Macox Zh Kid Tab 10sDrug brand named MACOX ZH KID TAB 10S is manufactured by MACLEODS PHARMACEUTICALS LTD and mainly contents the generic drug Isoniazid.
Active Ingredients of MACOX ZH KID TAB 10SIsoniazid 50mg Pyrazinamide 300mg Rifampicin 100mg
Can we use MACOX ZH KID TAB 10S during pregnencyPregnancy D There is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience or studies in humans but potential benefits may warrant use of the drug in pregnant women despite potential risks
Can we use MACOX ZH KID TAB 10S during lactationLactation L4 There is positive evidence of risk to a breastfed infant or to breastmilk production but the benefits of use in breastfeeding mothers may be acceptable despite the risk to the infant eg if the drug is needed in a lifethreatening situation or for a serious disease for which safer drugs cannot be used or are ineffective
For what type of diseases MACOX ZH KID TAB 10S may be prescribedTuberculosis
What are the known Side Effects of MACOX ZH KID TAB 10SNausea stomach upset skin rash acute toxicity
Precautions before taking MACOX ZH KID TAB 10SIsoniazid is known to interact with other drugs like Alcohol AlcoholAlprazolam Aluminium Hydroxide and Oxide Bovine Insulin BromazepamCalciferol Carbamazepine Chlorzoxazone Cycloserine DiazepamDigitoxin Disulfiram Enflurane Estazolam Ethionamide EthosuximideFosphenytoin Gestodene Human Insulin Insulin Glulisine KetoconazoleMagnesium Oxides and Hydroxides Metformin HCl ParacetamolParoxetine Phenytoin Na Podophyllum Porcine Insulin Prednisolone and Prednisone Primidone Prothionamide Pyrazinamide PyridoxineRifampicin Salicylamide Sevoflurane Stavudine Tacrolimus TriazolamZalcitabine Zolpidem Tartrate
Significance of MACOX ZH KID TAB 10SANTITUBERCULOSIS THERAPY FIRSTLINE DRUGS 1 ISONIAZID INH bactericidial unknown but thought to be inhibition of the biosynthesis of mycolic acids Penetrates readily into all body fluids and cells including the CNS similar to concentrations as in plasma Metabolized primarily by the liver as a result of enzymatic acetylation and enzymatic hydrolysis Halflife ranges from 13 hours and dependent on whether the patient is a fast or slow acetylator Doses are not reduced in renal impairment except in advanced renal failure 9 of all clinical isolates of TB resistant to INH a Dosage usually oral can be intramuscular Daily Dose Adults 5 mgkg Maximum dose 300 mg Children 10 to 20 mgkg Maximum dose 300 mg Twice Weekly Adults 15 mgkg Maximum dose 900 mg Children 20 to 40 mgkg Maximum dose 900 mg b Adverse Effects 54 incidence Hepatitis 1 Adverse reaction 1215 or more of patients on INH may have transaminase elevations 1 develop frank hepatitis which can lead to death in rare cases Patients with preexisitng liver disease older patients postpartem and pregnant patients are at risk for the development of hepatitis It is rarely seen in patients under 30 years but is reported in over 2 of patients over 50 years of age There is no increased risk of hepatitis for most patients when isoniazid and rifampin are used together Mild hepatic disease does not preclude the use of INH and rifampin although serial monitoring is suggested Elevations of the SGOT or SGPT to 35 times normal should lead to reassessment of the regimens if baseline SGOT or SGPT is 68 times normal levels INH and rifampin should be avoided Neurological Toxicity less common INH exerts its neurotoxic effect through enhanced elimination of pyridoxine andor competitive inhibition with pyridoxine in its action as a cofactor in the synthesis of synaptic neurotransmitters Peripheral neuropathies 02 most common but rarely seizures optic neuritis encephalopathies and the handshoulder syndrome can occur Concomitant administration of pyridoxine 1050 mg daily The routine prophylactic use of pyridoxine with isoniazid should be considered in patients predisposed to neurologic toxicity because of pregnancy diabetes uremia alcoholism malnutrition or a prior seizure disorder Hypersensitivity Reactions Fever 12 rash 2 and rheumatoid syndromes can occur Positive antinuclear antibodies and lupuserythematous cell preparation my be seen c Drug Interactions Inhibition of