Isoniazid
From the side of the nervous system: headache, dizziness, rarely unusual fatigability or weakness, irritability, euphoria, insomnia, paresthesia, numbness of limbs, peripheral neuropathy, optic neuritis, polyneuritis, psychosis, mood change, depression. Seizures can occur in patients with epilepsy.
From the cardiovascular system (SSS): palpitation, angina, increased blood pressure (BP).
On the part of the digestive system: nausea, vomiting, gastralgia, toxic hepatitis. Allergic reactions: skin rash, itching, hyperthermia, arthralgia.
Other: very rarely - gynecomastia, menorrhagia, tendency to bleeding and hemorrhage.
Rifampicin
On the part of the digestive system: nausea, vomiting, diarrhea, decreased appetite, erosive gastritis, pseudomembranous enterocolitis; increased activity of "hepatic" transaminases in the blood serum, hyperbilirubinemia, hepatitis.
Allergic reactions: urticaria, eosinophilia, angioedema, bronchospasm, arthralgia, fever.
From the nervous system: headache, reduced visual acuity, ataxia, disorientation.
From the urinary system: nephronecrosis, interstitial nephritis.
Other: leukopenia, dysmenorrhea, induction of porphyria, myasthenia gravis, hyperuricemia, exacerbation
gout.
With an irregular reception or with the resumption of treatment after the break, an influenza-like syndrome (fever, chills, headache, dizziness, myalgia), skin reactions, hemolytic anemia, thrombocytopenic purpura, acute renal failure are possible.
Pyrazinamide
On the part of the digestive system: nausea, vomiting, diarrhea, "metallic" taste in the mouth, impaired liver function (decreased appetite, liver tenderness, hepatomegaly, jaundice, yellow atrophy of the liver); exacerbation of peptic ulcer.
From the side of the central nervous system: dizziness, headache, sleep disturbances, increased excitability,
depression; in some cases - hallucinations, convulsions, confusion.
On the part of the hematopoiesis and hemostasis system: thrombocytopenia, sideroblastic
anemia, erythrocyte vacuolization, porphyria, hypercoagulation, splenomegaly.
From the musculoskeletal system: arthralgia, myalgia.
From the side of the urinary system: dysuria, interstitial nephritis.
Allergic reactions: skin rash, hives.
Other: hyperthermia, acne, hyperuricemia, exacerbation of gout, photosensitivity, increased serum iron concentration.
Ethambutol
From the side of the nervous system and sensory organs: weakness, headache, dizziness, impaired consciousness, disorientation, hallucinations, depression, peripheral neuritis (paresthesia in the extremities, numbness, paresis, itching), optic neuritis (decreased visual acuity, mostly green and red flowers, color blindness, scotoma).
On the part of the digestive system: decreased appetite, nausea, vomiting, gastralgia, impaired liver function - increased activity of "liver" transaminases. Allergic reactions: dermatitis, skin rash, itching, arthralgia, fever, anaphylaxis. Other: hyperuricemia, exacerbation of gout.
Pyridoxine hydrochloride
Allergic reactions, hypersecretion of hydrochloric acid, numbness, the appearance of a feeling of compression in the limbs - a symptom of "stocking" and "gloves", rarely - a skin rash, itching of the skin.
Treatment of patients with a multicomponent drug reduces the medical burden on the patient by 3 times, which contributes to the improvement of drug tolerance. Interactions with other drugs
The use of isoniazid, rifampicin, ethambutol, and especially pyrazinamide in a combined dosage form significantly increases antimicrobial activity against MBT. Rifampicin induces some enzymes of the cytochrome P-450 system, accelerating the metabolism of prednisolone, phenytoin, quinidine, oral anticoagulants, hormonal contraceptives, antifungals, cimetidine, cyclosporine A. Isoniazid reduces the association of rifampicin with plasma proteins, pyrazinamide slows the excretion of rifampicin. Paraaminosalicylic acid (PASK) worsens the absorption of rifampicin. The use of rifampicin with lomefloxacin and ofloxacin leads to a decrease in the antimicrobial activity of these combinations against MBT. Antacids, opioid analgesics reduce the bioavailability of rifampicin
Isoniazid
MAO inhibitors increase the risk of side effects from the CNS, CCC. Pyridoxine, glutamic acid reduce the risk of developing side effects of isoniazid. The combined use of isoniazid and cycloserine increases the risk of developing neurotoxic side effects.
Pyrazinamide
Pyrazinamide increases the concentration of isoniazid and rifampicin in the serum, slowing their excretion.When taking rifampicin together with pyrazinamide, the risk of developing hepatotoxic reactions increases.
Ethambutol
Aluminum hydroxide reduces the absorption of ethambutol. The use of ethambutol with aminoglycosides, ciprofloxacin, imipenem, carbamazepine, lithium salts, quinine increases the risk of neurotoxic action of the drug. Ethambutol enhances the antimicrobial activity of other antituberculosis drugs.
Pyridoxine hydrochloride
Pyridoxine hydrochloride weakens the action of levodopa when administered together. Pyridoxine hydrochloride reduces the risk of toxic effects of antituberculous drugs on pricesand peripheral nervous system.