Mairin

The anti-tuberculosis combination drug Myrin has a complex composition, represented by three active ingredients - isoniazid, rifampicin and ethambutol.

Indications Mairina

The medical drug Myrin is used in anti-tuberculosis treatment regimens:

• during intensive care;
• as a supportive treatment;
• at the initial stage of pulmonary and extrapulmonary pathology.

Myrin can be used in various therapeutic combinations, including with other anti-tuberculosis drugs such as Streptomycin or Pyrazinamide.

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Release form

The drug Myrin is available in tablet form: the tablet has a protective shell coating and is represented by such active ingredients as ethambutol 0.3 g, rifampicin 0.15 g and isoniazid 0.075 g.

The tablets are packed in blister strips of 10 pieces each. A cardboard box contains eight blister strips (80 tablets in total).

Pharmacodynamics

Mayrin is a combination drug with antimicrobial and anti-tuberculosis properties. Its activity is demonstrated against tuberculosis mycobacteria, regardless of the stage of development of the bacteria.

Rifampicin is a semi-synthetic antimicrobial agent belonging to the ansamycin group. Due to rifampicin, inhibition of DNA-dependent RNA polymerase occurs.

Isoniazid inhibits the production of mycolic acids in the cell membrane of tuberculosis mycobacteria.

Ethambutol enters the intensively developing cellular structures of mycobacteria, inhibits the production of metabolism, interfering with the metabolism of cells. This leads to disruption of vital activity and death of pathogenic microorganisms.

Rifampicin together with isoniazid show activity against rapidly developing extracellular bacteria. In addition to mycobacterium tuberculosis, the drug affects microbes that cause brucellosis, trachoma, typhus, legionellosis, leprosy.

Bacteria have difficulty developing resistance to the drug due to its complex composition.

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Pharmacokinetics

Ethambutol is detected in the maximum possible concentration in the blood after 3 hours (on average), which is from 2 to 5 mcg per ml. The concentration decreases only 24 hours after the drug is discontinued. Ethambutol is eliminated from the body: 50% - with urine, up to 15% - in the form of residual metabolic products, up to 22% - with feces.

Rifampicin reaches peak concentration within an average of 3 hours. The half-life is about 3 hours. Rifampicin passes through the blood-brain barrier, the placental barrier, and is found in breast milk.

Isoniazid is rapidly absorbed and well distributed in tissues and fluids. Up to 70% of the drug leaves the body in urine within 24 hours of taking the pill.

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Dosing and administration

Myrin tablets are swallowed whole, without chewing, with a sufficient amount of water, 60-120 minutes before meals.

The amount of the drug is determined based on the recommended daily dosages:

• ethambutol - from 15 to 25 mg per kilogram of weight;
• rifampicin – from 8 to 12 mg per kilogram of weight (but not more than 0.6 g);
• isoniazid – from 5 to 10 mg per kilogram of weight (but not more than 0.3 g).

Duration of treatment: from one to three months.

The average daily dose of Myrin is 1 tablet per 15 kg of the patient's weight. Another convenient dosing scheme is also possible:

• for patients weighing from forty to 49 kg – three tablets;
• For patients weighing over 50 kg – four tablets.

It is not recommended to interrupt treatment on your own, without the doctor’s permission, as this can have an extremely negative impact on further treatment of the disease.

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Use Mairina during pregnancy

Treatment with Myrin tablets during pregnancy is not advisable. But in some cases, if it is not possible to avoid taking the drug, it is still prescribed: however, it is necessary to first assess the degree of danger to the fetus and the probable benefit to the pregnant patient.

If Myrin is prescribed in the final trimester of pregnancy, then vitamin K preparations should be taken at the same time. This is due to the fact that rifampicin can provoke bleeding in the woman and in the baby after birth.

Contraindications

Myrin tablets should not be taken:

• in case of a high probability of hypersensitivity to the drug and its individual components;
• for hepatitis, jaundice;
• for optic neuritis;
• during periods of exacerbation of gout;
• children under 13 years of age.

Relative contraindications for treatment with Mayrin include:

• epilepsy;
• psychoses;
• severe kidney pathologies;
• gout in the subacute stage and the stage of remission.

If Myrin is prescribed to an elderly person or a child over 13 years of age, then ophthalmological monitoring, as well as periodic examination of the kidneys and assessment of blood counts are mandatory at the same time.

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Side effects Mairina

Anti-tuberculosis treatment with Myrin may be associated with a wide range of side effects, including:

• headaches, weakness, fatigue, irritability;
• sleep disorders, paresthesia, neuropathy, polyneuritis, psychosis, mood lability;
• increased heart rate, angina, changes in blood pressure;
• dyspepsia, intoxication hepatitis;
• allergic manifestations (rash, itching, fever);
• appetite disorders;

A flu-like condition with fever, dizziness and muscle pain;

• depressive states, hallucinations, paresthesia and paresis;
• exacerbation of gout;
• convulsions, metabolic acidosis.

If side effects are severe, your doctor may reconsider your treatment and replace Myrin with another, more suitable drug.

It is important to note that during treatment with Myrin, the skin, secretions, sweat, feces, urine and tears may become reddish-orange in color.

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Overdose

Taking too much Myrin may cause the following symptoms:

• nausea and vomiting;
• feeling of fatigue;
• disturbance of consciousness;
• pain in the right hypochondrium;
• jaundice;
• coloring of the skin and secretions in a deep red or brownish color.

Overdose is treated by rinsing the intestines and stomach, using a sorbent preparation. If necessary, symptomatic agents are prescribed, forced diuresis is used.

It is possible to connect hemodialysis and use biliary drainage.

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Interactions with other drugs

The bioavailability of Myrin may be reduced by antacids, opiates and ketoconazole.

Mayrin reduces the effectiveness of anticoagulant drugs, hypoglycemic agents, oral contraceptives, digoxin, antiarrhythmic drugs, glucocorticosteroids, theophylline, cyclosporine, β-blockers, cimetidine.

Antacid agents impair the absorption of Myrin.

Myrin increases the severity of side effects of phenytoin and impairs the elimination of triazolam.

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Storage conditions

Mayrin can be stored in dry rooms, away from heat and light sources, out of reach of children. The optimal temperature for storing the drug is from +20°C to +25°C.

Shelf life

Myrin is considered good for 24 months from the date of manufacture.

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