Rimstar 4-FDC Tablet -10's Strip
SKU: NRPT
Brand: Nevian Lifescience PLC
৳155
৳170
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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 feel better. Sudden discontinuation of the treatment may affect the potency of the medicine. The medicine may take some to show its effects on the symptoms. However, it is advised to consult the doctor if you feel an aggravation of the condition or if your condition does not improve. Some common side effects of this medicine are nausea, vomiting, fever, dark-colored urine, sweating, increased saliva, etc. To cope up with the side effects, you should drink plenty of water. If any of the side effects get aggravated, you must consult your doctor immediately. Generally, serious side effects are rare. If you experience any allergic reaction (rashes, itching, swelling, shortness of breath, etc.), you must seek immediate medical help. Before taking this medicine, you should tell your doctor if you are taking any medicines for any health condition. Patients with liver and kidney ailments must take this medicine with proper consultation and caution. Pregnant or breastfeeding women should also consult with the doctor before taking it. Avoid drinking alcohol as it can cause excessive drowsiness with this medicine. It usually does not impair your ability to drive, but you should not drive if it makes you feel sleepy or dizzy. During the treatment, you must take adequate rest and eat a healthy diet for a faster recovery. While on the medication, your doctor may ask for a few laboratory and diagnostic tests to know the effects of the medicine on your body.
Uses of Rimstar 4-FDC
- Tuberculosis (TB)
Side effects of Rimstar 4-FDC
Common
- Nausea
- Vomiting
- Rash
- Fever
- Dark colored urine
- Sweating
- Increased sputum production
- Salivation
- Watery eyes
- Peripheral neuropathy (tingling and numbness of feet and hand)
- Increased liver enzymes
- Jaundice
- Increased uric acid level in blood
- Visual 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.
Quick Tips
- You have been prescribed Rimstar 4-FDC for the treatment of tuberculosis.
- Take it on an empty stomach and preferably at the same time everyday.
- Try not to forget a dose, as this increases the risk of the bacteria becoming resistant to the medicine, and also increases the risk of getting side effects.
- It may discolour your urine, sweat, saliva and tears a reddish/orange colour. This is normal and not harmful.
- Your doctor may check your liver function before starting treatment and regularly thereafter. Inform your doctor if you notice yellowing of eyes or skin, dark urine, or stomach pain.
- Avoid drinking alcohol while taking Rimstar 4-FDC as this may increase the risk of side effects on the liver.
- It may cause vitamin B6 deficiency. Your doctor may prescribe vitamin B6 supplements to help avoid potential problems associated with its deficiency, such as inflammation of the nerves (neuritis).
- Use a reliable contraceptive method (such as condoms or a diaphragm) to prevent pregnancy while you are taking Rimstar 4-FDC as it may make hormonal contraceptives such as the pill less effective.
- Do not take indigestion remedies (antacids) within at least two hours of taking Rimstar 4-FDC.
- Finish the full course of the medication, even if you feel better. Stopping the course early increases the risk of coming back of the infection.
Brief Description
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 at a time daily. >70kg: Initial 2 months- 4-FDC 5 tablets at a time daily; next 4 months- continuation dose 2-FDC (Rifampicin 600mg + Isoniazid 300mg) 5 tablets at a time daily. Re-treatment patients: Body weight 30-37kg: Initial 3 months- 4-FDC 2 tablets at a time daily; & Streptomycin 500mg daily, next 5 months- continuation dose 2-FDC (Rifampicin 600mg + Isoniazid 300mg) 2 tablets at a time daily, & Ethambutol 400mg 2 tablets at a time daily. 38-54kg: Initial 3 months- 4-FDC 3 tablets at a time daily; & Streptomycin 750mg daily, next 5 months- continuation dose 2-FDC (Rifampicin 600mg + Isoniazid 300mg) 3 tablets at a time daily, & Ethambutol 400mg 3 tablets at a time daily. 55-70kg: Initial 3 months- 4-FDC 4 tablets at a time daily; & Streptomycin 1g daily, next 5 months- continuation dose 2-FDC (Rifampicin 600mg + Isoniazid 300mg) 4 tablets at a time daily, & Ethambutol 400mg 3 tablets at a time daily. >70kg: Initial 3 months- 4-FDC 5 tablets at a time daily; & Streptomycin 1g daily, next 5 months- continuation dose 2-FDC (Rifampicin 600mg + Isoniazid 300mg) 5 tablets at a time daily, & Ethambutol 400mg 4 tablets at a time daily. The dose of streptomycin should not exceed 750mg daily after the age of 50 years.
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 walls and is also effective in slow-growing pathogens. Has some action against atypical opportunistic Mycobacteria e.g. M kansasii, M avium complex (MAC).
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.
