Rifampin/Isoniazid/Pyrazinamide, Oral rif-AM-pin eye-soh-NY-ah-zid peer-a-ZIN-a-mide

What are other names for this medicine?

Type of medicine: anti-infective

Generic and brand names: rifampin/isoniazid/pyrazinamide, oral; Rifater

What is this medicine used for?

This medicine is a combination of 3 drugs taken by mouth to treat tuberculosis. It is usually given at the beginning of treatment of tuberculosis (for about 2 months). Then treatment may be switched to other medicines.

What should my healthcare provider know before I take this medicine?

Before using this medicine, tell your healthcare provider if you have ever had:

• an allergic reaction to any medicine
• a problem with alcohol abuse
• diabetes
• gout
• liver or kidney disease
• porphyria (nerve pain or sensitivity to sunlight)

Females of childbearing age: Tell your healthcare provider if you are pregnant or plan to become pregnant. It is not known whether this medicine will harm an unborn baby. This medicine may decrease the effectiveness of birth control pills. Ask your healthcare provider about other methods of birth control. Do not breast-feed while taking this medicine without your healthcare provider's approval.

How do I take it?

Check the label on the medicine for directions about your specific dose. Take this medicine exactly as your healthcare provider prescribes. Take the tablets with a full glass of water 1Â hour before or 2Â hours after a meal. Take the dose at the same time each day to help you remember.

Take this medicine exactly as your healthcare provider prescribes. Take it regularly for as long as prescribed, even if you start to feel better. The infection may return if you stop taking the medicine too soon.

What if I miss a dose?

If you miss a dose, take it as soon as you remember unless it is almost time for the next scheduled dose. In that case, skip the missed dose and take the next one as directed. Do not take double doses. If you are not sure of what to do if you miss a dose, or if you miss more than one dose, contact your healthcare provider.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: nausea, vomiting, stomach pain, yellowing of skin or eyes, slurred speech, blurred vision, dizziness, hallucinations, seizures, coma.

What should I watch out for?

This medicine can cause liver problems. You will need to have blood tests regularly to see how this medicine affects you. Keep all appointments for these tests. Contact your healthcare provider right away if you develop severe tiredness, nausea, vomiting, loss of appetite, dark urine, fever, headache, muscle or joint pain, yellowing of your eyes and skin. These are signs of possible liver damage. Do not drink alcohol while taking this medicine.

This medicine may affect your vision. You should have regular eye exams while taking this medicine. Ask your healthcare provider about this.

This medicine may color your urine, sweat, saliva, and tears red. Soft contact lenses may be permanently stained. Wear hard lenses or eyeglasses during treatment.

If you need emergency care, surgery, or dental work, tell the healthcare provider you are taking this medicine.

Diabetics: This medicine may affect your blood sugar level and change the amount of insulin or other diabetes medicine you may need. Talk to your healthcare provider about this.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you are unable to reach your healthcare provider right away, get emergency medical care or call 911 for help): Allergic reaction (hives; itching; rash; trouble breathing; tightness in your chest; swelling of your lips, tongue, and throat).

Serious (report these to your healthcare provider right away): Fever, sore throat, loss of appetite, sick feeling, unusual weakness or tiredness, nausea and vomiting, dark urine, yellow skin or eyes, pain or swelling in your joints, muscle pain, severe headache, chest tightness or pain, tingling in your hands or feet, eye pain or sudden changes in vision, itchy skin, increased heart rate, seizures, unusual bleeding or bruising.

