessary for bacterial RNA synthesis, thus preventing the bacteria from multiplying. Both medicines are effective against the bacteria that cause tuberculosis, but they work in different ways. They are often used together to prevent the bacteria from becoming resistant to treatment.
The usual adult daily dose for Isoniazid is typically 300 mg taken once a day. Rifampicin is usually taken at a dose of 600 mg once a day. Both drugs are taken orally, which means they are swallowed in pill form. They should be taken on an empty stomach, which means one hour before or two hours after a meal, to ensure better absorption. This combination therapy is more effective than using either drug alone.
Isoniazid can cause side effects like nausea, vomiting, and numbness in the hands and feet, which is called peripheral neuropathy. A significant adverse effect of Isoniazid is liver damage, which can lead to symptoms like yellowing of the skin or eyes, known as jaundice. Rifampicin can cause side effects such as stomach upset, heartburn, and a reddish-orange discoloration of bodily fluids like urine and tears. Both drugs share the risk of liver damage, so regular monitoring of liver function is important.
Isoniazid should be taken with caution in people with liver problems, as it can cause liver damage. It can also interact with certain medications like phenytoin, increasing their levels in the blood. Rifampicin can decrease the effectiveness of many drugs, including oral contraceptives, by speeding up their breakdown in the liver. Both drugs can interact with other medications, so it’s important to inform your doctor about all medicines you are taking. They should not be used by people who are allergic to them.
Indications and Purpose
How does combination of Isoniazid and Rifampicin work?
Isoniazid and Rifampicin are both used to treat tuberculosis, which is a bacterial infection that mainly affects the lungs. Isoniazid works by inhibiting the synthesis of mycolic acids, which are essential components of the bacterial cell wall. Without these acids, the bacteria cannot survive. Rifampicin, on the other hand, works by inhibiting RNA polymerase, which is an enzyme necessary for the bacteria to make proteins and reproduce. Both medicines are effective against the bacteria that cause tuberculosis, but they work in different ways. They are often used together to prevent the bacteria from becoming resistant to treatment. This combination therapy is more effective than using either drug alone. Both drugs are taken orally and are absorbed into the bloodstream, where they travel to the site of infection to exert their effects.
How effective is combination of Isoniazid and Rifampicin?
Isoniazid and Rifampicin are both effective in treating tuberculosis, which is a serious infectious disease that mainly affects the lungs. Isoniazid works by killing the bacteria that cause tuberculosis, which are called Mycobacterium tuberculosis. It is particularly effective in the early stages of treatment. Rifampicin also targets these bacteria but works by stopping them from making essential proteins, which are needed for their survival. Both medicines are often used together because they attack the bacteria in different ways, making the treatment more effective. They share the common attribute of being part of the first-line treatment for tuberculosis, which means they are among the first medicines used to treat this disease. However, each has unique attributes: Isoniazid is known for its ability to prevent the disease in people who have been exposed to the bacteria, while Rifampicin is also used to treat other infections like leprosy.
Directions for Use
What is the usual dose of combination of Isoniazid and Rifampicin?
The usual adult daily dose for Isoniazid, which is a medicine used to treat and prevent tuberculosis, is typically 300 mg taken once a day. Rifampicin, which is another medicine used to treat tuberculosis and other bacterial infections, is usually taken at a dose of 600 mg once a day. Isoniazid is unique because it specifically targets the bacteria that cause tuberculosis, and it is often used as a preventive measure for those who have been exposed to the disease. Rifampicin is unique in its ability to treat a broader range of bacterial infections beyond tuberculosis. Both medicines share the common attribute of being essential in the treatment of tuberculosis. They are often used together in combination therapy to effectively combat the disease and prevent the development of drug-resistant strains of bacteria.
How does one take combination of Isoniazid and Rifampicin?
Isoniazid should be taken on an empty stomach, which means one hour before or two hours after a meal, to ensure better absorption. It's important to avoid alcohol while taking Isoniazid, as it can increase the risk of liver damage. Rifampicin should also be taken on an empty stomach, either one hour before or two hours after a meal, for optimal absorption. Like Isoniazid, alcohol should be avoided with Rifampicin due to potential liver damage. Both medicines are used to treat tuberculosis, which is a bacterial infection affecting the lungs. They share the common attribute of requiring careful monitoring of liver function during treatment. However, Isoniazid is unique in that it may cause peripheral neuropathy, which is nerve damage, and taking vitamin B6 can help prevent this. Rifampicin is unique in that it can cause bodily fluids like urine and tears to turn a reddish-orange color, which is harmless but can be alarming.
For how long is combination of Isoniazid and Rifampicin taken?
Isoniazid and Rifampicin are both used to treat tuberculosis, which is a bacterial infection that mainly affects the lungs. The typical duration of use for these medicines is usually 6 to 9 months, depending on the specific treatment plan prescribed by a healthcare provider. Isoniazid is unique because it works by stopping the growth of bacteria. It is often used as a preventive treatment for people who have been exposed to tuberculosis but do not yet show symptoms. Rifampicin, on the other hand, is known for its ability to kill bacteria that are actively growing. It is also used to treat other infections like leprosy. Both medicines are often used together because they work in different ways to effectively combat the tuberculosis bacteria. They share the common attribute of being antibiotics, which are medicines that fight bacterial infections.
