Skip to Content
UW Health SMPH
American Family Children's Hospital
DONATE Donate
SHARE TEXT

isoniazid, pyrazinamide, and rifampin

Pronunciation: EYE soe NYE a zid, PIR a ZIN a mide, and rif AM pin

Brand: Rifater

What is the most important information I should know about isoniazid, pyrazinamide, and rifampin?

Multum finish

Take this medication for the full prescribed length of time. Your symptoms may get better before your infection is completely cleared. Isoniazid, pyrazinamide, and rifampin will not treat a viral infection such as the common cold or flu.

Multum noalcohol

Avoid drinking alcohol while taking isoniazid, pyrazinamide, and rifampin. Alcohol may increase your risk of liver damage.

Multum bcp

Isoniazid, pyrazinamide, and rifampin can make birth control pills less effective. Ask your doctor about using a different method of birth control while taking isoniazid, pyrazinamide, and rifampin.

Multum donot

Avoid foods that are high in tyramine, listed in the "What should I avoid while taking isoniazid, pyrazinamide, and rifampin?" section of this leaflet. Tyramine can interact with this medication and cause unpleasant side effects.

What is isoniazid, pyrazinamide, and rifampin?

Isoniazid, pyrazinamide, and rifampin are antibiotics. They prevent tuberculous bacteria from multiplying in your body.

The combination of isoniazid, pyrazinamide, and rifampin is used to treat tuberculosis (TB).

Isoniazid, pyrazinamide, and rifampin may also be used for other purposes not listed in this medication guide.

What should I discuss with my healthcare provider before taking isoniazid, pyrazinamide, and rifampin?

Multum donot

You should not use this medication if you are allergic to isoniazid, pyrazinamide, or rifampin (Rifamate, Rifadin, Rimactane), or if you have:

  • severe liver disease;
  • active gout; or
  • if you have ever had drug fever, chills, and arthritis caused by taking this medication.

If you have any of these other conditions, you may need a dose adjustment or special tests to safely use isoniazid, pyrazinamide, and rifampin:

  • kidney disease;
  • liver disease;
  • HIV;
  • porphyria;
  • gout;
  • diabetes; or
  • if you drink alcohol daily.
Multum nopreg

FDA pregnancy category C. It is not known whether isoniazid, pyrazinamide, and rifampin is harmful to an unborn baby. Before taking this medication, tell your doctor if you are pregnant or plan to become pregnant during treatment.

Multum bcp

Isoniazid, pyrazinamide, and rifampin can make birth control pills less effective. Ask your doctor about using a different method of birth control to prevent pregnancy while taking isoniazid, pyrazinamide, and rifampin.

Multum nobrfeed

Isoniazid, pyrazinamide, and rifampin can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I take isoniazid, pyrazinamide, and rifampin?

Take this medication exactly as prescribed by your doctor. Do not take it in larger amounts or for longer than recommended. Follow the directions on your prescription label.

Multum water

Take this medicine with a full glass (8 ounces) of water.

Multum icon26

Take isoniazid, pyrazinamide, and rifampin on an empty stomach, at least 1 hour before or 2 hours after a meal.

Multum finish

Take this medication for the full prescribed length of time. Your symptoms may get better before your infection is completely cleared. Isoniazid, pyrazinamide, and rifampin will not treat a viral infection such as the common cold or flu.

To be sure this medication is not causing harmful effects, your liver function will need to be checked with blood tests on a regular basis. You may also need routine eye exams during treatment. Do not miss any follow-up visits to your doctor.

This medication can cause you to have unusual results with certain medical tests. Tell any doctor who treats you that you are taking isoniazid, pyrazinamide, and rifampin.

Multum rt

Store this medication at room temperature away from moisture and heat.

What happens if I miss a dose?

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

What happens if I overdose?

Multum emt

Seek emergency medical attention if you think you have used too much of this medicine.

Overdose symptoms may include nausea, vomiting, slurred speech, hallucinations, and seizure.

What should I avoid while taking isoniazid, pyrazinamide, and rifampin?

Multum noalcohol

Avoid drinking alcohol while taking isoniazid, pyrazinamide, and rifampin. Alcohol may increase your risk of liver damage.

If you take an antacid, avoid taking it within 1 hour after you have taken isoniazid, pyrazinamide, and rifampin. Antacids can make it harder for your body to absorb rifampin.

Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or has blood in it, stop taking this medication and call your doctor. Do not use any medicine to stop the diarrhea unless your doctor has told you to.

