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This drug is a combination of five active pharmaceutical ingredients: isoniazid, rifampicin, pyrazinamide, ethambutol, and methylprednisolone. The first four—isoniazid, rifampicin, pyrazinamide, and ethambutol—are the standard first-line agents used in the intensive phase of tuberculosis (TB) treatment. They act synergistically to kill Mycobacterium tuberculosis by inhibiting cell wall synthesis (isoniazid), inhibiting RNA synthesis (rifampicin), disrupting energy production (pyrazinamide), and impairing cell wall formation (ethambutol)[2][5][6][7]. Methylprednisolone is a synthetic glucocorticoid corticosteroid with potent anti-inflammatory and immunosuppressive properties; it modulates immune responses by binding to the glucocorticoid receptor and altering gene transcription. This combination may be used in TB cases where adjunctive corticosteroid therapy is indicated—for example, TB meningitis or severe inflammatory complications.
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