Rifater

1 What is Rifater?

Brand: Rifater

Generic: Rifampin, Isoniazid, and Pyrazinamide

Rifater combination product containing three antitubercular agents namely rifampin, isoniazid, and pyrazinamide is used in the treatment of tuberculosis (TB).

You can get this product only after your doctor prescribes it for you. It is available as:

  • Tablet

2 What to Know Before Using

Before using Rifater, you must know all about the risks and complications associated with it. Together with your doctor, you can decide whether the medication will do you more goods than the harms.

Here are some factors to be considered before deciding to use this medicine:

Allergies

Inform your doctor about the allergies you have, such as to this medication, other medications, or to foods, dyes, or preservatives.

Pediatric

Using this combination in children and teenagers below 15 years is not recommended.

Geriatric

It may be used in elderly after assessing risks and benefits of the use.

Pregnancy

The pregnancy category of this product is C for all trimesters, meaning that due to lack of sufficient studies, it’s not clear if this combination is safe for use in pregnancy.

Breastfeeding

It may be used in a nursing mother after assessing risks and benefits of the use.

Drug Interactions

Taking two medicines together can be harmful due to possible interactions. In other cases, even if there is a possible interaction between two medicines your doctor may advise you to take them together after adjusting the dose or issuing precautions. Here is a list of the medicines which in general are not recommended to be used with rifampin.

Inform your doctor if you are using any of these medicines:

  • Atazanavir
  • Darunavir
  • Fosamprenavir
  • Ritonavir
  • Saquinavir
  • Tipranavir
  • Voriconazole

Though usually not recommended, your doctor may decide, after adjusting dose or frequency of one or both medicines, to use this medicine with any of the following medicines:

  • Acetaminophen
  • Afatinib
  • Amiodarone
  • Amprenavir
  • Atovaquone
  • Bedaquiline
  • Brexpiprazole
  • Bupropion
  • Carbamazepine
  • Clozapine
  • Cyclosporine
  • Dabigatran
  • Delavirdine
  • Domperidone
  • Donepezil
  • Doxorubicin
  • Efavirenz
  • Eliglustat
  • Etravirine
  • Everolimus
  • Fosphenytoin
  • Glimepiride
  • Indinavir
  • Itraconazole
  • Ketoconazole
  • Lamotrigine
  • Ledipasvir
  • Levodopa
  • Linagliptin
  • Mycophenolate Mofetil
  • Nevirapine
  • Nifedipine
  • Nimodipine
  • Palbociclib
  • Panobinostat
  • Phenytoin
  • Piperaquine
  • Pitavastatin
  • Posaconazole
  • Quinine
  • Sirolimus
  • Sorafenib
  • Tacrolimus
  • Telithromycin
  • Temsirolimus
  • Tolvaptan
  • Vilazodone
  • Vincristine
  • Vinflunine
  • Vortioxetine
  • Zidovudine

Rarely and only when absolutely needed, this medicine may be used with the following medicines even if using them together may put you at risk of certain side effects. In such cases, you may have to take the adjusted dose or change the frequency of intake.

  • Acetyldigoxin
  • Aminosalicylic Acid
  • Atorvastatin
  • Betamethasone
  • Bexarotene
  • Buspirone
  • Carbamazepine
  • Carvedilol
  • Chloramphenicol
  • Chlorpropamide
  • Citalopram
  • Clarithromycin
  • Clofibrate
  • Desogestrel
  • Diazepam
  • Dicumarol
  • Diltiazem
  • Disopyramide
  • Disulfiram
  • Doxycycline
  • Enalapril Maleate
  • Ethinyl Estradiol
  • Ethionamide
  • Fluconazole
  • Fosphenytoin
  • Gliclazide
  • Haloperidol
  • Levonorgestrel
  • Levothyroxine
  • Linezolid
  • Losartan
  • Mefloquine
  • Mestranol
  • Metformin
  • Methadone
  • Morphine
  • Moxifloxacin
  • Nisoldipine
  • Norelgestromin
  • Norethindrone
  • Norgestimate
  • Norgestrel
  • Phenytoin
  • Pioglitazone
  • Propafenone
  • Raltegravir
  • Rofecoxib
  • Rosiglitazone
  • Sertraline
  • Simvastatin
  • Tamoxifen
  • Theophylline
  • Triazolam
  • Valproic Acid
  • Warfarin
  • Zidovudine

Other Interactions:

Taking your medicine together with certain foods or items such as alcohol or tobacco may cause undesirable interactions. Talk to your doctor to know if using this medicine with food, alcohol, or tobacco is safe. AVOID high-tyramine foods such as beer, aged cheese, smoked meats, fermented pickles, sauces, and soybeans.

