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Suggest Dosage Of AKT-4 Tablet For Bone TB
Question: Hello, how should the akt-4 tablet be taken for bone tb? Some says to take it before food some says to take it after food? Which is correct?
Brief Answer:
Please take AKT4 on empty stomach and meals to be taken after 1 to 2 hours
Detailed Answer:
Hi XXXX,
Thanks for writing in to us.
I have read through your query in detail
AKT-4 kit is an anti-tuberculosis drug containing:
1 (tab) - Ethambutol Hydrochloride 800 mg + isoniazid 300 mg
2 (tabs) - pyrazinamide 750 mg
1 (cap) - rifampicin 450 mg
Latest medical research says the following about taking AKT 4
1. Administration of drugs in divided doses, rifampicin after meals and concomitant administration of antacids and prokinetic (anti vomiting) drugs affect the outcome of therapy.
2. All anti-tuberculosis drugs should be administered preferably in single daily doses to achieve peak serum levels.
3. The pharmacokinetics of rifampin and isoniazid are influenced by meals, and 50% of the patients are at risk of having sub-optimal concentration if rifampin is taken with food.
4. Carbohydrates and proteins seem to have virtually no influence, but a fatty meal reduces serum concentrations considerably. Prokinetic drugs and antacids containing aluminum and magnesium reduce the absorption of rifampicin.
5. As anti-TB drugs are preferably administered in fixed dose combinations, ATT must be given on empty stomach followed by meals 1-2 hours after drug intake to ensure absorption
In conclusion, it is said that taking AKT 4 all tablets on empty stomach in the morning. Please take food 1 to 2 hours later for best treatment. Please avoid taking meals with high fat content when taking the medication. Avoid taking medications for vomiting and gastritis when taking AKT4.
Wishing you a quick recovery.
Hope this answers your question. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Please take AKT4 on empty stomach and meals to be taken after 1 to 2 hours
Detailed Answer:
Hi XXXX,
Thanks for writing in to us.
I have read through your query in detail
AKT-4 kit is an anti-tuberculosis drug containing:
1 (tab) - Ethambutol Hydrochloride 800 mg + isoniazid 300 mg
2 (tabs) - pyrazinamide 750 mg
1 (cap) - rifampicin 450 mg
Latest medical research says the following about taking AKT 4
1. Administration of drugs in divided doses, rifampicin after meals and concomitant administration of antacids and prokinetic (anti vomiting) drugs affect the outcome of therapy.
2. All anti-tuberculosis drugs should be administered preferably in single daily doses to achieve peak serum levels.
3. The pharmacokinetics of rifampin and isoniazid are influenced by meals, and 50% of the patients are at risk of having sub-optimal concentration if rifampin is taken with food.
4. Carbohydrates and proteins seem to have virtually no influence, but a fatty meal reduces serum concentrations considerably. Prokinetic drugs and antacids containing aluminum and magnesium reduce the absorption of rifampicin.
5. As anti-TB drugs are preferably administered in fixed dose combinations, ATT must be given on empty stomach followed by meals 1-2 hours after drug intake to ensure absorption
In conclusion, it is said that taking AKT 4 all tablets on empty stomach in the morning. Please take food 1 to 2 hours later for best treatment. Please avoid taking meals with high fat content when taking the medication. Avoid taking medications for vomiting and gastritis when taking AKT4.
Wishing you a quick recovery.
Hope this answers your question. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hello Doctor,
Thank you for the prompt response.
What does single daily dose mean?
Actually I was advised to take dosage follows:
Isoniazid - 300mg,
Rifampicin - 450mg,
Ethambutol - 1200mg,
Pyrazinamide - 1500mg.
AKT-4 contains lesser amount of Ethambutol and pyrazinamide than the above dose. Hence I have to purchase these tablets separately. But these are not readily available in pharmacy, hence I was taking akt-4.
In akt-4, am taking the orange tablet(rifampin) before food at around 8.30 and remaining three after meals at around 10am.
Now I got the tablets from pharmacy as follows:
Rcinex(rifampin-450 + isoniazid -300mg).
Combutol 800 + combutol 400mg (for ethambutol 1200mg).
Pyzina 1000mg + pyzina 500mg (for pyrazinamide 1500mg).
Pharmacist says the tablets are available only as divided and not single.
Do I need to take any pyridoxine tablet? I have been given liv-52 and favarit tablets. Is it sufficient?
Please advice.
Thank you for the prompt response.
What does single daily dose mean?
Actually I was advised to take dosage follows:
Isoniazid - 300mg,
Rifampicin - 450mg,
Ethambutol - 1200mg,
Pyrazinamide - 1500mg.
AKT-4 contains lesser amount of Ethambutol and pyrazinamide than the above dose. Hence I have to purchase these tablets separately. But these are not readily available in pharmacy, hence I was taking akt-4.
In akt-4, am taking the orange tablet(rifampin) before food at around 8.30 and remaining three after meals at around 10am.
Now I got the tablets from pharmacy as follows:
Rcinex(rifampin-450 + isoniazid -300mg).
Combutol 800 + combutol 400mg (for ethambutol 1200mg).
Pyzina 1000mg + pyzina 500mg (for pyrazinamide 1500mg).
Pharmacist says the tablets are available only as divided and not single.
Do I need to take any pyridoxine tablet? I have been given liv-52 and favarit tablets. Is it sufficient?
Please advice.
Brief Answer:
Please find instructions below
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
Please find my observations below.
