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Drugs for Tuberculosis Treatment

Treatment of active tuberculosis (TB) requires a very strict regimen of several antibiotics that are often used together. The treatment lasts between six and 12 months, longer for drug-resistant TB. TB bacteria are very hearty and take a long time to completely destroy. The four most commonly used antibiotics are: isoniazid, rifampin, ethambutol and pyrazinamide. (Mayo Clinic, CDC)

  1. Isoniazid

    • Isoniazid's primary use is in preventing TB from multiplying. It should not be used by patients with liver problems, as it can increase the risk of severe hepatitis. Common reactions include nausea, vomiting, tingling or burning sensation on the skin (known as parathesia) and upper-middle abdominal pain. Inflammation of the optic nerve, seizures, anemia and toxic psychosis are possible severe side effects. Do not drink alcohol while taking isoniazid. Take caution when eating meats, dairies, bananas, chocolate and caffeine, as these foods may interact with isoniazid and cause headaches, vomiting and chest pain. Approximate retail price for ninety 300-milligram pills is $17. (Epocrates)

    Rifampin

    • Rifampin is used for treatment of TB, leprosy and meningitis. Some common side effects are tiredness, headache, nausea, dizziness and loss of appetite. It can also cause urine, stool, sweat, tears or saliva to turn a reddish-orange color. Serious side effects include kidney failure, shock, psychosis and a rare but life-threatening disease called Stevens-Johnson syndrome in which layers of the skin peel off as the skin cells die. This is the most expensive TB drug at approximately $64 for thirty 300-milligram pills. (Epocrates)

    Ethambutol

    • Ethambutol is another antibiotic that is primarily used to treat TB. Patients with kidney disease or cataracts may not be able to take ethambutol, or may need to take a lower dose. Disorientation, rash, loss of appetite, dizziness and fever may occur. Blindness, allergic reactions and liver toxicity are the more serious side effects associates with use. Thirty 400-milligram pills costs about $56. (Epocrates)

    Pyrazinamide

    • The exact mechanisms for how pyrazinamide work are unknown. Like isoniazid and ethambutol, its primary function is to treat TB. Those suffering from liver or kidney disease, diabetes or gout may not be able to take pyrazinamide. Common side effects are similar to the other TB drugs, including nausea, rash and fatigue. Increased light sensitivity may also occur. Pyrazinamide has few serious side effects. Liver toxicity is possible, as is anemia. Average cost is $40 for thirty 500-milligram pills. (Epocrates)

    Considerations

    • While there is the possibility of very serious adverse reactions associated with the tuberculosis class of medications, it is important to remember that these are considered less common and in some cases very rare. The benefits of the medication outweigh the risks, as these are the first line of defense against TB. Patients can decrease the risk by keeping their doctor informed about any medications or supplements they are taking and reporting any adverse reactions they are experiencing. It is important to complete the course of antibiotics to avoid creating drug-resistant TB.

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