Fixed dose combinations in the treatment of tuberculosis.
Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research, Sector 67, S. A.S. Nagar-160062, Punjab
R Panchagnula Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research, Sector 67, S. A.S. Nagar-160062, Punjab
Tuberculosis is a complex socio-economic problem that impedes human development. Tuberculosis exerts a toll of eight million new sufferers and two million deaths every year. Around one third of world population harbors Mycobacterium tuberculosis that is sensitive to rifampicin, isoniazid, pyrazinamide and ethambutol. As tuberculosis is contagious, it infects many others thereby necessitating early diagnosis and treatment. A standard 6 months treatment regimen formulated by World Health Organization (WHO), in its operational point of view is a complex procedure leading to treatment failure and resugence of drug resistant strains. To increase the patient compliance, in its recently revised Tuberculosis Treatment Guidelines for National Tuberculosis Programs, WHO encourages the use of Fixed Dose Combination (FDC) tablets, which assures ingestion of all the components of tuberculosis treatment regimen. However, the major quality issue associated with FDCs is assuring the bioavailability of rifampicin. If not carefully manufactured, bioavailability of rifampicin is negatively affected which could directly lead to poor treatment outcome and may lead to drug resistance. In the light of above scenario, this review mainly focuses the potential advantages of FDC formulations with special emphasis on quality of FDC preparation to be used for tuberculosis control.