Medical Problems

Inform your doctor about the following conditions, if any:

  • Alcoholism in the past: Daily alcohol intake while taking this medicine increases your risk of hepatitis.
  • History of diabetes
  • Porphyria: Use cautiously.
  • Acute or severe liver impairment: Do not use this medicine.
Have a question aboutTuberculosis?Ask a doctor now

3 Proper Usage

To use Rifater properly, you must follow all instructions given by your doctor. Here are some points to consider:

  • Follow your doctor’s instructions about the use of any medicine.
  • Never discontinue or skip the dose of any antitubercular medicines without consulting your doctor. Doing so can make the TB microorganism resistant to treatment. Remember that TB treatments last for months.
  • Take this medicine on an empty stomach. If doing so upsets your stomach, take it with a meal. You may also take aluminum-free antacids to help your upset stomach.
  • Take daily doses of pyridoxine (vitamin B6) if recommended by your doctor. Vitamin B6 helps to fight against some side effects of isoniazid.

Dosing

For best results, follow your doctor to know what amount of medicine you should take in a single dose. The doses of a medicine can differ according to the conditions for which it is being prescribed. Remember your doses can differ. Consult your doctor if you have anything to ask. The doses of tablets are:

For the treatment of tuberculosis

  • Adults and teenagers above 15 years and weight 55 kilograms (kg) or more: 6 tablets in a day.
  • Adults and teenagers above 15 years and weight 45 to 54 kg: 5 tablets in a day.
  • Adults and teenagers over 15 years and weight 44 kg or less: 4 tablets in a day.
  • Teenagers and children below 15 years: Not recommended.

Missed Dose

Take your missed dose once you remember but avoid it if it’s time to take your next dose, and follow your normal dosing schedule. Avoid taking double doses to make up for the missed dose.

Storage

  • Store in a closed container at room temperature.
  • Keep away from heat, moisture, and direct light.
  • Do not freeze.
  • Keep away from children.
  • Discard any unused or expired medicines.

4 Precautions to Take

Before using Rifater, there are some precautions you must take. Your progress should be regularly monitored to determine if you are responding to the treatment. You may also need blood tests to detect any undesirable effects.

Talk to your doctor if your symptoms do not respond even after 3 weeks or worsen. Remember:

  • Do not take this medicine if you are taking atazanavir, darunavir, fosamprenavir, ritonavir, saquinavir, tipranavir.
  • AVOID alcohol while taking this medicine as alcohol can further damage your liver and make the medicine less effective.
  • Consult your doctor immediately if you have blurry vision or any other vision changes.
  • Discontinue the medicine and call your doctor immediately if you have swollen, painful and stiff joints, lower back, side, or stomach pain, or swollen feet or lower legs.
  • You may have reddish-orange colored urine, stools, saliva, sputum, sweat, and tears while taking this medicine. Do not panic as it is normal. Colored tears can affect your soft contact lenses if you're wearing them. Therefore, during the treatment with this medicine, do not wear soft contact lenses.
  • If you develop symptoms indicative of serious liver damage, such as the tender upper stomach, pale stools, dark urine, decreased appetite, or yellowish eyes or skin, see your doctor immediately.
  • It can also affect your blood clotting mechanisms making your bleed or bruise more readily. Therefore, take extra care while brushing or flossing your teeth. Any dental procedure should be conducted only after your blood counts become normal.
  • If you are allergic to this medicine, you may develop a life-threatening allergic reaction called anaphylaxis. Seek emergency medical help if you have an itchy rash, rapid heart rhythm, hive, fever or chills, dizziness, or fainting, swollen eyelids or areas around the eyes, or abnormal bleeding, bruising.
  • It can also affect results of some medical tests. Inform the concerned doctor about your intake of rifampin.
  • Do not take high-tyramine foods such as beer, aged cheese, smoked meats, fermented pickles, sauces, and soybeans. If you have to flush, rapid heartbeat, headache, red or itchy skin, sweating, or dizziness, see your doctor immediately.
  • It can interfere with the action of some contraceptive pills. Therefore, use other contraceptive measures to avoid pregnancy.
  • Consult your doctor before taking any prescription or nonprescription medicines and herbal or vitamin supplements.

5 Potential Side Effects

Make sure you meet with your doctor in using Rifater to avoid unwanted potential side effects.

Consult your doctor immediately if you experience any of the following side effects:

More common:

  • Balance problems
  • Dark urine
  • Decreased appetite
  • Continuous nausea and vomiting
  • Numbness or tingling, burning sensations in the limbs
  • Painful joints
  • Excessive tiredness
  • Yellowish eyes or skin

Less common:

  • Chills
  • Breathing problems
  • Dizziness
  • Fever
  • Headache
  • Muscle and bone pain
  • Red skin
  • Tremors
  • Rash

Rare:

  • Blood in urine
  • Blurry vision
  • Inability to see
  • Seizures
  • Marked reduction in frequency of urination or urine volume
  • Depression
  • Mood alterations
  • Abnormal bleeding or bruising

Mild and non-serious side effects usually go away on their own without requiring medical intervention. You may also ask your doctor to learn more about how you may prevent or reduce the side effects.

Talk to your doctor if the side effects persist or worry you, including:

More common:

Less common:

  • Pain in mouth or tongue

You may also have reddish-brown urine, stool, saliva, sputum, sweat, and tears during this treatment. This is normal and usually harmless.

The side effects of the medicine are not limited to the ones listed above. Call your doctor immediately if you experience any side effects that are uncommon or worry you. To report side effects to the FDA, contact at 1-800-FDA-1088.

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