Isoniazid; Pyrazinamide; Rifampin oral tablet

What is this medication?

ISONIAZID; PYRAZINAMIDE; RIFAMPIN (eye soe NYE a zid; peer a ZIN a mide; RIF am pin) treats tuberculosis (TB). It belongs to a group of medications called antibiotics. It will not treat colds, the flu, or infections caused by viruses.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

COMMON BRAND NAME(S): Rifater

What should I tell my care team before I take this medication?

They need to know if you have any of these conditions:

• Diabetes (high blood sugar)
• Gout
• HIV or AIDS
• If you often drink alcohol
• Kidney disease
• Liver disease
• Poor nutrition
• Tingling of the fingers or toes, or other nerve disorder
• Wear contact lenses
• An unusual or allergic reaction to isoniazid, rifampin, rifabutin, other medications, foods, dyes or preservatives
• Pregnant or trying to get pregnant
• Breast-feeding

How should I use this medication?

Take this medication by mouth with water. Take it as directed on the prescription label at the same time every day. Take it on any empty stomach, at least 1 hour before and 2 hours after food. Take all of this medication unless your care team tells you to stop it early. Keep taking it even if you think you are better.

Take antacids at a different time of day than this medication. Take this medication at least 1 hour before antacids.

Talk to your care team regarding the use of this medication in children. While it may be prescribed for children as young as 15 years for selected conditions, precautions do apply.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

What may interact with this medication?

Do not take this medication with any of the following:

• Artemether; lumefantrine
• Atomoxetine
• Certain antivirals for HIV or hepatitis
• Elagolix
• Idelalisib
• Isavuconazonium
• Lonafarnib
• Lorlatinib
• Lurasidone
• Praziquantel
• Ranolazine
• Voriconazole

This medication may also interact with the following:

• Acetaminophen
• Aminosalicylic acid
• Antacids
• Atovaquone
• Certain antibiotics like chloramphenicol, clarithromycin, dapsone, doxycycline, moxifloxacin, or sulfamethoxazole; trimethoprim
• Certain medications for blood pressure, heart disease, irregular heartbeat
• Certain medications for depression, anxiety, or psychotic disorders
• Certain medications for diabetes, like glipizide, glyburide, or rosiglitazone
• Certain medications for fungal infections like fluconazole, itraconazole, or ketoconazole
• Certain medications for seizures like carbamazepine, phenytoin, primidone, or valproic acid
• Certain medications for sleep
• Certain medications that treat or prevent blood clots like warfarin
• Clopidogrel
• Cycloserine
• Cyclosporine
• Disulfiram
• Female hormones, like estrogen or progestins and birth control pills
• Irinotecan
• Levodopa
• Levothyroxine
• Meperidine
• Methadone
• Morphine
• Ondansetron
• Oxycodone
• Probenecid
• Quinine
• Simvastatin
• Steroid medications like prednisolone
• Tacrolimus
• Tamoxifen
• Theophylline
• Ticagrelor
• Toremifene

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medication?

Tell your care team if your symptoms do not start to get better or if they get worse.

Do not treat diarrhea with over the counter products. Contact your care team if you have diarrhea that lasts more than 2 days or if it is severe and watery.

This medication may cause serious skin reactions. They can happen weeks to months after starting the medication. Contact your care team right away if you notice fevers or flu-like symptoms with a rash. The rash may be red or purple and then turn into blisters or peeling of the skin. Or, you might notice a red rash with swelling of the face, lips or lymph nodes in your neck or under your arms.

You may need blood work done while you are taking this medication.

Your vision may be tested before and during use of this medication.

Tell your care team right away if you have any change in your eyesight.

Birth control may not work properly while you are taking this medication. Talk to your care team about using an extra method of birth control.

You should make sure you get enough vitamin B6 and vitamin D while you are taking this medication. Discuss the foods you eat and the vitamins you take with your care team.

What side effects may I notice from receiving this medication?

Side effects that you should report to your care team as soon as possible:

• Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
• Bleeding—bloody or black, tar-like stools, vomiting blood or brown material that looks like coffee grounds, red or dark brown urine, small red or purple spots on skin, unusual bruising or bleeding
• Gout—severe pain, redness, warmth, or swelling in joints, such as the big toe
• Liver injury— right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue
• Rash, fever, and swollen lymph nodes
• Redness, blistering, peeling, or loosening of the skin, including inside the mouth
• Severe diarrhea, fever
• Trouble breathing
• TTP—purple spots on the skin or inside the mouth, pale skin, yellowing skin or eyes, unusual weakness or fatigue, fever, fast or irregular heartbeat, confusion, change in vision, trouble speaking, trouble walking

Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):

• Change in color to urine, saliva, sweat, or other body fluids
• Chest pain (angina)—pain, pressure, or tightness in the chest, neck, back, or arms
• Confusion
• Cough
• Dizziness
• Drowsiness
• Fatigue
• Gas
• Headache
• Heartburn
• Loss of appetite
• Nausea
• Pain, tingling, or numbness in the hands or feet
• Vomiting

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medication?

Keep out of the reach of children and pets.

Store at 25 degrees C (77 degrees F). Keep medication away from extreme humidity. Get rid of any unused medication after the expiration date.

To get rid of medications that are no longer needed or have expired:

• Take the medication to a medication take-back program. Check with your pharmacy or law enforcement to find a location.
• If you cannot return the medication, check the label or package insert to see if the medication should be thrown out in the garbage or flushed down the toilet. If you are not sure, ask your care team. If it is safe to put it in the trash, take the medication out of the container. Mix the medication with cat litter, dirt, coffee grounds, or other unwanted substance. Seal the mixture in a bag or container. Put it in the trash.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.