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Rifafour (Myambutol)

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Rifafour (generic name: ethambutol; brand names include: EMB / Etibi / Combutol / Mycobutol / Tibitol / Servambutol / Tibinil) belongs to a group of medicines called antitubercular agents. Rifafour is used for the treatment of pulmonary tuberculosis, usually in combination with other antituberculosis medicines.

Other names for this medication:
Combutol, Etambutol, Ethambutol, Myambutol, Rimstar

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Also known as:  Myambutol.


Rifafour (EMB, E) is a medication primarily used to treat tuberculosis. It is usually given in combination with other tuberculosis medications, such as isoniazid, rifampicin and pyrazinamide. It may also be used to treat Mycobacterium avium complex, and Mycobacterium kansasii. It is taken by mouth.

Common side effects include problems with vision, joint pain, nausea, headaches, and feeling tired. Other side effects include liver problems and allergic reactions. It is not recommended in people with optic neuritis, significant kidney problems, or under the age of five. Use during pregnancy or breastfeeding has not been found to cause harm. In the United States the FDA has raised concerns about eye issues in the baby if used during pregnancy. Rifafour is believed to work by interfering with the bacteria's metabolism.


Rifafour is supplied as a tablet to be taken by mouth, usually once daily. This medication can be taken with or without food. Try to take Rifafour at the same time every day to get the most benefit. Continue taking Rifafour as directed by your doctor. Stopping the medicine too early may cause the infection to be more difficult to treat.

If you take aluminum-containing antacids, take this Rifafour at least 4 hours before the antacid.

Take Rifafour exactly as prescribed by your doctor. Follow the directions on your prescription label carefully. The dosage must be individualized. The dosage is based on your age, weight, medical condition, and response to treatment.


If you take too much Rifafour, call your local Poison Control Center or seek emergency medical attention right away.


Store at room temperature between 20 and 25 degrees C (68 and 77 degrees F) away from moisture and heat. Throw away any unused medicine after the expiration date. Keep out of the reach of children.

Side effects

The most common side effects associated with Rifafour are:

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Side effect occurrence does not only depend on medication you are taking, but also on your overall health and other factors.


Rifafour may cause dizziness. This effect may be worse if you take it with alcohol or certain medicines. Use Rifafour with caution. Do not drive, operate machinery, or perform other possibly unsafe tasks until you know how you react to it.

Rifafour only works against bacteria; it does not treat viral infections (eg, the common cold).

is rifafour an antibiotic

Drug resistance among new cases to any drug was found to be 43.0% and any resistance: S, 32.5%; H, 31.0%; R, 20.7%; and E, 10.3%. Drug resistance among previously treated cases to any drug was 68.2% and any resistance: S, 52.2%; H, 49.3%; R, 48.3%; and E, 20.4%. The cure rate for new cases was 43.3% and 29.4% for previously treated cases. The poor cure rate resulted mainly from a high defaulter rate.

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To examine the effect of first-line and second-line anti-tuberculosis agents on the ability of fluoroquinolones to kill mycobacteria.

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Ethambutol is known to cause optic neuropathy and, more rarely, axonal polyneuropathy. We characterize the clinical, neurophysiological, and neuroimaging findings in a 72-year-old man who developed visual loss and paresthesias after 11 weeks of exposure to a supratherapeutic dose of ethambutol. This case demonstrates the selective vulnerability of the anterior visual pathways and peripheral nerves to ethambutol toxicity.

rifafour drug reactions

One hundred and thirty-seven newly diagnosed TB patients (26 (19%) being HIV positive) from all age groups were recruited into the study. Each specimen was cultured using BACTEC MGIT960, followed by inoculation and growth on Lowenstein-Jensen (LJ) medium. Primary identification was carried out using an immunochromatographic technique (Capilia TB-Neo), and further confirmed by genotyping. Drug susceptibility testing (DST) was carried out by the agar proportion method.