Other: Diarrhea, ringing in your ears, dizziness, sweating, headache, trouble sleeping, anxiety, coughing, mild rash.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• acetaminophen (Tylenol)
• antacids (take them at least 1 hour after taking this medicine)
• antibiotics such as azithromycin (Zithromax), ciprofloxacin (Cipro), clarithromycin (Biaxin), cycloserine (Seromycin), doxycycline (Adoxa, Doryx, Monodox, Vibramycin), and erythromycin (Ery-Tabs, E.E.S.)
• antidepressants such as amitriptyline, desipramine (Norpramin), doxepin, imipramine (Tofranil), mirtazapine (Remeron), nefazodone, and nortriptyline (Pamelor)
• antifungals such as fluconazole (Diflucan), itraconazole (Sporanox), ketoconazole (Nizoral), and voriconazole (VFEND)
• anti-HIV medicines such as atazanavir (Reyataz), delavirdine (Rescriptor), efavirenz (Sustiva), maraviroc (Selzentry), nelfinavir (Viracept), nevirapine (Viramune), raltegravir (Isentress), ritonavir (Norvir), saquinavir (Invirase), and zidovudine (Retrovir)
• antipsychotic medicines such as haloperidol (Haldol), quetiapine (Seroquel), and risperidone (Risperdal)
• antiseizure medicines such as carbamazepine (Tegretol), phenytoin (Dilantin), primidone (Mysoline), and valproic acid (Depakote, Depakene)
• aprepitant (Emend)
• atovaquone (Mepron)
• barbiturates such as butabarbital (Butisol) and phenobarbital
• benzodiazepines such as alprazolam (Xanax), chlordiazepoxide (Librium), clorazepate (Tranxene), diazepam (Valium), flurazepam, lorazepam (Ativan), oxazepam, prazepam, (Centrax), temazepam (Restoril), and triazolam (Halcion)
• beta blockers such as metoprolol (Lopressor) and propranolol (Inderal)
• birth control pills and estrogen
• buspirone (BuSpar)
• calcium channel blockers such as diltiazem (Cardizem, Dilacor), nifedipine (Procardia), nisoldipine (Sular), and verapamil (Calan, Isoptin)
• chloramphenicol (Chloromycetin)
• cholesterol-lowering medicines such as atorvastatin (Lipitor), lovastatin (Mevacor), and simvastatin (Zocor)
• clofibrate
• corticosteroids such as betamethasone (Celestone), cortisone, dexamethasone, hydrocortisone (Cortef, Hydrocortone, A-HydroCort), prednisone, prednisolone (Orapred), and triamcinolone (Aristospan, Kenalog)
• dapsone
• diabetes medicines such as insulin, glipizide (Glucotrol), glyburide (DiaBeta), metformin (Glucophage), pioglitazone (Actos), repaglinide (Prandin), rosiglitazone (Avandia), and saxagliptin (Onglyza)
• disulfiram (Antabuse)
• heart medicines such as amiodarone (Cordarone), digoxin, disopyramide (Norpace), enalapril (Vasotec), flecainide (Tambocor), mexiletine (Mexitil), quinidine, and tocainide (Tonocard)
• immunosuppressants such as azathioprine (Imuran), cyclosporine (Sandimmune, Gengraf, Neoral), mycophenolate mofetil (CellCept), sirolimus (Rapamune), and tacrolimus (Prograf, Protopic)
• levodopa/carbidopa (Sinemet)
• medicines to treat cancer such as bendamustine (Treanda), erlotinib (Tarceva), exemestane (Aromasin), gefitinib (Iressa) imatinib (Gleevec), and sorafenib (Nexavar)
• narcotic pain medicines such as codeine, fentanyl (Duragesic), meperidine (Demerol), methadone (Dolophine), and morphine (MS Contin)
• probenecid
• quinine
• silodosin (Rapaflo)
• sleeping pills such as eszopiclone (Lunesta), ramelteon (Rozerem), zaleplon (Sonata), and zolpidem (Ambien, Ambien CR)
• St. John's wort
• tamoxifen (Nolvadex)
• theophylline
• thyroid medicines such as levothyroxine (Levothroid, Synthroid), liothyronine (Cytomel), liotrix (Thyrolar), and thyroid USP (Armour Thyroid)
• vitamin D
• warfarin (Coumadin)

Do not drink alcohol while you are taking this medicine.

When taken with certain foods or drinks, this medicine can cause an increase in blood pressure. To avoid this, do not eat large amounts of foods or drink beverages that have a high tyramine content. This includes foods that are aged, fermented, pickled, or smoked, such as aged cheeses; yogurt, dried fruits, smoked fish, meat, or poultry; sauerkraut; soy sauce; red wine; or tap beer. Talk with your healthcare provider about this.

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.

This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.