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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

Similar Products:
Moxifloxacin, Streptomycin, Etibi, Rifadin, Rofact, Levaquin, Avelox, Mycobutin


Also known as:  Myambutol.


Rifafour is a prescription medication used to treat tuberculosis (TB). Rifafour belongs to a group of drugs called antimycobacterial antibiotics. TB is caused by a certain bacteria. Rifafour works by stopping the bacteria from forming a cell wall, which kills the bacteria.

This medication comes in tablet form. It is taken once a day with or without food.

Common side effects of Rifafour include loss of appetite, upset stomach, and numbness or tingling in hands and feet.


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 decreased vision clearness, including vision loss. This effect may be related to the dose that you take and how long you take Rifafour. It is usually reversible when Rifafour is stopped. However, permanent blindness has been reported. Contact your doctor right away if you experience vision changes (eg, decreased vision clearness). Discuss any questions or concerns with your doctor.

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Corynebacterium glutamicum wild type lacks the ability to utilize the pentose fractions of lignocellulosic hydrolysates, but it is known that recombinants expressing the araBAD operon and/or the xylA gene from Escherichia coli are able to grow with the pentoses xylose and arabinose as sole carbon sources. Recombinant pentose-utilizing strains derived from C. glutamicum wild type or from the L-lysine-producing C. glutamicum strain DM1729 utilized arabinose and/or xylose when these were added as pure chemicals to glucose-based minimal medium or when they were present in acid hydrolysates of rice straw or wheat bran. The recombinants grew to higher biomass concentrations and produced more L-glutamate and L-lysine, respectively, than the empty vector control strains, which utilized the glucose fraction. Typically, arabinose and xylose were co-utilized by the recombinant strains along with glucose either when acid rice straw and wheat bran hydrolysates were used or when blends of pure arabinose, xylose, and glucose were used. With acid hydrolysates growth, amino acid production and sugar consumption were delayed and slower as compared to media with blends of pure arabinose, xylose, and glucose. The ethambutol-triggered production of up to 93 ± 4 mM L-glutamate by the wild type-derived pentose-utilizing recombinant and the production of up to 42 ± 2 mM L-lysine by the recombinant pentose-utilizing lysine producer on media containing acid rice straw or wheat bran hydrolysate as carbon and energy source revealed that acid hydrolysates of agricultural waste materials may provide an alternative feedstock for large-scale amino acid production.

is rifafour an antibiotic

Three groups of Balb/c mice (female, age 4-6 wk; 21 mice in each group) were infected intravenously with 106 CFU of M. tuberculosis H37Rv and two EMB resistant clinical isolates. Age and sex matched control animals were mock inoculated with Middlebrook 7H9 broth alone. At 10, 20, 30, 40, 50, 60, and 70 days post-infection three animals from each group were sacrificed by cervical dislocation and lung tissue was collected for further analysis.

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Bacteriostatic and bactericidal activities of rifampicin, ethambutol, enviomycin and streptomycin on Mycobacterium avium-Mycobacterium intracellulare complex (MAI complex) strains were determined. The susceptibility testings were made in Ogawa egg medium, and minimal inhibitory concentrations (MICs) were determined as the lowest concentration of drugs, in which the growth of 20 to 100 colony-forming units was completely inhibited. The MICs correspond to the MICs that can inhibit the growth of 95 to 99% of bacterial population. Bactericidal activity was determined in a modified Dubos liquid medium (1.3 g of Dubos TB Broth Base were dissolved in 180 ml of distilled water and this solution was supplemented by 20 ml of bovine serum). A one ml-sample of bacterial suspensions (10 mg wet weight per ml) was added to 9 ml of the Dubos liquid medium, and the medium was incubated at 37 degrees C for 0, 1, 3 and 7 days under shaking condition (56 strokes per minute; 8 cm amplitude). The bactericidal activity was measured as the number of colony-forming units contained in a 0.02 ml-sample of the medium. The bactericidal activities of rifampicin and ethambutol were weak or absent even in strains 13008 and 13016, which were very susceptible to all four drugs. However, the bactericidal activities of streptomycin and enviomycin could be observed in these strains.(ABSTRACT TRUNCATED AT 250 WORDS)

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To characterize the susceptibility to levofloxacin of clinical isolates of Mycobacterium tuberculosis (MTB) obtained from patients with HIV-related tuberculosis and to characterize the molecular genetics of levofloxacin resistance.

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A policy implemented in 2007 to restrict the prescription of fluoroquinolones was shown to be effective. Our survey revealed a decreasing trend of resistance to PZA, OFX and AM, which suggests the feasibility of adopting a short-course regimen and demonstrates the effectiveness of our management program for MDR-TB.

