Medication to Fight TB

Rifampicin

Rifampicin is an approved anti-mycobacterial drug that is a standard component of combination regimes for treating tuberculosis.

Dosage

Rifampicin is a generic product and is usually taken orally. Tablets of varying strength and tablet that contain rifampicin in combination with other anti-tuberculosis drugs are available in the market. Dosage is 600 mg per day or 450 mg per day for people weighing less than 50 kg.

Side effects and absorption

Side effects of rifampicin can include rash, fever, gastrointestinal distress and jaundice. Orange discoloration of body fluids such as spit and urine, and of soft contact lenses, also occurs.

There is some evidence that HIV infected people with TB or Diarrhea may have malabsorption of rifampicin.

How long may it take to work?

If you have a latent but inactive TB and you are under 35 years old, you must be at least one to two year with rifampicin if you cannot tolerate standard treatment with isoniazid or other TB treatments. 

How to take

Drug should be taken empty stomach at least 1 hour before or 2 hour after the meals. Avoid alcohol during this therapy because alcohol increases the chances of damage to the liver.

Ethambutol

Ethambutol is an approved anti-mycobacterial drug that is a standard component of combination regimes for treating tuberculosis.

Dosage

Ethambutol is a generic product and is usually taken orally. Tablets of varying strength are available in the market. Adults and children 13 years of age and older - 15 to 25 mg per kg of body weight once a day.

Side Effects

Ethambutol can decrease visual acuity which appears to be due to optic neuritis (eye nerve damage), apparently related to dose and duration of treatment. Other effects include anaphylactic reactions, pruritis and joint pain, anorexia, fever, malaise, headaches and dizziness. It may cause or worsen attack of gout. Patients with kidney disease are likely to have side effect.

How long it my take to work?

To help clear up tuberculosis infection completely, it is important to take medicine for the full time of treatment. It is also important not to miss any dose. It is taken everyday for as long as 1 to 2 year or more.

How to take?

Ethambutol may be taken with food if this medicine upsets the stomach.

Pyrazinamide

Pyrazinamide is a part of multidrug regimen of treating TB infection.

Dosage

It is taken orally 20 to 30 mg/kg in 3 to 4 equally divided doses not to exceed 3 gm daily. Dosages up to 60mg/kg have been used in the treatment of isonized-resistant TB. Tablets of varying strength of pyrazinamide are available in the market.

Side effects

Some of the side effects of pyrazinamide are liver toxicity, N/V, anorexia, sideroblestic anemia, rashes, kidney disfunction, eye disease and rarely perphyria, fever.

How long it may take to work

Pyrazinamide is taken for two months unlike other TB maintenance drugs which are taken for years. 

Isoniazid

Isoniazid is used as first line treatment for TB in combination with other drugs for the treatment of active disease. It is also used for people who have been exposed to active disease but have no symptoms.

Dosage

It is available in tablet, syrup and injectable forms. Dosage is 5-10 mg/kg/day (usually 300 mg) or 15 mg/kg 2-3 times per week.

Side effects

Most common side effect of isoniazid is peripheral neuropathy. signs and symptoms of peripheral neuropathy are numbness, tingling, or an unusual sensation such as burning or prickling on the skin. Hepatitis is inflammation of liver (yellow eyes, skin, nausea, vomiting, dark urine, unusual tiredness or weakness) which is most dangerous.

How long it takes to work?

It has to be taken for as long as 2 years.

How to take?

It should be taken empty stomach or at least 1-2 hours before meals. It is recommended to take it with vitamin B6 to reduce the incidence of peripheral neuropathy. Avoid alcohol.

Cycloserine

It is used in combination with other anti TB drugs to treat TB. Multi drug therapy reduces the colony of mycobacterium count in blood and leads to clinical improvement, especially the reduction of fever.

Dosage 

Cycloserine usually comes in capsules. The usual dosage for adult is 250 mg twice a day for the first three weeks. A daily dose of 1 gm should not be exceeded.

Side effects

Nervous system symptoms, which are usually related to higher doses of cycloserine, can be convulsions, drowsiness, headaches, tremor, dizziness, confusion and disorientation, hyperirritability and aggression. Other side effects are allergy, skin rash and elevated liver function tests. 

How long it may take to work?

TB treatment with cycloserine takes minimum of 1 year.

How to take?

Avoid alcohol, because it may increase the risk of seizures and should be taken with food.

Sodium PAS

Sodium PAS is an antibacterial, tuberculostatic drug.

Dosage

This is usually in a form of granules and is taken orally 10 to 15 g daily in divided doses.

Side Effects and absorption

Side effects of this drug can include itching, Jaundice, flu like illness, muscle cramps, vomiting, Red colored urine and CNS disturbances.

How long may it take to work?

Over a few days (2 to 3 weeks), if no response, check with your doctor.

How to take?

Drug should be taken with or after meals. If you do miss a dose of the medicine, take it as soon as possible to keep a constant amount of medicine in the blood.



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