Learn more about usage, cautions, and possible side effects .
Chemical Name: ISONIAZID (EYE-soe-NYE-a-zid), RIFAMPIN (rif-AM-pin), and PYRAZINAMIDE (PIR-a-ZIN-a-mide)
This medicine is a combination of 3 antibacterial agents used for treating tuberculosis (TB) of the lungs.
WARNING: This medicine may cause severe and sometimes fatal liver problems (eg, hepatitis). The risk of liver problems is greater in patients more than 35 years old. It may also be increased by daily use of alcohol, long-term liver problems, or unsanitary injectable drug use. Women, especially those who are black or Hispanic, or who have just had a baby, may also be at increased risk. Hepatitis can develop at any time during treatment, but usually occurs during the first 3 months. Your doctor will monitor your liver function and discuss your progress every month. Contact your doctor right away if you develop unusual fatigue, weakness or fever that lasts longer than 3 days, general feeling of discomfort, loss of appetite, nausea, vomiting, numbness or tingling of the hands or feet, dark urine, yellowing of the skin or eyes, or stomach pain or tenderness. Patients with active liver problems should not use this medicine. Some medicines or medical conditions may interact with this medicine. INFORM YOUR DOCTOR OR PHARMACIST of all prescription and over-the-counter medicine that you are taking. DO NOT TAKE THIS MEDICINE IF you are taking ranolazine, temsirolimus, a tyrosine kinase receptor inhibitor (eg, lapatinib), or voriconazole. ADDITIONAL MONITORING OF YOUR DOSE OR CONDITION may be needed if you are taking other prescription and nonprescription medicines (eg, used for alcoholism, allergic reactions, anxiety, arthritis, asthma, birth control, blood pressure, blood thinning, cancer, cholesterol, depression, diabetes, Hansen disease, heart problems, HIV, hormone replacement, immune system suppression, infections, irregular heartbeat, mental or mood problems, nausea and vomiting, pain, Parkinson disease, seizures, sleep). DO NOT START OR STOP any medicine without doctor or pharmacist approval. Inform your doctor of any other medical conditions including diabetes; the blood disease porphyria; kidney problems; nerve problems (eg, neuropathy) or risk of nerve problems; HIV; severe diarrhea due to antibiotic use (pseudomembranous colitis); a history of liver problems; gout; allergies; pregnancy; or breast-feeding. Tell your doctor if you have a history of alcohol or other substance abuse; have unsanitary injectable drug habits; drink alcohol daily; wear contact lenses; are more than 35 years old; have recently given birth; or have previously taken this medicine. USE OF THIS MEDICINE IS NOT RECOMMENDED if you have severe liver damage; active liver disease; liver damage from previous use of this medicine; active gout; or a history of hepatitis caused by any medicine. Contact your doctor or pharmacist if you have any questions or concerns about using this medicine.
Follow the directions for taking this medicine provided by your doctor. Take this medicine by mouth on an empty stomach at least 1 hour before or 2 hours after eating. Take this medicine with a full glass of water (8 oz/240 mL). If you also take an antacid, take this medicine at least 1 hour before you take the antacid. If you also take aminosalicylic acid granules, do not take them within 8 to 12 hours of this medicine. Check with your doctor if you have questions. STORE THIS MEDICINE between 59 and 86 degrees F (15 and 30 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. CONTINUE TO TAKE THIS MEDICINE even if you feel well. Do not miss any doses. Do not stop taking this medicine without checking with your doctor. Rarely, kidney problems have occurred when patients started taking this medicine again after stopping therapy. IF YOU MISS A DOSE of this medicine, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.
