Coadministration of TB drugs iv

Fråga: Can infusions of rifampicin (Rifadin), isoniazid (Isoniazid APL) and ethambutol (EMB-fatol Riemser) be coadministered? Is it possible to shorten the infusion time for rifampicin?

Sammanfattning: The infusions can be given during 1.5 hours instead of 6 hours. Rifampicin can be given during 30 minutes if 600 mg is diluted in 100 mL infusion fluid. Ethambutol and isoniazid are compatible, and can be given together, if diluted in sodium chloride 0.9% or glucose 5% and they can be given during one hour.

Svar: Rifadin (10.5 mL =600 mg) can be solved in 100 mL infusion fluid, and the solution can be administered in 30 minutes according to the manufacturer (1). This way of administration is also mentioned in the American SPC text as an alternative to the three hour infusion found in the Swedish SPC (2).

Ethambutol (EMB-fatol Riemser) can be administered during one hour instead of two hours, and it can be mixed with isoniazid if diluted in sodium chloride 0.9% or glucose 5% (3).

There is no information about the compability of rifampicin in solution with the other substances. According to the manufacturer, rifampicin should be administered alone (1). It is known that the storability decreases if rifampicin and isoniazid are mixed in a solution (4).