RIMSTAR ® is a drug based on Rifampicin + Isoniazid + Pyrazinamide + Etambutol hydrochloride
THERAPEUTIC GROUP: Antimycobacterials - Association of drugs for the treatment of tuberculosis
IndicationsAction mechanismStudies and clinical effectiveness Usage and dosage instructionsWarnings Pregnancy and lactationInteractionsContraindicationsUndesirable effects
Indications RIMSTAR ® Rifampicin + Isoniazid + Pyrazinamide + Ethambutol hydrochloride
RIMSTAR ® is indicated for the treatment of tuberculosis according to specific international guidelines.
Mechanism of action RIMSTAR ® Rifampicin + Isoniazid + Pyrazinamide + Ethambutol hydrochloride
RIMSTAR ® is a drug used only in the treatment of tuberculosis infections sustained by sensitive microorganisms such as Mycobacterium tubercolosis, thanks to the presence of different active ingredients with complementary pharmacodynamic properties.
More precisely :
- Rifampicin, by penetrating the cellular plasma membrane, reaches the cytoplasmic environment by inhibiting enzymes such as the bacterial-dependent DNA RNA polymerase, which are fundamental in ensuring the replication of mycobacteria, thus translating its activity into a bacteriostatic and bactericidal action.
- ? ™ Isoniazid limits the proliferation of mycobacteria by inhibiting the synthesis of mycoic acid, a fundamental element in the structuring of the mycobacterial cell wall, thus making the micro-organism particularly sensitive to osmotic lysis.
- Pyrazinamide, acting on the low-proliferative mycobacterial component, therefore not very sensitive to? ™ Isoniazid, compromises the survival of these pathogenic elements by altering the normal flow of electrons and the synthesis of fatty acids;
- The? Etambutol, on the other hand, through mechanisms not yet fully known, seems to interfere with the synthesis of? ™ RNA, thus inhibiting the proliferation of microorganisms in active multiplication.
The excellent pharmacokinetic properties of the aforementioned active ingredients allow the patient the optimal intake of the drug by oral route, thus allowing the achievement of the plasma peak and the beginning of the therapeutic activity only a few hours after administration.
Studies carried out and clinical efficacy
MULTIRESISTIC MICOBACTERIES
A study that shows how multidrug-resistant strains of mycobacteria to drug therapy can withstand even multi-therapy, thus leading to particularly serious clinical conditions.
BEST TOLERABILITY OF MULTYTHERAPY FOR TUBERCULOSIS
Study demonstrating that multiple therapy is effective when single therapy at high dosages, with patients describing a reduced incidence of side effects and better tolerability.
EFFECTIVENESS AND SAFETY OF COMBINED MULTYTHERAPY IN THE TREATMENT OF TUBERCULOSIS
Work that shows how pharmacological multi-therapy at fixed doses for the treatment of tuberculosis is particularly effective and safe as that provided for monotherapies, also reducing the onset of possible resistance.
Method of use and dosage
RIMSTAR ®
Tablets coated with 150 mg of Rifampicin, 75 mg of Isoniazid, 400 mg of Pyrazinamide and 275 mg of Ethambutol hydrochloride.
RIMSTAR ® therapy should be defined by a specialist doctor in the treatment of infectious diseases and in particular those of tuberculosis, in accordance with international guidelines.
In fact, different protocols have been tested based on the physical and physio-pathological characteristics of the affected patients.
Warnings RIMSTAR ® Rifampicin + Isoniazid + Pyrazinamide + Ethambutol hydrochloride
Medical supervision is necessary both before the start of treatment with RIMSTAR ® and during the whole therapeutic process.
More precisely, the physician should periodically monitor the degree of renal and above all hepatic function, given the high hepatotoxic potential of the active ingredients contained in RIMSTAR ®, ascertaining the absence of absolute contraindications rather than conditions that compromise the state of health of the patient in therapy.
Therefore the patient should immediately inform his doctor following the appearance of any sign or symptom of toxicity from the drug, taking into serious consideration the possibility of suspending the therapy in progress.
Glucid metabolism, hematology, metabolism of? ™ uric acid and neurological pattern should be further monitored during the whole treatment with RIMSTAR ®.
We also recall the need for vitamin B6 intake in conjunction with RIMSTAR ® therapy in elderly or malnourished patients.
PREGNANCY AND BREASTFEEDING
Having noted the various studies currently present in the literature it would be advisable to avoid, as far as possible, the use of RIMSTAR ® during pregnancy and in the subsequent period of breastfeeding, in order to avoid possible pharmacological exposure to the unborn child.
The same caution should be reserved during breastfeeding phases given the ability of the various active ingredients to pass through the breast filter concentrating in breast milk.
Interactions
The pharmacokinetic profile of the various active ingredients is known and the inducing and inhibiting activity of these on the various cytochromic liver enzymes is characterized, in order to limit as much as possible drug interactions such as to compromise the therapeutic activity of the drug and the state of health. of the patient, it would be advisable for the patient receiving RIMSTAR ® to avoid the simultaneous intake of:
- Oral anticoagulants;
- Psychotropic drugs;
- Oral contraceptives;
- Methadone;
- antihypertensive;
- anticonvulsants;
- glucocorticoids;
- anesthetics;
- Probenecid;
- and all other active ingredients metabolized by the cytochromial enzyme system.
It should also be remembered, given the ability of? ™ isoniazid to inhibit enzymes such as monoamine oxidases, that the simultaneous intake of histamine or tyramine, rather than of foods containing these active ingredients, could be associated with the appearance of clinically insignificant side effects.
Contraindications RIMSTAR ® Rifampicin + Isoniazid + Pyrazinamide + Ethambutol hydrochloride
RIMSTAR ® is contraindicated in patients who are hypersensitive to any of the active ingredients or excipients it contains, rather than in patients with severe impairment of liver, kidney and hematology.
Undesirable effects - Side effects
The side effects of RIMSTAR ® therapy should be related to those described for each individual active ingredient.
For this reason the most frequent in principle would be:
- Itching, skin rash and different hypersensitivity reactions;
- Gastrointestinal disorders such as nausea, abdominal pain, anorexia and hepatitis;
- Immunological disorders with eosinophilia, leukopenia, thrombocytopathies and myopathies;
- Increased blood concentrations of transaminases and bilirubin and liver function disorders;
- Asthenia;
- Neuropathies.
Note
RIMSTAR ® is a prescription-only drug.
