ethambutol + isoniazid + pyrazinamide + rifampicin

ethambutol + isoniazid + pyrazinamide + rifampicin is a fixed-dose combination (FDC) of four first-line antitubercular agents used for the intensive phase treatment of active tuberculosis caused by *Mycobacterium tuberculosis*. Developed by companies including Hongqi Pharmaceuticals, this combination therapy simplifies treatment regimens, improves patient adherence, and helps prevent the emergence of drug-resistant bacterial strains. The four components work synergistically through distinct mechanisms: isoniazid inhibits mycolic acid synthesis by targeting enoyl-ACP reductase (InhA); rifampicin blocks bacterial RNA synthesis by inhibiting DNA-directed RNA polymerase; pyrazinamide disrupts bacterial membrane energy metabolism and fatty acid synthesis; and ethambutol inhibits arabinosyl transferases (EmbB) involved in cell wall biosynthesis. The drug is administered orally and is included in the WHO Model List of Essential Medicines.

Brand names

VoractivRimstarAkurit-4Akurit4Akurit 4ForecoxCombi-4Combi4Combi 4

Other names

Four-drug anti-tuberculosis combination tabletsEthambutol/Pyrazinamide/Rifampin/Isoniazid combination tabletsRHZERifampicin, isoniazid, pyrazinamide and ethambutol hydrochloride tablets