4D PLUS TABLET belongs to the group of medicines called anti-tuberculosis drugs primarily used to treat tuberculosis. Tuberculosis is an infectious disease that mainly affects the lungs, but it can also spread to other body parts such as kidneys, brain, spine and bone marrow. 4D PLUS TABLET does not work against infections caused by the virus, including cold and flu.

4D PLUS TABLET is a combination of four anti-tuberculosis drugs, namely: Rifampicin, isoniazid, pyrazinamide and ethambutol. Isoniazid prevents the formation of the bacterial cell wall, while rifampicin inactivates a bacterial enzyme (RNA-polymerase) which is required by TB bacteria (Mycobacterium tuberculosis) to make essential proteins and to reproduce. Ethambutol and pyrazinamide work by slowing the growth of bacteria. Altogether, they kill the bacteria and treat the infection.

The dose and duration of 4D PLUS TABLET can vary depending upon your condition and severity of the infection. In some cases, you may experience certain common side-effects such as weakness, nausea, vomiting, malaise (feeling of discomfort), fatigue and vision problems. Most of these side-effects do not require medical attention and will resolve gradually over time. However, you are advised to talk to your doctor if you experience these side-effects persistently.

Avoid foods and drinks containing histamine or tyramine such as cured meat, matured cheese, soya, tuna, salmon, mackerel, wine and beer while taking 4D PLUS TABLET as they might cause interaction. Maintain a gap of one hour between 4D PLUS TABLET and antacid medicines. Consult your doctor before taking 4D PLUS TABLET if you are pregnant. Avoid breastfeeding while taking 4D PLUS TABLET as it passes into breast milk. 4D PLUS TABLET is not recommended for use in children. 4D PLUS TABLET may cause dizziness and vision problems, so drive only if you are alert. Avoid consuming alcohol along with 4D PLUS TABLET as it might lead to liver problems and increased dizziness.

4D PLUS TABLET belongs to the group of medicines called anti-tuberculosis drugs primarily used to treat and prevent tuberculosis. 4D PLUS TABLET is a combination of four anti-tuberculosis drugs, namely: Rifampicin, isoniazid, pyrazinamide and ethambutol. Isoniazid prevents the formation of the bacterial cell wall, while rifampicin inactivates a bacterial enzyme (RNA-polymerase) which is required by TB bacteria (Mycobacterium tuberculosis) to make essential proteins and to reproduce. Ethambutol and pyrazinamide work by slowing the growth of bacteria. Altogether, they kill the bacteria and treat the infection.

• Weakness
• Nausea
• Vomiting
• Malaise (feeling of discomfort)
• Fatigue
• Vision problems

Do not take 4D PLUS TABLET if you are allergic to any of its contents, if you have jaundice or if you are taking HIV medicines (saquinavir or ritonavir). Before starting 4D PLUS TABLET, please inform your doctor if you have diabetes, epilepsy, gout, mental health problems, HIV infection, malnutrition, peripheral neuropathy, porphyria, bleeding problems, kidney or liver problems. Consult your doctor before taking 4D PLUS TABLET if you are pregnant. Avoid breastfeeding while taking 4D PLUS TABLET as it passes into breast milk. 4D PLUS TABLET is not recommended for use in children. 4D PLUS TABLET may cause dizziness and vision problems, so drive with caution. Avoid consuming alcohol along with 4D PLUS TABLET as it might lead to liver problems and increased dizziness.

Drug-Drug Interactions: 4D PLUS TABLET may interact with an antibiotic (erythromycin), pain killer (acetaminophen), anti-diabetic (insulin isophane), MAO inhibitors (isocarboxazid, linezolid, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, safinamide, selegiline, tranylcypromine), calcium channel blockers (diltiazem, verapamil), azole antifungals (itraconazole, ketoconazole), blood thinners (warfarin), Antiepileptics (phenytoin, carbamazepine), Immunosuppressive agents (ciclosporin, sirolimus, tacrolimus, leflunomide, azathioprine) and anti-HIV (saquinavir, ritonavir, atazanavir).

Drug-Food Interactions: Do not consume alcohol while taking 4D PLUS TABLET as it could lead to increased dizziness and liver damage. Avoid foods and drinks containing histamine or tyramine such as cured meat, matured cheese, soya, tuna, salmon, mackerel, wine and beer while taking 4D PLUS TABLET as they might cause interaction.

Drug-Disease Interaction: Inform your doctor if you have colitis (inflammation in the lining of the colon), peripheral neuropathy (numbness and pain in hands and feet), porphyria, haemodialysis, diabetes, gout (high uric acid), liver toxicity, dialysis, optic neuritis (vision problems), kidney and liver dysfunction.

• ERYTHROMYCIN
• ACETAMINOPHEN
• INSULIN ISOPHANE
• SAQUINAVIR
• RITONAVIR
• ISOCARBOXAZID
• LINEZOLID
• MOCLOBEMIDE
• METHYLENE BLUE
• PHENELZINE
• PROCARBAZINE
• RASAGILINE
• SAFINAMIDE
• SELEGILINE
• TRANYLCYPROMINE
• DILTIAZEM
• VERAPAMIL
• ITRACONAZOLE
• KETOCONAZOLE
• ATAZANAVIR
• WARFARIN
• PHENYTOIN
• CARBAMAZEPINE
• CICLOSPORIN
• SIROLIMUS
• TACROLIMUS
• LEFLUNOMIDE
• AZATHIOPRINE

• Pineapple juice might help soothe the symptoms of cough and cold. It also has anti-inflammatory and mucolytic properties.
• Foods rich in vitamin C such as kiwi, broccoli and bell pepper helps in improving the immune system. 
• Avoid processed and fried foods.
• Warm ginger tea or warm soup can help in providing relief from cough.
• Avoid foods and drinks containing histamine or tyramine such as cured meat, matured cheese, soya, tuna, salmon, mackerel, wine and beer.
• Quit smoking and avoid alcohol consumption.

• 4D PLUS TABLET may affect test results of some blood tests such as tests for folate, vitamin B12 and liver function. Inform the person doing the tests that you are taking 4D PLUS TABLET.
• Your doctor may advise you to get regular liver tests while taking 4D PLUS TABLET to check how your liver is functioning.
• 4D PLUS TABLET may cause vit B6 deficiency, your doctor may suggest vit B6 supplements while using 4D PLUS TABLET.
• Maintain a gap of one hour between 4D PLUS TABLET and antacid medicines.

Tuberculosis (TB): Tuberculosis is an infectious disease that affects the lungs, but it could also spread to other body parts such as kidneys, brain, spine and bone marrow. Tuberculosis is caused by a bacteria named Mycobacterium tuberculosis. It is a contagious disease which can spread to others through small droplets released into the air by a person suffering from tuberculosis. Symptoms include a cough that lasts for a few weeks, pain while coughing or with normal breathing, unexplained fatigue, fever, night sweats, and loss of appetite and weight. People who smoke or consume alcohol, and people diagnosed with HIV and immune system problems are more likely at risk of developing active TB.