Multum donot

Certain foods can interact with isoniazid, pyrazinamide, and rifampin, causing unpleasant side effects. Avoid foods that are high in tyramine, including:

  • avocados, bananas, figs, raisins, and sauerkraut;
  • beef or chicken liver, fish, meats prepared with tenderizer, bologna, pepperoni, salami, summer sausage, game meat, meat extracts, caviar, dried fish, herring, and shrimp paste;
  • beer (alcoholic and nonalcoholic), red wine (especially Chianti), sherry, vermouth, and other distilled spirits;
  • caffeine (including coffee, tea, cola); and
  • cheeses, including American, blue, boursault, brick, brie, camembert, cheddar, emmenthaler, gruyere, mozzarella, parmesan, romano, roquefort, stilton, and Swiss;
  • chocolate;
  • ginseng;
  • sour cream and yogurt;
  • soy sauce, miso soup, bean curd, fava beans; or
  • yeast extracts.

Do not wear soft contact lenses while taking isoniazid, pyrazinamide, and rifampin. This medicine may turn certain body fluids a red color (including tears, saliva, urine, and sweat). While this is a harmless side effect, it may permanently stain contact lenses.

What are the possible side effects of isoniazid, pyrazinamide, and rifampin?

Multum emt

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Multum emt

Isoniazid, pyrazinamide, and rifampin can cause severe liver symptoms. Stop taking this medication and call your doctor at once if you have any of these liver symptoms:

  • low fever;
  • nausea, stomach pain, loss of appetite;
  • dark urine, clay-colored stools; or
  • jaundice (yellowing of the skin or eyes).
Multum donot

Call your doctor at once if you have any other serious side effects such as:

  • fever, chills, body aches, flu symptoms, weakness, sores in your mouth and throat;
  • pale skin, easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin;
  • feeling short of breath, feeling like you might pass out;
  • cough, chest pain or tightness;
  • diarrhea that is watery or bloody;
  • vision problems;
  • urinating less than usual or not at all; or
  • drowsiness, mood changes, increased thirst, swelling, weight gain.

Less serious side effects may include:

  • mild stomach pain, heartburn, diarrhea;
  • mild rash or itching;
  • muscle or joint pain;
  • drowsiness, dizziness, spinning sensation;
  • ringing in your ears; or
  • numbness or tingling in your legs.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect isoniazid, pyrazinamide, and rifampin?

Many drugs can interact with isoniazid, pyrazinamide, and rifampin. Below is just a partial list. Tell your doctor if you are using:

  • cyclosporine (Gengraf, Neoral, Sandimmune);
  • haloperidol (Haldol);
  • nortriptyline (Pamelor),
  • probenecid (Benemid);
  • theophylline (Elixophyllin, Theo-24, Uniphyl);
  • an antibiotic such as ciprofloxacin (Cipro), clarithromycin (Biaxin), dapsone, erythromycin (E.E.S., Erythrocin, Ery-Tab), and others;
  • antifungal medication such as fluconazole (Diflucan), itraconazole (Sporanox), ketoconazole (Nizoral);
  • a barbiturate such as butabarbital (Butisol), secobarbital (Seconal), pentobarbital (Nembutal), or phenobarbital (Solfoton);
  • birth control pills or hormone replacement therapy;
  • a blood thinner such as warfarin (Coumadin);
  • diabetes medications you take by mouth;
  • heart or blood pressure medication such as atenolol (Tenormin, Tenoretic), carvedilol (Coreg), digoxin (Lanoxin), diltiazem (Cartia, Cardizem), metoprolol (Toprol), propranolol (Inderal), nifedipine (Procardia), verapamil (Covera, Isoptin, Verelan), and others;
  • heart rhythm medication such as disopyramide (Norpace), mexiletine (Mexitil), quinidine (Quinaglute, Quinidex, Quin-Release);
  • narcotic medications such as buprenorphine (Buprenex, Subutex), fentanyl (Actiq, Duragesic, Fentora), methadone (Dolophine, Methadose);
  • a sedative such as diazepam (Valium);
  • seizure medication such as carbamazepine (Carbatrol, Tegretol), phenytoin (Dilantin), primidone (Mysoline), valproic acid (Depakene);
  • a steroid such as prednisolone; or
  • a sulfa drug (Cotrim, Bactrim, Septra, SMX-TMP, and others).
Multum donot

There are many other medicines that can interact with isoniazid, pyrazinamide, and rifampin. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor. Keep a list of all the medicines you use and show this list to any doctor or other healthcare provider who treats you.

Where can I get more information?

Your pharmacist can provide more information about isoniazid, pyrazinamide, and rifampin.


Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2013 Cerner Multum, Inc. Version: 4.02. Revision date: 12/15/2010.

Your use of the content provided in this service indicates that you have read, understood and agree to the End-User License Agreement, which can be accessed by clicking on this link.

This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.

Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.