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Written By
Dr. Love Sharma
PhD (Pharmacology), PGDPRA
Reviewed By
Dr. Shilpa Garcha
MD (Pharmacology), MBBS
Last updated
05 Dec 2023 | 06:14 PM (IST)

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Introduction of Monto 4 Tablet

Monto 4 Combipack is a combination medicine used in the treatment of tuberculosis. It prevents the growth of the microorganisms that cause the infection.

Monto 4 Combipack is a combination of isoniazid, rifampicin, ethambutol, and pyrazinamide.

Uses of Monto 4 Tablet

Benefits of Monto 4 Tablet

In Treatment of Tuberculosis (TB)

Monto 4 Combipack is a combination of medicines that is used to treat tuberculosis, an infectious disease that mainly affects the lungs but can affect other parts of the body as well. It kills as well as stops the growth of infection causing bacteria and helps in treating the infection. Take it in the dose and duration advised by the doctor. Your symptoms may improve before the infection is completely cured. Do not stop taking it without consulting your doctor as doing so may cause the infection to return or worsen. Follow your doctor’s instructions carefully to get maximum benefit.

Side effects of Monto 4 Tablet

Most side effects do not require any medical attention and disappear as your body adjusts to the medicine. Consult your doctor if they persist or if you’re worried about them

Common side effects of Monto 4

  • Nausea
  • Vomiting
  • Peripheral neuropathy (tingling and numbness of feet and hand)
  • Abdominal pain
  • Skin rash
  • Hepatitis (viral infection of liver)
  • Lethargy
  • Low blood platelets
  • Joint pain
  • Thrombocytopenic purpura
  • Cutaneous reactions
  • Retrobulbar optic neuritis

How to use Monto 4 Tablet

Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Monto 4 Combipack is to be taken empty stomach.
Avoid Monto 4 Combipack with tyramine-rich food such as cheese, smoked fish, meats and some types of beer.

Safety advice

Alcohol
UNSAFE
Consuming alcohol while taking Monto 4 Combipack may cause symptoms such as flushing, increased heart beat, nausea, thirst, chest pain and low blood pressure (Disulfiram reaction).
Pregnancy
CONSULT YOUR DOCTOR
Monto 4 Combipack may be unsafe to use during pregnancy. Although there are limited studies in humans, animal studies have shown harmful effects on the developing baby. Your doctor will weigh the benefits and any potential risks before prescribing it to you. Please consult your doctor.
Breast feeding
SAFE IF PRESCRIBED
Monto 4 Combipack is probably safe to use during breastfeeding. Limited human data suggests that the drug does not represent any significant risk to the baby.
Driving
UNSAFE
Monto 4 Combipack may cause side effects which could affect your ability to drive.
Monto 4 Combipack occasionally causes sight problems and tingling or numbness in hand or feet. After taking this medicine you should not drive until you know how it affects you.
Kidney
CAUTION
Monto 4 Combipack should be used with caution in patients with kidney disease. Dose adjustment of Monto 4 Combipack may be needed. Please consult your doctor.
Kidney function tests are advisable before the start of this medicine.
Liver
CAUTION
Monto 4 Combipack should be used with caution in patients with liver disease. Dose adjustment of Monto 4 Combipack may be needed. Please consult your doctor.
Regular monitoring of liver function tests is advised before and after the start of the treatment.

All substitutes

For informational purposes only. Consult a doctor before taking any medicines.
Monto 4 Combipack
₹8.4/Tablet
Coxwin 4 Tablet
Marc Laboratories Pvt Ltd
₹1.48/tablet
82% cheaper

Quick tips

Monto 4 Tablet

  • You have been prescribed Monto 4 Combipack for the treatment of tuberculosis.
  • Take it on an empty stomach and preferably at the same time everyday.
  • Try not to forget a dose, as this increases the risk of the bacteria becoming resistant to the medicine, and also increases the risk of getting side effects.
  • It may discolour your urine, sweat, saliva and tears a reddish/orange colour. This is normal and not harmful.
  • Your doctor may check your liver function before starting treatment and regularly thereafter. Inform your doctor if you notice yellowing of eyes or skin, dark urine, or stomach pain.
  • Avoid drinking alcohol while taking Monto 4 Combipack as this may increase the risk of side effects on the liver.
  • It may cause vitamin B6 deficiency. Your doctor may prescribe vitamin B6 supplements to help avoid potential problems associated with its deficiency, such as inflammation of the nerves (neuritis). 
  • Use a reliable contraceptive method (such as condoms or a diaphragm) to prevent pregnancy while you are taking Monto 4 Combipack as it may make hormonal contraceptives such as the pill less effective.
  • Do not take indigestion remedies (antacids)  within at least two hours of taking Monto 4 Combipack.
  • Finish the full course of the medication, even if you feel better. Stopping the course early increases the risk of coming back of the infection.

