Rifampin/isoniazid/pyrazinamide (By mouth)


Isoniazid (eye-soe-NYE-a-zid), Pyrazinamide (pir-a-ZIN-a-mide), Rifampin (rif-AM-pin)

Treats tuberculosis (TB). May be used alone or together with other medicines for TB.

Brand Name(s)


When This Medicine Should Not Be Used

How to Use This Medicine


  • Take your medicine as directed.
  • It is best to take this medicine on an empty stomach, 1 hour before or 2 hours after a meal with a full of glass of water. It is important to take this medicine on a regular schedule.
  • Take all of the medicine in your prescription to clear up your infection, even if you feel better after the first few doses.
  • Your doctor may also want you to take pyridoxine (e.g., Hexa-Betalin, vitamin B6) everyday to help prevent or lessen some of the side effects of isoniazid. If it is needed, it is very important to take pyridoxine everyday along with this medicine. Do not miss any doses.

If a dose is missed:

  • Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose.

How to Store and Dispose of This Medicine

  • Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.
  • Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any outdated medicine or medicine no longer needed.
  • Keep all medicine out of the reach of children. Never share your medicine with anyone.

Drugs and Foods to Avoid

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

  • There are many other drugs that interact with this medicine. Make sure your doctor knows all other medicines you are using.
  • Make sure your doctor knows if you are also using chloramphenicol (Chloromycetin®, Chloroptic®), ciprofloxacin (Cipro®), clarithromycin (Biaxin®), cotrimoxazole (Bactrim®, Septra®), digitoxin, digoxin (Lanoxin®), para-aminosalicylic acid, phenobarbital, phenytoin (Dilantin®) or other medications for seizures, sulfapyridine, sulfasalazine (Azulfidine®), medicine for heart rhythm problems (such as disopyramide, mexiletine, quinidine, tocainide, Mexitil®, Norpace®, Quinora®, or Tonocard®), medicine for blood pressure (such as atenolol, diltiazem, enalapril, metoprolol, nifedipine, propranolol, verapamil, Adalat®, Calan®, Cardizem®, Isoptin®, Procardia®, Toprol®, Vasotec®, or Verelan®), medicine for fungal infection (such as fluconazole, itraconazole, ketoconazole, Diflucan®, Nizoral®, or Sporanox®), or a blood thinner (such as warfarin, Coumadin®).
  • Tell your doctor if you are using atovaquone (Mepron®), clofibrate (Atromid®-S), cycloserine (Seromycin®), cyclosporine (Gengraf®, Neoral®, Sandimmune®), dapsone (Aczone®), diazepam (Valium®), disulfiram (Antabuse®), doxycycline (Vibramycin®), enflurane, haloperidol (Haldol®), levodopa (Dopar®), levothyroxine (Levoxyl®, Synthroid®), meperidine (Demerol®), methadone (Dolophine®), probenecid (Benemid®), quinine, tacrolimus, theophylline (Theo-Dur®), zidovudine (Retrovir®), diabetes medicine that you take by mouth (such as glipizide, glimepiride, tolbutamide, Amaryl®, Glucotrol®, or Orinase®), medicine for depression (such as amitriptyline, nortriptyline, Elavil®, or Pamelor®), narcotic pain relievers, or a steroid medicine (such as dexamethasone, prednisolone, prednisone, or Medrol®).
  • If you are using antacids (such as Amphojel®, Maalox®, or Mylanta®), take this medicine at least 1 hour before using any antacids.
  • Birth control pills may not work properly while you are using this medicine. To keep from getting pregnant, use another form of birth control along with your birth control pills. Other forms include condoms, diaphragms, or contraceptive foams or jellies.
  • While you are using this medicine, eating some types of fish, cheese, or drinking red wine may cause reactions such as flushing, chills, headache, slow or pounding heartbeat, lightheadedness or dizziness, nausea or vomiting while taking this medicine. Talk to your doctor if you have concerns about this.
  • Do not drink alcohol while you are using this medicine.

Warnings While Using This Medicine

  • Make sure your doctor knows if you are pregnant or breastfeeding, or if you have kidney disease, diabetes, or an enzyme problem called porphyria. Tell your doctor if you have been addicted to alcohol.
  • Check with your doctor immediately if blurred vision, difficulty in reading, or any other change in vision occurs during or after treatment. Your doctor may want you to have your eyes checked by an eye doctor.
  • Stop using this medicine and check with your doctor right away if you have joint pain, stiffness, or swelling; lower back, side, or stomach pain; or swelling of the feet or lower legs.
  • Your urine, stool, saliva (spit), sweat, and tears may turn red in color while taking this medicine. This is normal when you take this medicine.
  • Soft contact lenses may become permanently stained if you wear them while using this medicine. Avoid wearing contact lenses until your treatment has ended.
  • Rifampin, isoniazid, and pyrazinamide combination may cause blood problems. These problems may result in a greater chance of certain infections, slow healing, and bleeding of the gums. Therefore, you should be careful when using regular toothbrushes, dental floss, and toothpicks. Dental work should be delayed until your blood counts have returned to normal. Check with your medical doctor or dentist if you have any questions about proper oral hygiene (mouth care) during treatment.
  • If you develop a skin rash, hives, or any allergic reaction to this medicine, stop taking the medicine and check with your doctor as soon as possible.
  • This medicine may make you dizzy or drowsy. Avoid driving, using machines, or doing anything else that could be dangerous if you are not alert.
  • Call your doctor if your symptoms do not improve or if they get worse.
  • Tell any doctor or dentist who treats you that you are using this medicine. This medicine may affect certain medical test results.
  • Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.

Possible Side Effects While Using This Medicine

Call your doctor right away if you notice any of these side effects:

  • Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
  • Blistering, peeling, or red skin rash.
  • Chest pain, or fast, pounding heartbeat.
  • Dark-colored urine or pale stools.
  • Fever.
  • Nausea, vomiting, loss of appetite, or pain in your upper stomach.
  • Numbness, tingling, or burning pain in your hands, arms, legs, or feet.
  • Swelling in your face, hands, ankles, or feet.
  • Unusual bleeding, bruising, or weakness.
  • Yellowing of your skin or the whites of your eyes.

If you notice these less serious side effects, talk with your doctor:

  • Blurred vision or ringing in your ears.
  • Headache, sweating, or trouble sleeping.
  • Joint or muscle pain.
  • Mild nausea, vomiting, diarrhea, or stomach pain.
  • Mild skin rash or itching.

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088

Version Info

  • Last reviewed on 8/4/2014

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