Combining Rifampicin and isoniazid with Ecstasy pills.

[Fantasian]

Rifampicin and isoniazid are used to treat TB in the UK.

SWIF has a friend who has used MDMA previously and would like to use it again in the near future. She has recently been shown to have TB but not a particularly severe version of it and is therefore being given the two drugs Rifampicin and isoniazid.

In a coming Rave would it be dangerous to combine these drugs with MDMA as she is looking to have a magical time just like SWIF himself.

Thanks, rapid responses appriciated.

[Jatelka]

Rifampicin is a liver enzyme inducer and Isoniazid is a liver enzyme inhibitor.

MDMA is metabolised by the liver, with people who are "poor metabolisers" and have lower levels CYP2D6 reported in some studies to be more sensitive to the effects of MDMA.

SWIJ doesn't know whether the Rifampicin and Isoniazid effects would cancel out. She would counsel avoiding stressing SWIF's friends liver by trying to push/pull in multiple directions by adding MDMA in this situation.

She would suggest that MDMA should be enjoyed when SWIY is in good health and can fully appreciate the experience, without the added anxiety of wondering "is this safe".

SWIJ thinks that SWIF's friend should treat the TB and then when fully recovcered revisit the idea of MDMA

[Fantasian]

Thanks for the reply, SWIF also advised at the time that MDMA should be enjoyed when in full health and without other drugs in the equation. However SWIF's friend was adament, is this combination dangerous or just ill advised?

[Jatelka]

SWIJ has done a (very quick because of time restraints) search: She can't find ANYTHING on the combination suggested. SWIF's friend would be entering uncharted territory, true guinea pig territory.

Her gut feeling is that this would be ill-advised and potentially problematic.

Will try to do some more digging: Tomorrow OK?

[Fantasian]

Thanks massively appriciated.

[Micklemouse]

To echo J's advice, best left till in full health, & doing something that could further compromise her health (i.e. taking drugs, staying up all night in a hot sweaty environment)is not advised.

To expand, there are other considerations than SWiYour friends own health here Fantasian - that being a certain consideration for the health of others. TB is a highly infectious disease, passed on by droplet infection, as in breathing, coughing or sneezing on someone. Given the lack of ventilation & the amount of moisture in the atmosphere at a rave, it would be a prime environment for the transmission of this scary, & increasingly popular in the lungs of our youth, little bacterium. SWiYour friend needs to be clear whether her particular infection is active or latent - if latent it won't be transmissable, if active she needs to stay well away from raves. Not doing so is tantamount to sleeping around without a condom when you know you've got the clap!

As for potential interactions...

From aidsinfo.nih

Concurrent use of alcohol, alfentanil, disulfiram, and other hepatotoxic medications with isoniazid may increase the potential for hepatotoxicity and should be avoided. Concurrent use of rifampin with isoniazid also may increase the potential for hepatotoxicity, requiring additional monitoring of liver enzymes and clinical symptoms.


Isoniazid may have MAO-inhibiting activity, so there is a slight risk of serotonin syndrome when isoniazid is given in combination with selective serotonin-reuptake inhibitors (SSRIs) or other serotonergic medications.

http://www.aidsinfo.nih.gov/DrugsNew...sID=6&TypeID=1