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This drug is a fixed-dose combination of five agents: ethambutol, isoniazid, N-acetyl cysteine, pyrazinamide, and rifampicin. Four of these—ethambutol, isoniazid, pyrazinamide, and rifampicin—are first-line antitubercular drugs used in the intensive phase of tuberculosis (TB) treatment. They act synergistically to inhibit various aspects of Mycobacterium tuberculosis metabolism and cell wall synthesis to prevent resistance and maximize bactericidal activity[2][3][4][8]. N-acetyl cysteine (NAC) is not a standard component in WHO-recommended TB regimens but may be included for its mucolytic properties or as an adjunctive antioxidant therapy; it acts by replenishing intracellular glutathione levels and reducing oxidative stress. The primary indication for this combination would be the treatment of active pulmonary or extrapulmonary tuberculosis.
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