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Since TB is an infectious disease caused by Mycobacterium (M) tuberculosis the diagnosis of TB should (as far as possible) be by demonstration of M. tuberculosis on culture or acid-fast bacilli (AFB) on smear examination. The World Health Organization (WHO) has strongly recommended sputum smear examination as the preferred screening test and suggests examination of 3 deeply coughed out sputum samples - spot sample on day 1, overnight sample and a spot sample in the morning on day 2. Recently it has been shown that sputum smear positivity is greater than 90% where greater than 5 ml of sputum is used for smear diagnosis of pulmonary TB. Culture of M. tuberculosis is the gold standard for diagnosis of TB. Culture of mycobacteria is a much more sensitive test than smear examination and has been estimated to detect 10-100 viable mycobacteria per ml of sample and in case of active disease they are found to be 81% sensitive and 98.5% specific. Culture methods are also required for further drug sensitivity testing in cases of suspected drug resistant cases. Isoniazid and rifampicin resistance can be reliably measured; resistance to pyrazinamide, ethambutol, and streptomycin is more difficult due to limitations of technique. The therapeutic index for a given drug is low for certain second-line drugs such as ethionamide, cycloserine, viomycin and para amino salicylic acid (PAS) and it leads to misinterpretation of results due to failure to distinguish between sensitive and resistant strains. Misdiagnosis of MDR-TB due to laboratory related errors has been reported recently.

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M. tuberculosis isolates were resistant to some of the usual drugs in 51 patients. Twenty of these patients had HSA (39%) and in 18 patients the antibiotic sensitivity testing showed resistance to isoniazid, rifampin, ethambutol, and streptomycin. The remaining 86 patients had episodes of TB with drug-susceptible microorganism and only three patients had HSA (3%) (p < 0.001). The 23 patients with tuberculous HSA had a mean CD4+ lymphocyte count of 33 x 10(6) cells/L (2-111) and 7 had a previous episode of TB. The abdominal echography showed hepatosplenomegaly in all cases. Abscesses were located at the liver in 12 patients (52%), spleen in 18 (78%) and both organs in 7 (30%). In 16 cases a corticosteroid therapy was indicated. In the 3 patients with susceptible TB and HSA the clinical course was good. The 20 patients with resistant TB died.

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A series of 11 alpha,omega-diaminoalkanes, (H(2)N(CH(2))(n)NH(2), n=2-12) have been evaluated for their in vitro antibacterial activity against Mycobacterium tuberculosis H37Rv. Compounds, (H(2)N(CH(2))(n)NH(2), n=9-12), exhibited a very good activities in the range 2.50-3.12 microg/mL, which can be compared with that of the first line drug, ethambutol (3.12 microg/mL). These results and a preliminary QSAR study can be considered an important start point for the rational design of new leads for anti-TB compounds.

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To determine the accuracy of drug-susceptibility testing (DST) for isoniazid, rifampicin, ethambutol and streptomycin in a provisional network of 22 regional laboratories in Italy.

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rifafour overdose 2015-10-22

Modern tuberculosis (TB) chemotherapy is widely viewed as a crowning triumph of anti-infectives research. However, only one new TB drug has entered clinical practice in the past 40 years Clindacne Gel Bula while drug resistance threatens to further destabilize the pandemic. Here, we review a brief history of TB drug development, focusing on the evolution of mechanism(s)-of-action studies and key conceptual barriers to rational, mechanism-based drugs.

rifafour drug class 2017-03-21

Aspirin resulted in insignificantly lesser strokes and significantly reduced 3 month mortality in patients Ranoxyl Drug with TBM.

rifafour dose 2017-10-13

Patients after organ transplantations are at risk for mycobacteriosis development. Frequency of the mycobacterial infection after bone marrow transplantation (BMT) is not as high as one could expect. It ranges from 0.4 to 4.9%. We present a case of a female patient after allogenic BMT as a treatment of chronic myelogenous leucaemia, with bronchiolitis obliterans as a symptom of graft versus host disease (GvHD), treated with corticosteroids and infected with Mycobacterium avium. She was admitted to the hospital with dyspnoea, cough with large amount of sputum production and subfebrile status. She had partial respiratory insufficiency and obturative disturbances of respiration (FEV(1) 0.67 l i.e. 22% of normal) with decline of VC (2.23 l i.e. 64% of normal). The high-resolution computed tomography (HRCT) revealed multifocal infiltrations and bronchiectases in the upper and middle pulmonary fields, which were absent in the previous HRCT taken 3 years earlier. In the bronchial secretion acid-fast bacilli were found by smear and culture. The isolate was classified as Mycobacterium avium complex (MAC) by high performance liquid chromatography (HPLC). The patient was treated with clarithromycin, ciprofloxacin, isoniazide (INH), ethambutol (EMB), amikacin, but M. avium was still present in the sputum after 3 months. Treatment was continued in her parent hospital, where after a few months her sputum became negative for M. avium. But she died over a year later from progressive respiratory insufficiency in the course of bronchiolitis obliterans. The patient was in the group of high risk for mycobacterial infection development and the course of her illness was typical. We decided however to present the case as the topic seems to be quite Denvar Tabletas 400 Mg neglected in the literature.