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Compared with recent US surveys in 1991 and 1992, isoniazid resistance has remained relatively stable. In addition, the percentage of MDR TB has decreased, although the national trend was significantly influenced by the marked decrease in New York City. Foreign-born and HIV-positive patients and those with prior TB have higher rates of resistance. The widespread extent of isoniazid resistance confirms the need for drug susceptibility testing to guide optimal treatment of patients with culture-positive disease.

rifafour dosage adults

The authors examined during the period 2003-2004 in an eye practice 652 patients who were hospitalized due to active lung tuberculosis. All patients were treated with combination of 3-4 antituberculotic drugs and the examination was performed to observe the possible side effects of ethambutol to the optic nerve. The most interesting was the ocular finding in a young man treated due to acute lung tuberculosis in whom during the antituberculotic therapy with combination of 4 antituberculotics, the acute retinal vasculitis developed. This type of vasculitis is rare demonstration of ocular tuberculosis. The ocular finding resolved after starting the systemic corticoid therapy.

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The response to ATD was achieved in all the patients who completed the therapy. Four (26.6%) patients on regimen A developed hepatotoxicity as compared to none on regimen B (P = 0.043). None of these patients could be restarted on ATD using the same regimen A because of the persistently deranged liver functions.

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The rise in isoniazid resistance reflects increasing numbers of patients from sub-Saharan Africa and the Indian subcontinent, who might have acquired resistance abroad, and inadequate control of transmission in London. The observed increases highlight the need for early case detection, rapid testing of susceptibility to drugs, and improved treatment completion.

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Genotyping of Mycobacterium tuberculosis helps to understand the molecular epidemiology of tuberculosis and to address evolutionary questions about the disease spread. Certain genotypes also have implications for the spread of infection and treatment. Indonesia is a very diverse country with a population with multiple ethnicities and cultures and a history of many trade and tourism routes. This study describes the first attempt to map the molecular epidemiology of TB in the Indonesian archipelago.

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Mycobacterium tuberculosis isolates from 1,105 patients with smear-positive pulmonary tuberculosis admitted to 46 randomly stratified treatment centres all over mainland Portugal were submitted to susceptibility testing with four drugs. Human immunodeficiency virus (HIV) testing was included in the patients' evaluation scheme.

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Discordant results in conventional susceptibility testing of ethambutol against Mycobacterium tuberculosis may lead to underreporting of drug resistance.

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Effective antituberculosis drugs have radically improved the prognosis of the patient with active tuberculosis. Surgical therapy is rarely needed, and sanatoria have largely vanished. Initially, triple-drug therapy is indicated in cavitary pulmonary disease and severe renal disease and it is generally used in miliary tuberculosis and meningitis. Use of one of the three drugs may be discontinued after there is evidence that the bacillary population has been decreased. Two-drug therapy is indicated for other active disease. Isoniazid alone is adequate for prophylaxis. The major cause of therapeutic failure is failure of the patient to take the antituberculosis medication regularly. The second major cause of treatment failure is resistance of tubercle bacilli to the antimicrobials used. When treatment failure is apparent, careful reassessment by experienced physicians is indicated. A single drug should never be added to a failing regimen.

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rifafour overdose 2016-01-06

Antibiotic treatment of bacterial pathogens has contributed Avelox Tabs enormously to the increase in human health. Despite the apparent importance of antibiotic treatment of bacterial infections, surprisingly little is known about the molecular functions of antibiotic actions in the bacterial cell. Here, we analyzed the molecular effects of ethambutol, a first-line antibiotic against infections caused by members of the genus Mycobacterium We find that this drug selectively blocks apical cell growth but still allows for effective cytokinesis. As a consequence, cells survive ethambutol treatment and adopt a pneumococcal cell growth mode with cell wall synthesis only at the site of cell division. However, combined treatment of ethambutol and beta-lactam antibiotics acts synergistically and effectively stops cell proliferation.

rifafour and alcohol 2017-04-01

Tuberculosis (TB) is a worldwide infectious disease. Recently, standard therapy has become very effective for treating patients with TB; however, as a result of this powerful regimen, serious side effects have become an important problem. The aim of this prospective study Para Que Sirve El Krobicin Suspension was to evaluate the usefulness of the drug lymphocyte stimulation test (DLST) to determine anti-TB drugs causing side effects.

rifafour drug class 2017-02-01

We report a case of osteomyelitis and synovitis produced by Mycobacterium marinum in the left index finger of a fisherman. A combination of surgical intervention and antimicrobial therapy with minocycline, rifampin, and ethambutol Betamox Plus Tablet was efficacious.

