4 Lw Sachet Plus

4 LW SACHET PLUS by MANEESH PHARMACEUTICALS LTD.

Name

• Common Name: 4 LW Sachet Plus, Scc 4 LW Plus Pouch
• Brand Name: 4 LW SACHET PLUS

Composition

4 LW Sachet Plus is a fixed-dose combination anti-tuberculosis medicine. Each sachet contains four essential anti-TB drugs:

• Rifampicin: 225 mg (also listed as 300 mg in some sources)
• Isoniazid: 150 mg
• Pyrazinamide: 800 mg (also listed as 750 mg in some sources)
• Ethambutol: 550 mg (also listed as 400 mg in some sources) Some formulations also include Pyridoxine (Vitamin B6) to help reduce the risk of drug-induced neuropathy.

Uses

4 LW Sachet Plus is primarily used for the treatment and prevention of tuberculosis (TB), an infectious disease that mainly affects the lungs but can spread to other body parts like kidneys, brain, spine, and bone marrow. It is specifically designed for the intensive (initial) phase of TB treatment to rapidly kill TB bacteria, reduce bacterial load, prevent drug resistance, and eliminate Mycobacterium tuberculosis from the body. In some cases, it may also be included in treatment regimens for drug-resistant TB under strict medical supervision and for supportive treatment of secondary infections during tuberculosis treatment.

Dosage and Administration

This medicine is a prescription medicine and should be taken as advised by a doctor. It is typically taken once daily on an empty stomach. The sachet powder should be mixed in a glass of water and consumed. It is crucial to complete the full course of treatment to prevent relapse or the development of drug-resistant TB. Doses should not be skipped, and treatment should not be stopped early. A gap of one hour should be maintained between 4 LW Sachet Plus and antacid medicines.

Side Effects

Common side effects may include:

• Nausea, vomiting, or stomach upset
• Loss of appetite or weight
• Joint pain (due to pyrazinamide)
• Fatigue, weakness, or malaise
• Numbness or tingling sensation (peripheral neuropathy), especially in hands and feet
• Skin rash or cutaneous reactions
• Dizziness

Serious side effects can include:

• Liver issues such as jaundice, yellowing of skin/eyes, dark-colored urine, increased liver enzymes, or hepatitis.
• Vision changes, including blurred vision, color blindness, or retrobulbar optic neuritis (due to ethambutol).
• Low blood platelets (thrombocytopenic purpura).
• Hallucinations, disorientation, or confusion.

The medicine may also discolour urine, sweat, saliva, and tears a reddish/orange colour, which is usually normal and not harmful, but dark urine accompanied by other symptoms could indicate liver damage.

Precautions

• Medical Supervision: 4 LW Sachet Plus should only be taken under strict medical supervision.
• Alcohol: Avoid consuming alcohol, as it increases the risk of liver damage and can cause adverse reactions like flushing, increased heart rate, and low blood pressure (Disulfiram reaction).
• Liver and Kidney Conditions: Caution is advised in patients with liver or kidney conditions; regular liver function tests may be required during treatment.
• Pregnancy and Breastfeeding: Consult a doctor if pregnant, as it may be unsafe during pregnancy. It passes into breast milk, so breastfeeding should be avoided while taking this medicine.
• Diabetes: Inform your doctor if you are diabetic.
• Oral Contraceptives: May interfere with oral contraceptives, so alternate birth control methods should be used.
• Vision Tests: Regular vision tests may be required during treatment.
• Other Conditions: Inform your doctor if you have epilepsy, gout, mental health problems, HIV infection, malnutrition, porphyria, or bleeding problems.
• Vitamin B6: Your doctor may prescribe Vitamin B6 supplements to prevent potential problems like nerve inflammation associated with isoniazid.
• Driving: May cause dizziness and vision problems, so caution is advised when driving or operating machinery.

Storage

Store below 25°C in a dry place. Protect from direct sunlight and moisture. Keep out of reach of children. Unused medicine should be disposed of properly to ensure it is not consumed by pets, children, or other people.