Rimstar 4-FDC - Tablet Ethambutol + Isoniazid + Pyrazinamide + Rifampicin - 10 Tablet(s) / Strip Nevian Lifescience PLC Introduction: Rimstar 4-FDC is a combination medicine used in the treatment of tuberculosis. It prevents the growth of the microorganisms that cause the infection. Rimstar 4-FDC is a prescription medicine and it is to be taken it as suggested by the doctor. It should be taken in an empty stomach and take it at a fixed time to ensure better efficacy. Do not consume more than the recommended dose, as this may have harmful effects on your body. If you miss a dose, take it as soon as you remember. The course of the treatment must be completed even if you... Uses of Rimstar 4-FDC: Tuberculosis (TB) Side effects of Rimstar 4-FDC: NauseaVomitingRashFeverDark colored urineSweatingIncreased sputum productionSalivationWatery eyesPeripheral neuropathy (tingling and numbness of feet and hand)Increased liver enzymesJaundiceIncreased uric acid level in bloodVisual impairment How to use Rimstar 4-FDC: Take this medicine in the dose and duration as advised by your doctor. Check the label before use. Rimstar 4-FDC is to be taken empty stomach. Avoid Rimstar 4-FDC with tyramine-rich food such as cheese, smoked fish, meats and some types of beer. How Rimstar 4-FDC works: Rimstar 4-FDC is a combination of four medicines: Isoniazid, rifampicin, ethambutol and pyrazinamide which treat tuberculosis. Isoniazid works by preventing the TB bacteria from forming their own protective covering, while rifampicin inactivates a bacterial enzyme (RNA-polymerase) which is required by TB bacteria to make essential proteins and to reproduce. Together, they kill the bacteria and eradicate the infection. Ethambutol and pyrazinamide on the other hand, work by slowing the growth of these bacteria. Indication: Tuberculosis Administration: Should be taken on an empty stomach: Take at least1 hour before or 2 hours after a meal with a full glass of water. Swallow whole. Adult Dose: Fixed-dose combinations (FDCs) Tablets Rifampicin 150mg + Isoniazid 75mg + Pyrazinamide 400mg + Ethambutol 275mg (4FDC) New patients: Body weight 30-37kg: Initial 2 months- 4-FDC 2 tablets at a time daily; next 4 months- continuation dose 2-FDC (Rifampicin 600mg + Isoniazid 300mg) 2 tablets at a time daily. 38-54kg: Initial 2 months- 4-FDC 3 tablets at a time daily; next 4 months- continuation dose 2-FDC (Rifampicin 600mg + Isoniazid 300mg) 3 tablets at a time daily. 55-70kg: Initial 2 months- 4-FDC 4 tablets at a time daily; next 4 months- continuation dose 2-FDC (Rifampicin 600mg + Isoniazid 300mg) 4 tablets... Contraindication: Hypersensitivity, history of drug-induced hepatitis, acute liver disease, peripheral or optic neuritis, renal dysfunction, epilepsy, chronic alcoholism. Mode of Action: Rifampicin, isoniazid and pyrazinamide are all active bactericidal antituberculosis drugs. Rifampicin and isoniazid are particularly active against the rapidly growing extracellular organisms and have an intracellular bactericidal activity. Rifampicin also inhibits DNA-dependent RNA polymerase activity in susceptible cells and it has activity against slow and intermittently-growing M tuberculosis. Pyrazinamide, particularly in the acid pH environment of macrophages is active against intracellular organisms. Combination of these agents covers activity against the 3 different bacterial populations. Ethambutol interferes with RNA synthesis, causing suppression of Mycobacteria multiplication. It also has bacteriostatic action against M tuberculosis by acting on rapidly growing pathogens in cavity... Precaution: Impaired renal or liver function, DM, chronic alcoholism, undernourishment, history of gout, patients w/ convulsive disorders, acute porphyria. Elderly. Pregnancy & lactation. Perform periodic blood counts & liver function tests. Avoid use w/ soft contact lenses. Childn <8 yr or patients who are not able to communicate visual disturbances. Check visual ability before starting treatment & monitor during treatment. Side Effect: Rifampicin: Reddish discolouration of body fluids, asymptomatic increase in liver enzymes, elevations of BUN & uric acid, hemolysis, hematuria, intestinal nephritis, renal insufficiency, GI discomfort, CNS effects, hematological changes, skin rash, endocrine effects. INH: Disturbances of liver function, hepatitis, GI disturbances, peripheral neuropathy, dizziness, lightheadedness, hematological changes, allergic reactions. Pyrazinamide: Transient rise in serum transaminases, hepatotoxicity, hepatomegaly, jaundice, hyperuricemia, intestinal nephritis, dysuria, GI disturbances, hematological changes, allergic reactions. Ethambutol: Confusion, disorientation, headache, visual disturbances, jaundice, transient liver dysfunction, GI disturbances, hematological changes, allergic effects, acute gout (rare). Interaction: Rifampicin: Induces microsomal enzymes (accelerates clearance of methadone, oral anticoagulants, glucocorticoids, oestrogen, oral hypoglycaemic agents, digitoxin, antiarrhythmics, theophylline, anticonvulsants, ?-blockers, azole antifungal, cyclosporin). INH: Inhibits metabolism of antiepileptics, benzodiazepines, warfarin, theophylline. Increases metabolism of enflurane. Alcohol, ASA, Al-containing antacids, corticosteroids, ketoconazole, propranolol. PZA: Decreases efficacy of gout therapy agents. Ethambutol: Neurotoxic agents.