✅ Active Ingredient Overview Table:

🔬 Active Ingredients:	Isoniazid 300 mg, Rifampicin 450 mg
💊 Indication:	Tuberculosis (TB) Treatment
🇺🇸 US Brand Equivalent:	Isoniazid/Rifampin (Generic), Rifamate
🏭 Manufacturer:	Lupin Limited (Founded: 1968)
📦 Packaging:	10 Capsules per Strip
🧪 Strength:	Isoniazid 300 mg, Rifampicin 450 mg
🚚 Delivery Time:	6–15 days

🌿 What Is R-Cinex 300 mg/450 mg?

R-Cinex combines Isoniazid, a bactericidal agent that inhibits mycolic acid synthesis, with Rifampicin, a broad-spectrum antibiotic that inhibits bacterial RNA polymerase. This fixed-dose combination (FDC) is recommended for the intensive phase of tuberculosis therapy to ensure adherence, reduce pill burden, and prevent drug resistance. R-Cinex effectively targets Mycobacterium tuberculosis by attacking different bacterial pathways, providing rapid bacterial clearance and reducing transmission risk.

🧬 Pharmacology & Mechanism of Action

Component	Mechanism
Isoniazid (INH)	• Prodrug activated by mycobacterial catalase-peroxidase (KatG) → forms reactive species that inhibit production of mycolic acids → disrupts cell wall synthesis → bactericidal against actively dividing M. tuberculosis
Rifampicin (RIF)	• Binds to β-subunit of DNA-dependent RNA polymerase → prevents transcription initiation → bactericidal against intracellular and extracellular mycobacteria
Pharmacokinetics	INH: Rapid absorption, hepatic acetylation (fast/slow acetylators), half-life 1–4 hours. RIF: Well absorbed, induces cytochrome P450 enzymes, half-life ~3–5 hours.

💡 Indications & Dosing

Phase	Regimen (Adults)
Intensive Phase	• R-Cinex 300/450 mg: 2 capsules once daily on an empty stomach for 2 months • Combined with Pyrazinamide and Ethambutol or Streptomycin
Continuation Phase*	• Isoniazid 300 mg: 2 capsules 3× weekly; Rifampicin 450 mg: 1 capsule 3× weekly for 4 months (use separate INH/RIF FDC or individual)

*Continuation phase usually uses separate FDC of Isoniazid/Rifampicin if available.

Administration: Take on an empty stomach (1 hour before or 2 hours after meals) to enhance absorption. – Monitoring: Baseline liver function tests, visual acuity and color vision (if Ethambutol used), periodic sputum cultures and sensitivity. – Directly Observed Therapy (DOT): Recommended to ensure adherence and reduce resistance.

⚠️ Warnings & Side Effects

Common:

Gastrointestinal upset (nausea, vomiting)
Hepatotoxicity (elevated transaminases)
Orange-red discoloration of body fluids (urine, sweat, tears) due to Rifampicin

Less Common:

Peripheral neuropathy (Isoniazid)
Thrombocytopenia, leukopenia (Rifampicin)
Skin rash, pruritus

Serious (Rare):

Severe hepatotoxicity → jaundice, hepatic failure
Drug-induced lupus (INH)
Acute kidney injury (RIF)
Hemolytic anemia (RIF)

Precautions:

Baseline Evaluation: LFTs, CBC, visual exam (if on Ethambutol), HIV status, hepatitis B/C.
Co-administer Pyridoxine (Vitamin B6): 10–25 mg daily to prevent Isoniazid-induced peripheral neuropathy, especially in diabetics, HIV-positive, pregnant, or malnourished patients.
Drug Interactions: RIF induces CYP450 → reduces levels of antiretrovirals, oral contraceptives, warfarin, certain antifungals.
Pregnancy: Category C; use only if benefit outweighs risk; avoid during first trimester if possible.
Pediatric Use: Dose adjusted by weight; use pediatric FDCs where available.

🏥 Storage Instructions

Store R-Cinex capsules at 20–25°C in a cool, dry place away from direct sunlight. Keep in original packaging to protect from moisture. Ensure out of reach of children.

🌐 Availability & Purchasing

United States: Isoniazid and Rifampin FDCs are available through TB control programs under prescription.
United Kingdom & EU: Regulated through National TB programs; prescription required.
Australia: Available under PBS with prescription; DOT often used.

Importing R-Cinex from India can be cost-effective; ensure compliance with national TB program guidelines, importation policies, and maintain valid prescription to avoid customs issues.

🔗 Authoritative Resources

🔗 Related Antitubercular Therapies (Indian Brands)

Isonex 100 mg – Isoniazid by Lupin Ltd.
Pyrazinamide 500 mg – Pyrazinamide by Intas Pharmaceuticals.

🎥 Educational Video on First-Line TB Therapy

Learn about R-Cinex’s role in TB treatment and DOTS strategy:

👨‍⚕️ Expert Insight: Dr. Priya Menon, Infectious Disease Specialist

“Fixed-dose combinations like R-Cinex simplify TB treatment by reducing pill burden and ensuring correct dosing, which is crucial for adherence and preventing resistance. Close monitoring of liver function and patient counseling on adverse effects significantly improves outcomes.”