R-CINEX Z KID Tablet
Isoniazid + Pyrazinamide + Rifampicin
100mg + 50mg + 300mg
Lupin Ltd.
| Pack size | 1 |
|---|---|
| Dispensing mode | |
| Source | |
| Agent | |
| Retail Price | 2.35 NPR |
Available as:
Indications
R-CINEX Z KID Tablet is used for:
Tuberculosis
Adult Dose
Oral
Tuberculosis
Adult: Isoniazid + Pyrazinamide + Rifampicin
Initial Phase 2 months
30-37 kg: 2 tab daily;
38-54 kg: 3 tab daily;
55-70 kg: 4 tab daily;
>71 kg: 5 tab daily.
then
Continuation Phase 4 months
Isoniazid + Rifampicin
30-37 kg: 2 tab daily;
38-54 kg: 3 tab daily;
55-70 kg: 4 tab daily;
>71 kg: 5 tab daily.
Total Dosage Requirement: Rifampicin: 10 (8-12) mg/kg body mass/day.
Isoniazid: 5 (4-6) mg/kg body mass/day.
Pyrazinamide: 25 (20-30) mg/kg body mass/day.
Child Dose
Oral
Tuberculosis
Adult: Isoniazid + Pyrazinamide + Rifampicin
Initial Phase 2 months
upto 7 kg: 1 tab daily;
8-9 kg: 1.5 tab daily;
10-14 kg: 2 tab daily;
15-19 kg: 3 tab daily.
20-24 kg: 4 tab daily.
25-29 kg: 5 tab daily.
then
Continuation Phase 4 months
Isoniazid + Rifampicin
upto 7 kg: 1 tab daily;
8-9 kg: 1.5 tab daily;
10-14 kg: 2 tab daily;
15-19 kg: 3 tab daily.
20-24 kg: 4 tab daily.
25-29 kg: 5 tab daily.
Renal Dose
Administration
Should be taken on an empty stomach. Take on an empty stomach 1 hr before or 2 hr after meals. Avoid antacids w/in 1 hr of intake.
Contra Indications
Known or suspected hypersensitivity to rifamycins and/or to isoniazid and to pyrazinamide and/or to any of the excipients including a history of drug-induced hepatitis, acute liver diseases regardless of their origin, and peripheral neuritis.
Precautions
Caution is advised in patients with impaired renal or liver function, diabetes mellitus, chronic alcoholism and undernourished patients, patients with a history of gout and patients suffering from convulsive disorders and acute porphyria. Precautions need to be taken: Blood counts and liver function tests (SGPT, SGOT) should be performed periodically (especially in prolonged treatment) and at baseline, if possible.
Patients with current chronic liver disease or impaired liver function should be treated with caution and under strict medical supervision. Careful monitoring of liver function should be carried out and attention should be paid to possible prodromal symptoms of hepatitis eg, fatigue, weakness, malaise, anorexia, nausea or vomiting. If these symptoms appear or if signs suggestive of hepatic damage are detected, treatment should be discontinued promptly. The occurrence of severe and sometimes fatal hepatitis associated may develop even after many months of treatment.
Pregnancy-Lactation
Interactions
Rifampicin may reduce effectivity of hormonal contraceptives, ACE inhibitors (e.g. enalapril, imidapril), antiemetics (e.g. aprepitant), antineoplastics (e.g. imatinib), diuretics (e.g. eplerenone), drugs for erectile dysfunction (e.g. tadalafil), oral hypoglycaemics (e.g. nateglinide, repaglinide), NSAIDs (e.g. etoricoxib). Rifampicin may reduce serum levels of atovaquone, ketoconazole. Antacids may reduce absorption of rifampicin. Anaesthetics and halothane may increase risk for hepatotoxicity w/ rifampicin and isoniazid.
Isoniazid may increase serum levels of phenytoin and theophylline; and may decrease carbamazepine metabolism. Stavudine may increase risk of distal sensory neuropathy w/ isoniazid. Antacids may reduce isoniazid absorption. May increase plasma levels of isoniazid w/ para-aminosalicylic acid. Increased risk of CNS toxicity when isoniazid is used concomitantly w/ cycloserine.
Pyrazinamide antagonizes the effects of probenecid and sulfinpyrazone.
Potentially Fatal: Concominant use w/ saquinavir/ritonavir may increase risk of severe hepatotoxicity. May reduce antiviral efficacy of atazanavir, darunavir, fosamprenavir, saquinavir, or tipranavir
Adverse Effects
Side effects of Isoniazid + Pyrazinamide + Rifampicin :
Unwanted effects which may occur during continuous daily or intermittent therapy: Rifampicin: Rifampicin may cause reddish discolouration of body fluids and occasionally other body secretions eg, urine, sputum, lacrimal fluid, faeces, saliva and sweat. It may permanently discolour soft contact lenses.
Hepatic Effects: Very common (>10%) is an asymptomatic increase in liver enzymes; severe life-threatening hepatic reactions eg, hepatic failure and acute fulminant hepatitis are uncommon (>0.1% and <1%). In isolated cases (<0.01%), a fatal outcome was observed.
Renal Effects: Elevations of BUN and serum uric acid, haemolysis, haematuria, interstitial nephritis, renal insufficiency.
Gastrointestinal Effects: Nausea, abdominal pains, vomiting or diarrhoea, pseudomembranous colitis.
Central and Peripheral Nervous System Effects: Tiredness, drowsiness, headache, dizziness, ataxia, mental confusion, muscular weakness, visual disturbances.
Haematological Changes: Leucopenia, eosinophilia, thrombocytopenia and thrombocytopenic purpura.
Effects on Skin and Appendages: Flushing, itching with or without skin rash, urticaria, reddening of the eyes, exudative conjunctivitis or generalised hypersensitivity reactions involving the skin eg, exfoliative dermatitis, Lyell's syndrome and pemphigoid reactions.
Endocrine Effects: Disturbances in the menstrual cycle, induction of crisis in Addison patients.
Unwanted effects chiefly occurring during intermittent therapy or upon resumption of treatment after temporary interruption:
Mechanism 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.
Note
R-CINEX Z KID 100mg + 50mg + 300mg Tablet manufactured by Lupin Ltd.. Its generic name is Isoniazid + Pyrazinamide + Rifampicin. R-CINEX Z KID is availble in Nepal.
Farmaco Nepal drug index information on R-CINEX Z KID Tablet is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.
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