rifafour drug reactions 2015-12-17

In 1990, specific antituberculous chemotherapy can cure almost 100 p. cent of patients with pulmonary tuberculosis in France, provided practitioners follow strict therapeutic rules and Ciloxan Eye Drops Dose patients' compliance with treatment is perfect. A single standard treatment is proposed for those patients whose tuberculosis has never previously been treated; it consists of a six months' course of isoniazid (5 mg/kg/day) and rifampicin (10 mg/kg/day); combined with ethambutol (20 mg/kg/day) and pyrazinamide (30 mg/kg/day) during the first two months. This treatment must be administered under regular medical supervision, and it must be prolonged for some time after cure has been obtained. In case of relapse or in some special situations (e.g. pregnant women, HIV positive patients, serofibrinous pleurisy, complex anatomico-clinical forms of the disease) treatment is more difficult, but it should always give favourable results.

rifafour pills 2017-08-14

The low level of drug resistance enables antituberculosis treatment of non-treated patients to start with the standardised three Cefixime And Ofloxacin Tablets Uses -drug regimes except in the case of foreign people from countries with a high level of drug resistance. Susceptibility tests are recommended on all M. tuberculosis strains isolated, together with controlled studies of drug resistance surveillance.

rifafour dosage adults 2016-08-25

TIW therapy was less effective for MAC-PD patients with cavitary disease and a history of Evoclin Generic Name chronic obstructive pulmonary disease, bronchiectasis, or previous treatment for MAC-PD. Further research is needed to study the long-term outcomes of TIW treatment.

rifafour medication 2017-02-25

Growth of MTC strains occurred in specimens of 445/509 (87.4%) patients: 433 (97.3%) were identified as M. tuberculosis, 10 (2.3%) as M. africanum and 2 (0.4%) as M. bovis. The overall resistance rate was 7.9%, with 7.3 Suprax Cefixime Tablets 400mg % resistance in new cases and 21.1% in previously treated cases. Isoniazid resistance in new cases was most common (4.2%), followed by streptomycin (3.3%), rifampicin (1.9%) and ethambutol (0.9%). Multidrug-resistant tuberculosis was more frequent in previously treated than in new cases (10.5% vs. 1.4%, P < 0.05).

is rifafour an antibiotic 2015-03-10

As a result, INH resistance in Van province with agar proportion method was detected as 12%, followed by INH + RIF resistance of 1.7% and INH + SM resistance of 1.7%. These result compared with other studies conducted country wide are in median range. The systems included in our study were determined to have 100% sensitivity for all of the drugs for detecting resistance and sensitivity rates. Specificities for INH for TK anti-TB, MGIT and MB/BacT were detected as 98%, 96% and 95% respectively Enhancin 1g Tablets Side Effects . Multidrug resistance rates were detected in 100% sensitivity and specificity with all of the three systems. Only MB/BacT system gave a false negative RIF resistance for 1 strain. Fastest system according to resistance determination times is found to be the MGIT system.

rifafour dose 2016-12-05

These data suggest that the GenoType ® MTBDRsl assay is rapid, novel test for detection of Combutol 1000 Mg Side Effects resistance to second line anti-tubercular drugs. This assay provides additional information about the frequency and mutational patterns responsible for XDR-TB resistance.

rifafour medicine 2017-11-30

Of the 225 participants, 36 (16%) experienced poor treatment outcome (treatment failure or death); 155 (69%) were infected with human immunodeficiency virus (HIV). Compared with published standards, low isoniazid C(max) occurred in 84 patients (37%), low rifampin C(max) in 188 (84%), low ethambutol C(max) in 87 (39%), and low pyrazinamide C(max) in 11 (5%). Median rifampin and pyrazinamide levels differed significantly by HIV status and CD4 cell count category. Only pyrazinamide pharmacokinetics were significantly associated with treatment outcome; low pyrazinamide C(max) was associated with a higher risk of documented poor treatment outcome, compared with normal C(max) (50% vs. 16%; P < .01). HIV-infected patients with a CD4 cell count <200 cells/microL had a higher risk of poor treatment outcome (27%) than did HIV-uninfected patients (11%) or HIV-infected patients with a CD4 cell count 200 cells/microL (12%; P = .01). After adjustment for HIV infection and CD4 cell count, patients with low pyrazinamide C(max) were 3 times more likely than patients with normal pyrazinamide C(max) to have poor outcomes (adjusted risk ratio, 3.38; 95% confidence interval, 1.84-6.22).