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Antitubercular fixed-dose combination (RHZ)

Rifampicin with isoniazid and pyrazinamide

Brand names: Rifater

Adult dose

Dose: Weight-based: 40–49kg = 4 tabs OD; 50–64kg = 5; ≥65kg = 6 tabs PO OD for 2 months
Route: PO
Frequency: OD (intensive)

Clinical pearls

  • Older 3-drug FDC; 4FDC (Voractiv) preferred where ethambutol indicated
  • Co-prescribe pyridoxine

Contraindications

  • Hypersensitivity
  • Severe hepatic impairment
  • Acute gout

Side effects

  • Hepatotoxicity
  • Hyperuricaemia / gout
  • Peripheral neuropathy
  • Orange body fluids
  • Cytopenias

Interactions

  • Many — strong enzyme inducer
  • Hormonal contraceptives
  • Allopurinol

Monitoring

  • LFTs
  • Urate
  • FBC

Reference: BNF; NICE NG33; https://bnf.nice.org.uk/drugs/rifampicin-with-isoniazid-and-pyrazinamide/. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.