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Has TB, Lower, Spinal And Hip Joint Problem. Taking R-Cinex, PZA-CIRA And Combutol. Side Effects Of These Medications?

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Posted on Fri, 12 Jul 2013
Question: My mom 73 years of age - has tuberculous - lower back - spinal - hip joint - the following medicines have been given for her treatment R - Cinex 450 mg / PZA - CIRA 750 mg / Combutol 800 mg / Rabifast DSR* - I need to know the side effects of these medicines - no vitimanis has been given - pls advise
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Answered by Dr. Chobufo Ditah (3 hours later)
Hi and thanks for this query. I am so sorry to hear about what your mother has been going through with tuberculosis of the lower back, spine, and hip joint(extrapulmonary tuberculosis: osteoarticular and Spinal).
I am Dr. Ditah and feel humbled having to opportunity to contribute towards your moms's care.

Pyridoxine is given to prevent and/or treat peripheral neuropathy caused by isoniazid. Preventive treatment for this side effect with pyridoxine is reserved for breasfeeding mothers, pregnant women, malnourished patients, diabetics, alcohol dependent patients, , HIV positive patients and those with chronic liver or kidney disease at a dose of 10mg/day in adults. Higher dosages(25mg/day) are discouraged because of the risk of interfering with the action of isoniazid. For now, unless there is some more information i do not have your mother would not need preventive treatment. However, if she should develop this side effect, she would be offered this. You may want to talk with the treating physician if you think she qualifies for this given the above information.

The four main drugs contained in the treatment of Tuberculosis are isoniazid, pyrazinamid, ethambutol and rifampicine.

Side effects of these drugs are classified as follows:
Minor sides effects include, nausea, vomiting, orange coloration of urine, tears, skin saliva(rifampicin) etc, peripheral neuropathy (isoniazide) and arthralgia(joint pains).

Major side effects include skin rash(all the drugs), optic neuritis(combutol/ethambutol), hepatitis(Rifampicin, isoniazid, pyrazinamid), thrombocytopenic purpura (rifampicin).

Rabifast is an a combination of an anti gastritis drug(because the above tablets can cause pills induced gastritis) and domperidone for nausea/vomiting relief.

In all, i think the treatment prescription is okay. please be informed that this is a 12months treatment and the treatment will be revised after 8weeks of using these 4 drugs. Other medications/vitamins/pyridoxine may be added if so needed during the treatment.

I hope your query has been answered fully. If there is any more information you wish to know related to this query, please feel free to contact me.
I wish your mother a good response to treatment and a prompt recover.
Dr. Ditah, MD.

NB: Treating TB patients is my daily task as a tropical disease specialist and I feel very comfortable addressing any treatment related questions to TB and that is why I choose to answer this question personally.

Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Shanthi.E
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Dr. Chobufo Ditah

General & Family Physician

Practicing since :2009

Answered : 6323 Questions

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Has TB, Lower, Spinal And Hip Joint Problem. Taking R-Cinex, PZA-CIRA And Combutol. Side Effects Of These Medications?

Hi and thanks for this query. I am so sorry to hear about what your mother has been going through with tuberculosis of the lower back, spine, and hip joint(extrapulmonary tuberculosis: osteoarticular and Spinal).
I am Dr. Ditah and feel humbled having to opportunity to contribute towards your moms's care.

Pyridoxine is given to prevent and/or treat peripheral neuropathy caused by isoniazid. Preventive treatment for this side effect with pyridoxine is reserved for breasfeeding mothers, pregnant women, malnourished patients, diabetics, alcohol dependent patients, , HIV positive patients and those with chronic liver or kidney disease at a dose of 10mg/day in adults. Higher dosages(25mg/day) are discouraged because of the risk of interfering with the action of isoniazid. For now, unless there is some more information i do not have your mother would not need preventive treatment. However, if she should develop this side effect, she would be offered this. You may want to talk with the treating physician if you think she qualifies for this given the above information.

The four main drugs contained in the treatment of Tuberculosis are isoniazid, pyrazinamid, ethambutol and rifampicine.

Side effects of these drugs are classified as follows:
Minor sides effects include, nausea, vomiting, orange coloration of urine, tears, skin saliva(rifampicin) etc, peripheral neuropathy (isoniazide) and arthralgia(joint pains).

Major side effects include skin rash(all the drugs), optic neuritis(combutol/ethambutol), hepatitis(Rifampicin, isoniazid, pyrazinamid), thrombocytopenic purpura (rifampicin).

Rabifast is an a combination of an anti gastritis drug(because the above tablets can cause pills induced gastritis) and domperidone for nausea/vomiting relief.

In all, i think the treatment prescription is okay. please be informed that this is a 12months treatment and the treatment will be revised after 8weeks of using these 4 drugs. Other medications/vitamins/pyridoxine may be added if so needed during the treatment.

I hope your query has been answered fully. If there is any more information you wish to know related to this query, please feel free to contact me.
I wish your mother a good response to treatment and a prompt recover.
Dr. Ditah, MD.

NB: Treating TB patients is my daily task as a tropical disease specialist and I feel very comfortable addressing any treatment related questions to TB and that is why I choose to answer this question personally.