DO NOT USE THIS MEDICINE IF you are allergic to any ingredient in this medicine or have had severe side effects from isoniazid (eg, drug fever, chills, or arthritis). LAB TESTS, including complete blood cell counts, uric acid levels, liver function, and eye exams, may be performed to monitor your condition or check for side effects. KEEP ALL DOCTOR AND LAB APPOINTMENTS. THIS MEDICINE MAY CAUSE DROWSINESS OR DIZZINESS. These effects may be worse if you take it with alcohol or certain medicines. DO NOT DRIVE OR PERFORM OTHER POSSIBLY UNSAFE TASKS until you know how you react to it. CHECK WITH YOUR DOCTOR BEFORE DRINKING ALCOHOL while taking this medicine. Alcohol may increase the risk of liver problems. IF YOU HAVE A HISTORY OF ALCOHOL ABUSE, you may also be at increased risk of developing nerve problems from this medicine. Notify your doctor if you notice any unusual tingling or numbness in your hands or feet. IF YOU HAVE A HISTORY OF DIABETES, ALCOHOL ABUSE, OR POOR NUTRITION, your doctor may recommend that you also take vitamin B6 while you are taking this medicine to help decrease your risk of nerve problems. THIS MEDICINE MAY CAUSE A REDDISH ORANGE COLOR of urine, stools, saliva, tears, sweat, sputum, and skin. This is normal and not a cause for concern. THIS MEDICINE MAY CAUSE A PERMANENT REDDISH ORANGE COLOR of soft contact lenses. DO NOT EAT FOODS HIGH IN TYRAMINE (eg, aged cheeses, red wines, beer, certain meats and sausages, liver, sour cream, soy sauce, raisins, bananas, avocados) while you take this medicine as this may cause severe high blood pressure. Seek medical attention at once if symptoms of severe high blood pressure occur (eg, severe headache, fast or irregular heartbeat, sore or stiff neck, nausea, vomiting, sweating, enlarged pupils, or sensitivity to light). DO NOT EAT FOODS HIGH IN HISTAMINE (eg, skipjack, tuna, tropical fish) while you take this medicine as this may cause low blood pressure, irregular heartbeat, headache, sweating, or flushing. Contact your doctor at once if any of these symptoms occur. ASK YOUR HEALTHCARE PROVIDER for a complete list of all foods you should avoid while you are taking this medicine. MILD DIARRHEA IS COMMON with antibiotic use. A MORE SERIOUS FORM OF DIARRHEA (PSEUDOMEMBRANOUS COLITIS) MAY RARELY OCCUR. This may develop while you take the antibiotic or within several months after you stop taking it. Contact your doctor right away if stomach pain or cramps, severe diarrhea, or bloody stools occur. Do not treat diarrhea without first checking with your doctor. TELL YOUR DOCTOR OR DENTIST THAT YOU TAKE THIS MEDICINE before you receive any medical or dental care, emergency care, or surgery. THIS MEDICINE MAY INTERFERE WITH CERTAIN LAB TESTS. Tell your doctor and lab personnel you are taking this medicine. USE THIS MEDICINE WITH CAUTION IN BLACK AND HISPANIC WOMEN OR IN PATIENTS OVER 35 YEARS OLD; they may have a greater risk of severe liver problems from this medicine. BEFORE YOU BEGIN TAKING ANY NEW MEDICINES, either prescription or over-the-counter, check with your doctor or pharmacist. FOR WOMEN: Hormonal birth control (eg, birth control pills) may not work as well while you are using this medicine. To prevent pregnancy, use an extra form of birth control (eg, condoms). IF YOU BECOME PREGNANT, contact your doctor to discuss the benefits and risks of taking this medicine while you are pregnant. THIS MEDICINE IS FOUND in breast milk. DO NOT BREAST-FEED while taking this medicine. DIABETES PATIENTS: This medicine may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine. You may also be at increased risk of developing nerve problems from this medicine. Contact your doctor if you notice any unusual tingling in your hands or feet.
SIDE EFFECTS that may occur while taking this medicine include diarrhea; dizziness; drowsiness; gas; headache; heartburn; mild joint or muscle aches; mild stomach upset or cramps; nausea; or trouble sleeping. If they continue or are bothersome, check with your doctor. CONTACT YOUR DOCTOR IMMEDIATELY if you experience bloody stools; change in the amount of urine produced; changes in vision; chest pain; coughing up blood; dark urine; fever, chills, or sore throat; general feeling of discomfort; increased thirst or urination; irregular heartbeat; joint pain or swelling; loss of appetite; memory problems; menstrual changes; mental or mood changes; nausea; ringing in the ears; seizures; severe diarrhea, nausea, or stomach cramps; severe or persistent muscle pain; severe pain or tenderness in the big toe; shortness of breath; stomach pain or tenderness; swelling of the hands or legs; swollen lymph nodes; symptoms of low B6 levels (eg, confusion, cracks in the corners of the mouth, irritability, mouth redness or soreness, scaly rash); tingling or numbness in the hands or feet; unusual bruising or bleeding; unusual tiredness or weakness; vomiting; or yellowing of the skin or eyes. This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. AN ALLERGIC REACTION to this medicine is unlikely, but seek immediate medical attention if it occurs. Symptoms of an allergic reaction include rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue; or unusual hoarseness. If you notice other effects not listed above, contact your doctor, nurse, or pharmacist. This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your healthcare provider. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Drug interactions can result in unwanted side effects or prevent a medicine from doing its job. Use our drug interaction checker to find out if your medicines interact with each other. Check drug interactions
If overdose is suspected, contact your local poison control center or emergency room immediately. Symptoms may include blurred vision, hallucinations, loss of consciousness, seizures, severe dizziness or nausea, sluggishness, slurred speech, stomach pain or tenderness, symptoms of high blood sugar (such as increased thirst or urination, rapid breathing, confusion, unusual drowsiness), very slow breathing, vomiting, and yellowing of the skin or eyes.
DO NOT SHARE THIS MEDICINE with others for whom it was not prescribed. DO NOT USE THIS MEDICINE for other health conditions. KEEP THIS MEDICINE out of the reach of children. IF USING THIS MEDICINE FOR AN EXTENDED PERIOD OF TIME, obtain refills before your supply runs out.
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