How long does it take for combination of Isoniazid and Rifampicin to work?
The time it takes for a combination medicine to start working depends on the individual medicines involved. For example, if the combination includes ibuprofen, which is a pain reliever and anti-inflammatory drug, it typically starts working within 20 to 30 minutes. On the other hand, if the combination includes acetaminophen, which is another pain reliever, it usually begins to work within 30 to 60 minutes. Both medicines are used to relieve pain and reduce fever, which means they share the common attribute of providing pain relief. However, ibuprofen also reduces inflammation, which is swelling and redness, while acetaminophen does not. Therefore, the combination medicine may start working within 20 to 60 minutes, depending on the specific medicines included and their unique attributes.
Warnings and Precautions
Are there harms and risks from taking combination of Isoniazid and Rifampicin?
Isoniazid and Rifampicin are both used to treat tuberculosis, which is a bacterial infection that mainly affects the lungs. Isoniazid can cause side effects like nausea, vomiting, and numbness in the hands and feet, which is called peripheral neuropathy. A significant adverse effect of Isoniazid is liver damage, which can lead to symptoms like yellowing of the skin or eyes, known as jaundice. Rifampicin can cause side effects such as stomach upset, heartburn, and a reddish-orange discoloration of bodily fluids like urine and tears. A significant adverse effect of Rifampicin is also liver damage, similar to Isoniazid. Both drugs share the risk of liver damage, so regular monitoring of liver function is important. They are often used together in treatment, but each has unique side effects that need to be managed carefully.
Can I take combination of Isoniazid and Rifampicin with other prescription drugs?
Isoniazid and Rifampicin are both used to treat tuberculosis, which is a bacterial infection that mainly affects the lungs. Isoniazid can interact with certain medications like phenytoin, which is used to control seizures, by increasing its levels in the blood, potentially leading to toxicity. It can also affect the metabolism of other drugs like warfarin, which is a blood thinner, increasing the risk of bleeding. Rifampicin, on the other hand, can decrease the effectiveness of many drugs, including oral contraceptives, which are birth control pills, and certain antiretrovirals, which are used to treat HIV. This happens because Rifampicin speeds up the breakdown of these drugs in the liver. Both Isoniazid and Rifampicin can cause liver damage, so they should be used with caution in people with liver problems. They also share the common attribute of being part of the standard treatment regimen for tuberculosis.
Can I take combination of Isoniazid and Rifampicin if I am pregnant?
Isoniazid, which is a medication used to treat and prevent tuberculosis, is generally considered safe during pregnancy. However, it is important for pregnant women to take vitamin B6 supplements alongside it to prevent nerve damage. Rifampicin, which is another drug used to treat tuberculosis, is also used during pregnancy but with caution. It can cross the placenta, which means it can reach the baby, and may cause bleeding problems in the newborn. Both Isoniazid and Rifampicin are used to treat tuberculosis, which is a serious infection that can harm both the mother and baby if left untreated. While both drugs are used during pregnancy, they require careful monitoring by a healthcare provider to ensure the safety of both the mother and the baby. It is crucial to weigh the benefits of treating tuberculosis against the potential risks of these medications during pregnancy.
Can I take combination of Isoniazid and Rifampicin while breastfeeding?
Isoniazid, which is a medication used to treat tuberculosis, is generally considered safe during breastfeeding. It passes into breast milk in small amounts, but these are not expected to harm a nursing infant. However, infants should be monitored for any signs of liver problems, as isoniazid can affect the liver. Rifampicin, which is another tuberculosis medication, also passes into breast milk in small amounts. It is usually safe for breastfeeding mothers, but it can cause the breast milk to turn a reddish color, which is harmless. Infants should be observed for any unusual symptoms. Both isoniazid and rifampicin are used to treat tuberculosis and are considered safe during breastfeeding. They share the common attribute of passing into breast milk in small amounts, but neither is expected to harm the infant. Monitoring the infant for any side effects is recommended for both medications.
Who should avoid taking combination of Isoniazid and Rifampicin?
Isoniazid and Rifampicin are medications used to treat tuberculosis, which is a bacterial infection that mainly affects the lungs. Both drugs can cause liver damage, so people with liver disease should use them cautiously. Regular liver function tests are recommended during treatment. Isoniazid can cause nerve damage, which refers to harm to the nerves that can lead to tingling or numbness in the hands and feet. To prevent this, doctors often prescribe vitamin B6 alongside it. Rifampicin can cause urine, sweat, and tears to turn a reddish-orange color, which is harmless but can stain clothing. It can also reduce the effectiveness of birth control pills, so alternative contraception methods should be used. Both drugs can interact with other medications, so it’s important to inform your doctor about all medicines you are taking. They should not be used by people who are allergic to them.
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