Generic Name: isoniazid, pyrazinamide, and rifampin (EYE soe NYE a zid, PIR a ZIN a mide, and rif AM pin)Brand Names: Rifater
Isoniazid, pyrazinamide, and rifampin are antibiotics. They prevent tuberculous bacteria from multiplying in your body.
The combination of isoniazid, pyrazinamide, and rifampin is used to treat tuberculosis (TB).
Isoniazid, pyrazinamide, and rifampin may also be used for other purposes not listed in this medication guide.What is the most important information I should know about Rifater (isoniazid, pyrazinamide, and rifampin)?Take this medication for the full prescribed length of time. Your symptoms may get better before your infection is completely cleared. Isoniazid, pyrazinamide, and rifampin will not treat a viral infection such as the common cold or flu. Avoid drinking alcohol while taking isoniazid, pyrazinamide, and rifampin. Alcohol may increase your risk of liver damage. Isoniazid, pyrazinamide, and rifampin can make birth control pills less effective. Ask your doctor about using a different method of birth control while taking isoniazid, pyrazinamide, and rifampin. Avoid foods that are high in tyramine, listed in the "What should I avoid while taking isoniazid, pyrazinamide, and rifampin?" section of this leaflet. Tyramine can interact with this medication and cause unpleasant side effects.What should I discuss with my healthcare provider before taking Rifater (isoniazid, pyrazinamide, and rifampin)?You should not use this medication if you are allergic to isoniazid, pyrazinamide, or rifampin (Rifamate, Rifadin, Rimactane), or if you have:
severe liver disease;
active gout; or
if you have ever had drug fever, chills, and arthritis caused by taking this medication.
If you have any of these other conditions, you may need a dose adjustment or special tests to safely use isoniazid, pyrazinamide, and rifampin:
if you drink alcohol daily.
Take this medication exactly as prescribed by your doctor. Do not take it in larger amounts or for longer than recommended. Follow the directions on your prescription label.Take this medicine with a full glass (8 ounces) of water. Take isoniazid, pyrazinamide, and rifampin on an empty stomach, at least 1 hour before or 2 hours after a meal. Take this medication for the full prescribed length of time. Your symptoms may get better before your infection is completely cleared. Isoniazid, pyrazinamide, and rifampin will not treat a viral infection such as the common cold or flu.
To be sure this medication is not causing harmful effects, your liver function will need to be checked with blood tests on a regular basis. You may also need routine eye exams during treatment. Do not miss any follow-up visits to your doctor.
This medication can cause you to have unusual results with certain medical tests. Tell any doctor who treats you that you are taking isoniazid, pyrazinamide, and rifampin.Store this medication at room temperature away from moisture and heat.
Take the missed dose as soon as you remember. If it is almost time for your next dose, wait until then to take the medicine and skip the missed dose. Do not take extra medicine to make up the missed dose.
Overdose symptoms may include nausea, vomiting, slurred speech, hallucinations, and seizure.What should I avoid while taking Rifater (isoniazid, pyrazinamide, and rifampin)?Avoid drinking alcohol while taking isoniazid, pyrazinamide, and rifampin. Alcohol may increase your risk of liver damage.
If you take an antacid, avoid taking it within 1 hour after you have taken isoniazid, pyrazinamide, and rifampin. Antacids can make it harder for your body to absorb rifampin.
Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or has blood in it, stop taking this medication and call your doctor. Do not use any medicine to stop the diarrhea unless your doctor has told you to.Certain foods can interact with isoniazid, pyrazinamide, and rifampin, causing unpleasant side effects. Avoid foods that are high in tyramine, including:
avocados, bananas, figs, raisins, and sauerkraut;
beef or chicken liver, fish, meats prepared with tenderizer, bologna, pepperoni, salami, summer sausage, game meat, meat extracts, caviar, dried fish, herring, and shrimp paste;
beer (alcoholic and nonalcoholic), red wine (especially Chianti), sherry, vermouth, and other distilled spirits;
caffeine (including coffee, tea, cola); and
cheeses, including American, blue, boursault, brick, brie, camembert, cheddar, emmenthaler, gruyere, mozzarella, parmesan, romano, roquefort, stilton, and Swiss;
sour cream and yogurt;
soy sauce, miso soup, bean curd, fava beans; or
Do not wear soft contact lenses while taking isoniazid, pyrazinamide, and rifampin. This medicine may turn certain body fluids a red color (including tears, saliva, urine, and sweat). While this is a harmless side effect, it may permanently stain contact lenses.
nausea, stomach pain, loss of appetite;
dark urine, clay-colored stools; or
jaundice (yellowing of the skin or eyes).
fever, chills, body aches, flu symptoms, weakness, sores in your mouth and throat;
pale skin, easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin;
feeling short of breath, feeling like you might pass out;
cough, chest pain or tightness;
diarrhea that is watery or bloody;
urinating less than usual or not at all; or
drowsiness, mood changes, increased thirst, swelling, weight gain.
Less serious side effects may include:
mild stomach pain, heartburn, diarrhea;
mild rash or itching;
muscle or joint pain;
drowsiness, dizziness, spinning sensation;
ringing in your ears; or
numbness or tingling in your legs.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Many drugs can interact with isoniazid, pyrazinamide, and rifampin. Below is just a partial list. Tell your doctor if you are using:
cyclosporine (Gengraf, Neoral, Sandimmune);
theophylline (Elixophyllin, Theo-24, Uniphyl);
an antibiotic such as ciprofloxacin (Cipro), clarithromycin (Biaxin), dapsone, erythromycin (E.E.S., Erythrocin, Ery-Tab), and others;
antifungal medication such as fluconazole (Diflucan), itraconazole (Sporanox), ketoconazole (Nizoral);
a barbiturate such as butabarbital (Butisol), secobarbital (Seconal), pentobarbital (Nembutal), or phenobarbital (Solfoton);
birth control pills or hormone replacement therapy;
a blood thinner such as warfarin (Coumadin);
diabetes medications you take by mouth;
heart or blood pressure medication such as atenolol (Tenormin, Tenoretic), carvedilol (Coreg), digoxin (Lanoxin), diltiazem (Cartia, Cardizem), metoprolol (Toprol), propranolol (Inderal), nifedipine (Procardia), verapamil (Covera, Isoptin, Verelan), and others;
heart rhythm medication such as disopyramide (Norpace), mexiletine (Mexitil), quinidine (Quinaglute, Quinidex, Quin-Release);
narcotic medications such as buprenorphine (Buprenex, Subutex), fentanyl (Actiq, Duragesic, Fentora), methadone (Dolophine, Methadose);
a sedative such as diazepam (Valium);
seizure medication such as carbamazepine (Carbatrol, Tegretol), phenytoin (Dilantin), primidone (Mysoline), valproic acid (Depakene);
a steroid such as prednisolone; or
a sulfa drug (Cotrim, Bactrim, Septra, SMX-TMP, and others).