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New Drug for Children
Friday, June 09, 2006

The other night was the launching of another new drug for children with tuberculosis. It is called Rimcure Paed for the tablet containing Rifampicin, Isoniazid, and Pyrazinamide; and Rimactazid Paed for the tablets containing Rifampicin and Isoniazid for the maintainance phase of treatment. Yes! You have read the right thing....these are tablets for children. They are chewable and dissolve easily in water if the child is still unable to chew the medication. These are the first pediatric anti-TB fixed-dose combinations here in the Philippines.

Why the need for a fixed dose combination? When we say FDC, we don't need anymore to compute for the dose in order to deliver the correct dosage to a child patient with TB. We just weigh the patient and based on the weight the correct number of drugs is given to the patient. This has the advantage of reducing risk of developing drug resitant TB because monotheraphy is prevented, it simplifies prescription and administration of the drug and it will enhance patient compliance. With these we can be certain to a faster TB eradication.
posted by Amelyn R. Rafael,MD @ 10:07 AM  
14 Comments:
  • At 2:01 PM, Blogger arlene said…

    Dear Super Dok,
    My child was diagnose as having primary complex recently.
    Her pediatrician prescribed rimcure 5 tabs dissolved in 15cc of water before breakfast.For days I noticed her urine to be red in color.Is this normal? I was nt told about its side effects.
    Pls enlighten me on this matter.Thanks.

     
  • At 9:32 AM, Blogger Amelyn R. Rafael,MD said…

    Arlene, the red coloring of the urine is the side effect of Rifampicin, one of the components of Rimcure. As long as your child is taking the drug the urine color will be red.There is nothing to worry. It will disappear after completion of treatment.

     
  • At 11:29 PM, Blogger alyssa said…

    Dear Super Dok,
    I have 2 kids 4 and 6 their xray shows that they have primary complex.Our pedia gave them rim cure, after taking the medine for 3 days my eldest daugther develop rashes on her legs. What are the side effects of taking rim cure? Will their liver be damage?, my kids have asthma and skin allergies,is this the right medicine? My pedia said that they will only take it for 2 months,if their weight improve they will continue taking the medicine. Im really confused and I hope you can help me. My kids never lost their appetite, they dont have frequent cough and colds, they are only 19 and 14 lbs. but I think it is hereditary because everyone in the family is slim, they never experienced having fever for more than 3 days with no reason at all like pain or due to cough and cold. please help!!!

     
  • At 3:25 PM, Blogger Amelyn Rafael,MD said…

    Alyssa, your pedia diagnosed primary complex on your children based on their chest x-ray. I think its best that you show the rashes to her pedia and let her decide whether to lessen the dosage or shift to other preparations. The dosage for children is computed based on weight so there's nothing to worry about the liver. Rimcure is given 1 tablet per 7kg body weight.

     
  • At 9:13 PM, Blogger daisy said…

    I want to have a second opinion regarding the right dosage of Rimactazid. How often should the patient take it? They take rimcure for 2 months, do they also need to take rimactazid everyday? thanks..

     
  • At 3:49 PM, Blogger Amelyn R. Rafael,MD said…

    Daisy, Rimactazid Paed which is given to children has the same dosage as that of Rimcure Paed. On the average it is 1 tablet/7kgBW. Yes, it is also given daily but for 4 months. We have the adult preparation for rimactazid and the dosage is different to that for pedia cases.

     
  • At 1:36 PM, Anonymous Anonymous said…

    I have 2 kids,and they were both diagnose to have primary complex.They were taking kidz kit 2 right now.I was just wondering on how to compute for the dosage of the drugs since the 2 pedia doc of my kids gave different computation.Please help.Tnx.

     
  • At 7:51 PM, Blogger Amelyn R. Rafael,MD said…

    Anonymous, kidz kit 2 is given for the maintenance phase of treatment. (2nd to 6th month)Hence, it is comprised only of two kinds of drugs, rifampicin and INH.

    Computation is 10-20 mg/kg body weight in single or divided doses. One doctor might have used the lower range and the other the higher range of dosage that's why they gave different computation.

     
  • At 5:05 PM, Blogger Bong said…

    Hi Doc, my son Miguel (8 yo) has the following radiographic findings after his x-ray.

    - Chest Ap and lateral views show reticular densities in both preihilar areas
    - heart is not enalrged
    - Diaphragm and sulci are intact
    - Impression : perihilar pneumonitis

    Is this Primary Complex?

     
  • At 9:07 AM, Blogger Amelyn R. Rafael,MD said…

    No, Bong, it is not primary complex. It is an infection of the lungs which is only treated with antibiotics.

     
  • At 5:56 PM, Anonymous Rose said…

    Dear Doc,

    I have 2 kids, 4yo & 8-month old baby. They were exposed from their father with TB. Have already done the PPD test & resulted to negative. Their pedia still gave them the anti-TB kit (rimaped & comprilex. She advised to take 2ml each for my baby & 5ml each for my 4 years old kid every morning before meal for 3 mos. Is there any side effects if my kids will take it even if they do not have Primary complex? Also, as per the drug information included in the said kit, dosage of comprilex for infants is from 0.5 to 1.5ml only. Is there any risk if I will not follow his pedia's prescription of 2ml? For example, I will give him 1.5ml only instead of 2ml. And last for rimaped, infants are not included under the dosage/administration part of the drug information. Any comment why the pedia prescribed it also to my 8-month old baby? Appreciate your response.

     
  • At 7:43 PM, Blogger Amelyn R. Rafael,MD said…

    Sorry for the late response, Rose.
    Your pedia might have seen some symptoms of primary complex in your kids that's why prescription was still given though negative on PPD. Dosaging is based on weight of the child. Giving below the prescribed dose might not do any good to the patient. The giving of medicine is useless if underdose and resistance to the drug becomes a problem.

     
  • At 12:13 PM, Anonymous Anonymous said…

    Hi Doc,

    My son was diagnosed with primary complex and his pedia gave him rimaped and comprilex. Just like to confirm if rimaped should be taken before breakfast and comprilex after breakfast or both before breakfast? I'm a bit confused because my aunt told me that comprilex should be taken after light breakfast but it says in the medicine packaging that it should be taken before breakfast or 2 hours after breakfast. It was my aunt who brought my son to the doctor so the medicine instruction was not clear to me. Thank you very much.

     
  • At 12:57 PM, Anonymous tom latty said…

    My fiancee has a son 7 who had cough. chest xray showed Hilar Adenophathy. Given RIMACTAZID PAED for two months. was to go back but now they are at St Lukes and fiancee does not want to jepordize sons immigration to usa by mentioning the xray. Her son stopped taking it nine days ago. I told her he should finish six months of tb meds. Well I now read that four months is OK. Should he resume the meds for two more months? should i find a doctor in manila? should he simply wait until here in USA?

    thanks.

     
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Name: Amelyn R. Rafael,MD
Home: San Fabian, Pangasinan, Philippines
About Me: Family Physician, and Associate Professor (Clinical Anatomy and Medical Physiology)
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