Fact Box

Habit Forming
No
Therapeutic Class
ANTI INFECTIVES

Patient concerns

Patient concerns

arrow
My daughter is given tb medicine even though she is not infected taking these medicine will cause tb???
Dr. Rahul Yadav
Paediatrics
Hello, TB medicines are given only when there is indication of tuberculosis. They are for treating tuberculosis.
MORE
Though took vaccines in childhood, the test for TB came positive. Was advised to undergo treatment.physically absolute fit and healthy, is it advisable to take treatment?
Dr. Anshum Aneja Arora
Pulmonology
If sputum is positive for Tb , treatment is absolutely essential. Read more at www.arohealth.com/tuberculosis
MORE
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User feedback

FAQs

Monto 4 Tablet

How to take Monto 4 Combipack?

Take Monto 4 Combipack on an empty stomach which means at least one hour before and two hours after a meal and with full glass of water.

Can I drink alcohol while taking Monto 4 Combipack?

No, avoid drinking alcohol while taking Monto 4 Combipack. Drinking alcohol will increase the risk of hepatitis caused by Monto 4 Combipack because of isoniazid.

Can the use of Monto 4 Combipack cause discoloration of the urine?

Yes, Monto 4 Combipack contains Rifampicin. It can cause temporary discoloration of your teeth, sweat, urine, saliva and tears (red, orange or brown color). This side effect is usually not harmful. However, discoloration of urine can be a sign of liver damage. Contact your doctor if you notice discoloration of urine accompanied with stomach pain, loss of appetite and jaundice (yellowing of your skin or eyes).

Can Monto 4 Combipack cause visual impairment?

Monto 4 Combipack contains Ethambutol which may cause visual impairment. Inform the doctor immediately if you notice any changes in your eyesight.

Can I discontinue Monto 4 Combipack if I feel well?

No, do not discontinue Monto 4 Combipack. Take the proper course of a drug that has been prescribed for you even if you begin to feel better. If you stop taking Monto 4 Combipack then your infection may become worse, difficult to treat and it may result in drug-resistant TB (drugs you are taking may no longer work).

Can I take oral contraceptive pills while taking Monto 4 Combipack?

No, Monto 4 Combipack can make birth control pills less effective. So, ask your doctor about using a birth control method which does not affect your hormone levels (such as a condom, diaphragm, spermicide).

What are the instructions for storage and disposal of Monto 4 Combipack?

Keep this medicine in the container it came in, tightly closed. Store it according to the instructions mentioned on the pack or label. Dispose of the unused medicine. Make sure it is not consumed by pets, children and other people.
Related lab tests
  • Complete Blood Count
  • Erythrocyte Sedimentation Rate
  • Mycobacterium Tuberculosis DNA PCR - Qualitative
  • Peripheral Smear Examination

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    Disclaimer:

    Tata 1mg's sole intention is to ensure that its consumers get information that is expert-reviewed, accurate and trustworthy. However, the information contained herein should NOT be used as a substitute for the advice of a qualified physician. The information provided here is for informational purposes only. This may not cover everything about particular health conditions, lab tests, medicines, all possible side effects, drug interactions, warnings, alerts, etc. Please consult your doctor and discuss all your queries related to any disease or medicine. We intend to support, not replace, the doctor-patient relationship.

    References

    1. Gumbo T. Chemotherapy of Tuberculosis, Mycobacterium Avium Complex Disease, and Leprosy. In: Brunton LL, Chabner BA, Knollmann BC, editors. Goodman & Gilman's: The Pharmacological Basis of Therapeutics. 12th ed. New York, New York: The McGraw-Hill Companies, Inc.; 2011. [Accessed 09 Apr. 2019] (online) Available from:External Link
    2. Drugs.com. Rifampicin. [Accessed 09 Apr. 2019] (online) Available from:External Link
    3. Ethambutol. Ontario, Canada: Patheon Inc.; 2007. [Accessed 09 Apr. 2019] (online) Available from:External Link
    4. Drugs.com. Pyrazinamide. [Accessed 09 Apr. 2019] (online) Available from:External Link

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