rifafour generic name 2015-09-10

All tuberculosis patients with isolation and identification of M. tuberculosis strains from October 1995 to September 1997 were included. Susceptibility tests isoniazid, rifampin, ethambutol, streptomycin and pyrazinamide were performed Sulfa Drugs List using the Bactec 460 system and the proportions method on solid medium. Logistic progression was used for statistical analysis.

rifafour medication 2017-09-12

A 1-yr prospective noncomparative trial of TIW treatment was conducted during 2000-2003 in 17 U.S. cities. Participants Cefixime Dosing Pediatrics were 91 HIV-negative adults, diagnosed with moderate to severe MAC-PD, who originally participated in a trial of an inhaled IFN-gamma treatment. Improvement in sputum culture, high-resolution computed tomography (HRCT), and symptoms were assessed.

rifafour dosage weight 2016-01-16

After exposure to 2 mg/L (14)C-labelled KRM-1648 (a new broad-spectrum benzoxazinorifamycin antibiotic) for 5 min, a steady-state concentration Ceftin Dosing Weight of 31.3 +/- 3 ng/mg cells KRM-1648 and 12. 6 +/- 0.3 ng/mg cells KRM-1648 was accumulated by wild-type antibiotic-susceptible Mycobacterium aurum (A+) and Mycobacterium tuberculosis (H37Rv), respectively. However, 2 mg/L KRM-1648 was bactericidal for M. tuberculosis. A steady-state concentration of 3. 7 +/- 0.1 ng/mg cells KRM-1648 was accumulated after exposure to 0.5 mg/L. At pH 4 higher concentrations were accumulated than at pH 7. A sub-inhibitory concentration of ethambutol increased the concentration of KRM-1648 accumulated, but Tween 80 and reserpine had little or no effect.

is rifafour an antibiotic 2017-10-12

The study included thirty healthy drivers, aged 28-40, with 500 km driven per a week, who had caused at least one traffic accident, but Antirobe Capsules 300mg not being intoxicated by alcohol or drugs during the accident. The same number of controls were included. Both the cases and controls were interviewed.

rifafour pills 2015-08-10

The analysis revealed that mutations in the genes rpoB (rifampicin), katG (isoniazid), inhA-promoter (isoniazid), rpsL ( Tab Azithromycin 500 Mg Price streptomycin) and embB (ethambutol) were responsible for the majority of resistance observed. A subset of the mutations identified in rpoB and katG were predicted to affect protein stability. Further, a strong direct correlation was observed between the minimum inhibitory concentration values and the distance of the mutated residues in the three-dimensional structures of rpoB and katG to their respective drugs binding sites.

rifafour medicine 2017-04-01

Numerous drugs have structures that suggest that they and/or their metabolites are chelating agents, and therefore might affect trace metal metabolism. Ethambutol, used therapeutically in the treatment of tuberculosis, is an example. The objective of this study was to determine the effects of ethambutol on tissue concentrations and balance of 4 essential trace metals: copper, iron, manganese, and zinc. Eighteen male Sprague-Dawley rats (148 +/- 7 g) were housed individually in metabolic cages. Six rats received ethambutol (400 mg/kg/day) via the drinking water. There were 2 control groups of 6 rats each, an ad-lib and a pair-fed group. Iron concentrations in kidney, liver, heart, and spleen were significantly increased in both the pair-fed and ethambutol-dosed rats, an effect related to reduced food intake. However, the total iron content of these organs was comparable to that of the ad-lib controls, suggesting retention of iron by these organs with reduced food intake during growth. Trace element balance was not affected by ethambutol administration. Ethambutol produced significant decreases in heart copper, kidney zinc, plasma zinc, and liver copper and zinc not due to the associated reduced food intake. The latter results support the hypothesis that chelating drugs may alter trace metal metabolism.

rifafour renal dose 2015-08-09

Numerous chromatographic and non-chromatographic methods of analysis for anti-tuberculosis drugs and metabolites in biological tissues have been discussed in this review. Depending upon the analytical methodology selected, limits of detection range from microgram to picogram levels. A number of examples have been given of the correlation between different types of assay procedures. The metabolism and pharmacokinetics have been described along with some of the commonly associated problems of sample collection and storage.