• Pulmonary and extrapulmonary tuberculosis (TB)
  • Intensive phase of TB treatment (typically first 2 months)

Dosage (based on body weight — fixed-dose combination (FDC)):

  • 30–37 kg:2 tablets
  • 38–54 kg:3 tablets
  • 55–70 kg:4 tablets
  • >70 kg:5 tablets
  • Rifampicin: 150 mg
  • Isoniazid: 75 mg
  • Pyrazinamide: 400 mg
  • Ethambutol: 275 mg
  • Take on an empty stomach, 30–60 mins before food
  • Do not skip doses; adherence is critical for success and resistance prevention
  • Monitor liver function during therapy
  • Rifampicin: Bactericidal; inhibits RNA polymerase
  • Isoniazid: Bactericidal; inhibits mycolic acid synthesis
  • Pyrazinamide: Active in acidic pH; disrupts membrane transport
  • Ethambutol: Bacteriostatic; inhibits arabinosyl transferase (cell wall synthesis)
  • GI upset (nausea, vomiting)
  • Hepatotoxicity (esp. with isoniazid, rifampicin, pyrazinamide)
  • Orange/red discoloration of urine/tears (rifampicin)
  • Peripheral neuropathy (isoniazid)
  • Visual disturbances (ethambutol → optic neuritis)
  • Acute hepatic disease
  • Severe renal impairment (adjust dose or use separate drugs)
  • Known hypersensitivity to any component
  • Rifampicin is a potent enzyme inducer:
    • ↓ effectiveness of oral contraceptives, warfarin, antiretrovirals
  • Avoid alcohol (↑ risk of liver damage)

                                   Drug Status

Availability
Pregnancy
Breastfeeding
Schedule
BRAND NAME STRENGTH FORMULATION PACK SIZE MANUFACTURER DISTRIBUTOR
AkuriT-4 150mg/75mg/400mg/275mg Tablet 90’s Lupin Limited Nairobi Enterprises
Forecox trac 150mg/75mg/400mg/275mg Tablet 60’s Macleods Pharma Sai Pharma
Rihaz-E 150mg/75mg/400mg/275mg Tablet 168’s Cosmos Ltd Cosmos Ltd
Rimstar 4-FDC 150mg/75mg/400mg/275mg Tablet 30’s Sandoz GMBH Novartis Kenya