metabolism of phenytoin carbamazepine primidone and warfarin 2 RIFAMPIN bactericidal MOA Inhibits DNAdependent RNA polymerase of mycobacteria and other microorganisms leading to suppression of initiation of chain formation in RNA synthesis The oral form is well absorbed from the GI tract in the fasting state Rifampin is well distributed with adequate concentrations in body fluids serum urine saliva pleura including the CSF Rifampin is deacetylated by the liver and its halflife 155 hours is prolonged in hepatic diseases There is no need to adjust doses in renal failure 4 of all TB clinical isolates resistant to RIF a Dosage usually oral can be intravenous Daily Dose Adults 10 mgkg Maximum dose 600 mg Children 10 to 20 mgkg Maximum dose 600 mg Twice Weekly Adults 10 mgkg Maximum dose 600 mg Children 10 to 20 mgkg Maximum dose 600 mg b Adverse Effects 4 Hepatotoxicity 2030 of patients who receive a combination of INHRIF will experience a mildmoderate rise in transaminanses Immunological Reactions Allergic andor hypersensitivity reactions such as drug fever skin rashes and eosinophilia are uncommon A flulike syndrome with fever myalgia and headache can occur Occurs more common with irregular administration vs routine intermittent tuberculosis regimens Redorange Discoloration of the urine saliva sweat and tears and patients should be forewarned of this to prevent unnecessary anxiety soft contact lenses may become permanently discolored Gastrointestinal Epigastric distress nausea and vomiting 15 abdominal cramps diarrhea have occasionally required discontinuation of the drug c Drug Interactions Rifampin is a potent inducer of hepatic drug metabolizing enzymes It can alter the metabolism of AZT protease inhibitors contraceptives oral anticoagulants 3 PYRAZINAMIDE PZA bactericidal MOA Split into ammonia and pyrazinoic acid It is well absorbed orally and penetrates the CNS when the meninges are inflamed he major route of excretion is renal glomerular filtration but the drug is also hydrolyzed and then hydroxylated 6 of all TB clinical isolates resistant to PZA a Dosage oral Daily Dose Adults 15 to 30 mgkg Maximum dose 20 Gm Children 15 to 30 mgkg Maximum dose 20 Gm Twice Weekly Adults 50 to 70 mgkg Children 50 to 70 mgkg b Adverse Effects Hepatotoxicity uncommon Serial liver function tests should be monitored only in highrisk patients or during longterm therapy PZA does not significantly increase the risk of hepatotoxicity when used at a dosage of 15 to 30 mgkgday when added to a regimen of INH and rifampin during the initial 2 months of therapy Hyperuricemia Uncommon Interferes with the excretion of urate by decreasing its tubular secretion Nausea vomiting 4 ETHAMBUTOL bactericidal MOA Inhibit the incorporation of mycolic acid into the mycobacterial cell wall About 7580 of an oral dose is absorbed from the GI tract Penetrates tissue well except the CNS even when the meninges are inflamed About 80 of the dose is excreted unchanged in the urine and 20 passes unchanged in the feces 8 to 15 is excreted in the urine in the form of various metabolites Elimination halflife is 34 hours Doses must be reduced in renal failure 23 of all TB clinical isolates resistant to EMB a Dosage oral Daily Dose Adults 15 to 25 mgkg Maximum dose 25 Gm Children 15 to 25 mgkg Maximum dose 25 Gm Twice Weekly Adults 50 mgkg Children 50 mgkg b Adverse Effects 2 at 15 mgkgday dose Retrobulbar Neuritis 08 Symptoms include blurred vision central scotomata and redgreen color blindness Doserelated complication 1 of patients receiving 15 mgkgday 5 of patients receiving 25 mgkgday and 15 of patients receiving 50 mgkgday The intensity of the visual difficulty is related to duration of therapy after the decrease in visual acuity first becomes apparent and it may be unilateral or bilateral Tests of visual acuity and redgreen discrimination prior to the start of therapy and periodically are recommended Recovery usually occurs when ethambutol is withdrawn Rash Fever Arthalgias GI irritation 5 STREPTOMYCIN bactericidal MOA Inhibition of mRNA ribosomal subunit synthesis It provides only fair tissue penetration into the CNS Renally excreted and dosage