1. As there is suspected TB of the spine, therefore the treatment dose of ethambutol 1200 mg and Pyrazinamide 1500mg is as required.
2. Rifampicin must be taken before food as its effect is less if taken after meals.
3. AKT4 is a combination of 4 tablets packed together. Even if you purchase tablets separately to maintain dosage of ethambutol then there is nothing to worry. The end result is the same whether you buy kit containing 4 tablets or purchase from different company.
4. The medications purchased by you are correct. These tablets are available as separate but in AKT 4 it is packed together for convenience. The pharmacist is right that the tablets come separately and in AKT 4 it is only packing the tablets in one strip to help illiterate patients.
5. Rcinex has to be taken 1 to 2 hours before food. The others can be taken after meals. But please make sure you take prescribed dose of medicines.
6. The rest of the tablets can be taken after meals. So you can take Combutol 800 + combutol 400mg (for ethambutol 1200mg) and Pyzina 1000mg + pyzina 500mg (for pyrazinamide 1500mg) together after meals as per your choice.
World Health Organization guidelines tell to take all anti TB medications on empty stomach but if you take at least Rcinex before food and others after meals then there is no serious concern.
7. Vitamin B6 is called pyridixine and if you have been given the that then take it. Even if you have not been given pyridoxine then take green leafy vegetables in adequate amount. You can continue to take Liv 52. I am unable to find favarit tablet, please check the spelling and composition and let me know if the generic name of the medication.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Please find instructions below
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
Please find my observations below.
1. As there is suspected TB of the spine, therefore the treatment dose of ethambutol 1200 mg and Pyrazinamide 1500mg is as required.
2. Rifampicin must be taken before food as its effect is less if taken after meals.
3. AKT4 is a combination of 4 tablets packed together. Even if you purchase tablets separately to maintain dosage of ethambutol then there is nothing to worry. The end result is the same whether you buy kit containing 4 tablets or purchase from different company.
4. The medications purchased by you are correct. These tablets are available as separate but in AKT 4 it is packed together for convenience. The pharmacist is right that the tablets come separately and in AKT 4 it is only packing the tablets in one strip to help illiterate patients.
5. Rcinex has to be taken 1 to 2 hours before food. The others can be taken after meals. But please make sure you take prescribed dose of medicines.
6. The rest of the tablets can be taken after meals. So you can take Combutol 800 + combutol 400mg (for ethambutol 1200mg) and Pyzina 1000mg + pyzina 500mg (for pyrazinamide 1500mg) together after meals as per your choice.
World Health Organization guidelines tell to take all anti TB medications on empty stomach but if you take at least Rcinex before food and others after meals then there is no serious concern.
7. Vitamin B6 is called pyridixine and if you have been given the that then take it. Even if you have not been given pyridoxine then take green leafy vegetables in adequate amount. You can continue to take Liv 52. I am unable to find favarit tablet, please check the spelling and composition and let me know if the generic name of the medication.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hello Doctor,
Thank you for the instructions and advice.
Favarit seems to be a multi vitamin tablet. Am fine with it.
I have one worry to be addressed/clarified.
You mentioned that,
"Administration of drugs in divided doses, rifampicin after meals and concomitant administration of antacids and prokinetic (anti vomiting) drugs affect the outcome of therapy.".
But as I said pharmacist told ethambutol and pryazinamide is available only as divided dose as 800mg+400mg(combutol) and 1000mg+500mg. Single dose tablet is not available. What should I do?
Thank you for the instructions and advice.
Favarit seems to be a multi vitamin tablet. Am fine with it.
I have one worry to be addressed/clarified.
You mentioned that,
"Administration of drugs in divided doses, rifampicin after meals and concomitant administration of antacids and prokinetic (anti vomiting) drugs affect the outcome of therapy.".
But as I said pharmacist told ethambutol and pryazinamide is available only as divided dose as 800mg+400mg(combutol) and 1000mg+500mg. Single dose tablet is not available. What should I do?
Brief Answer:
Single dose refers to taking total dose of a medicine at once daily
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
Please find my observations below.
1. Taking two tablets of same medication is considered one dose as long it is taken together. So if you take
(i) 800mg+400mg(combutol) together then it is still one single dose
and
(ii) 1000mg+500mg pryazinamide together also makes one single dose.
2. By divided dose it is meant as if you are taking
(i) ethambutol 800 mg in morning and 400 mg in afternoon or night
or
(ii) pryazinamide 1000 mg in morning and 500 mg in afternoon or night
In conclusion, you have to take the total amount of medication (one or two tablets of the medication) at a single time for best treatment response and to kill the bacteria.
So you should take ethambutol 800 mg and 400 mg together and pryazinamide 1000 mg and 500 mg together. This will kill the tuberculosis bacteria and treatment will work.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Single dose refers to taking total dose of a medicine at once daily
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
Please find my observations below.
1. Taking two tablets of same medication is considered one dose as long it is taken together. So if you take
(i) 800mg+400mg(combutol) together then it is still one single dose
and
(ii) 1000mg+500mg pryazinamide together also makes one single dose.
2. By divided dose it is meant as if you are taking
(i) ethambutol 800 mg in morning and 400 mg in afternoon or night
or
(ii) pryazinamide 1000 mg in morning and 500 mg in afternoon or night
In conclusion, you have to take the total amount of medication (one or two tablets of the medication) at a single time for best treatment response and to kill the bacteria.
So you should take ethambutol 800 mg and 400 mg together and pryazinamide 1000 mg and 500 mg together. This will kill the tuberculosis bacteria and treatment will work.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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