Rifampicin 150 mg+ Isoniazid 75 mg + Pyrazinamide 400 mg + Ethambutol 275 mg Tablets USP

Who is this for?

This is a combination tablet containing four anti-tuberculosis medicines (Rifampicin, Isoniazid, Pyrazinamide, and Ethambutol) that work together to kill the bacteria that cause TB by attacking it in different ways, making treatment more effective and reducing the chance the bacteria becomes resistant.

Inhibits multiple stages of mycobacterial growth through complementary mechanisms: rifampicin binds bacterial RNA polymerase to block transcription; isoniazid and pyrazinamide inhibit mycolic acid synthesis essential for cell wall integrity; ethambutol inhibits arabinosyl transferases required for cell wall arabinogalactan synthesis. These synergistic actions prevent both active and latent Mycobacterium tuberculosis replication.

Is Ethambutol safe to take with another drug?

Take all your tablets together once daily, on an empty stomach — ideally 1 hour before food or 2 hours after food for best absorption. The number of tablets depends on your body weight: 30–39 kg takes 2 tablets, 40–54 kg takes 3 tablets, 55–70 kg takes 4 tablets, and above 70 kg takes 5 tablets. Your doctor will tell you exactly how many to take. This 4-drug combination is usually taken for the first 2 months (intensive phase) of TB treatment.

If you miss a dose, take it as soon as you remember on the same day. If it is almost time for your next dose, skip the missed one and continue your normal schedule. Never take a double dose. Missing doses regularly can cause the TB bacteria to become drug-resistant, so try your best to take your medicine every single day.

• Orange or reddish colour of urine
• tears
• sweat
• and saliva (this is normal and harmless — it is caused by Rifampicin)
• stomach upset or nausea especially in the first few weeks
• joint pain or body aches
• loss of appetite

Avoid alcohol completely during treatment — combining alcohol with these medicines greatly increases the risk of liver damage. Rifampicin reduces the effectiveness of birth control pills, so women should use additional contraception methods like condoms. If you are taking medicines for HIV (especially ARVs like Efavirenz or Dolutegravir), diabetes, epilepsy, or blood thinners, tell your doctor because Rifampicin affects how many other drugs work in your body.

Store in a cool, dry place away from direct sunlight and heat — avoid storing near windows or in hot kitchens. Keep the tablets in their original container and protect from moisture. Always keep out of reach of children.