TB medication and its side effects

TB medication and its side effects

The following medications are commonly used to treat TB and they come combined in one tablet, the dose is dependent on the patients’ weight:
Isoniazid

  • Adverse effects are uncommon but they can sometimes cause minor symptoms such as feeling irritable, tiredness, lack of concentration, and a worsening of acne.
  • Isoniazid can affect your liver. If you develop nausea (feeling sick), vomiting, stomach pain, yellow skin or eyes, or darker coloured urine you should contact your doctor immediately.
  • Tingling of the fingers and toes can sometimes occur and your doctor may prescribe Vitamin B6 (pyridoxine) to prevent this. Skin itchiness and rashes are rare.
  • Drug interactions may occur with the anti-convulsant medication given for epilepsy. Tell your doctor or TB case manager if you are taking any of them.
    Rifampicin
  • Rifampicin colours your urine, sweat, tears, semen and saliva to an orange reddish colour. This side effect is harmless.
  • The main side effects are stomach upsets and discomfort, nausea and loss of appetite. Vomiting and diarrhoea may occur although this is rare.
  • Mild flushing, itchiness, skin and a pale rash are often brief side effects, and are not reasons to stop your TB treatment. Occasionally these symptoms may get worse and are associated with fever. When that happens let your doctor or TB case manager know immediately
  • Inflammation of the liver is rare unless the liver has already been damaged by other diseases or alcohol use.
  • Rifampicin can reduce the effectiveness of the birth control pill. Women taking the birth control pill will need to discuss other forms of contraception with their doctor or an adviser at a family planning clinic.
  • Rifampicin can interact with many other medications. Before starting TB treatment let the doctor or the Pharmacist know about all the other medicines you are already taking.
    Pyrazinamide
  • Common side effects include loss of appetite, nausea and flushing. Report problems to your doctor with immediate effect
  • Some people experience pain in their joints. This is usually mild and painkillers such as Aspirin or Paracetamol will ease the pain.
  • Inflammation of the liver is not common, however if you develop nausea (feeling sick), vomiting, stomach pain, yellow skin or eyes, or darker coloured urine, please contact your doctor.
  • Skin reactions such as itchiness, rashes and photosensitivity (becoming sunburned easily) could also occur, but are uncommon.
    Ethambutol
  • It is important to report any change in your eye-sight particularly if you notice a change in your colour vision or you develop blurred vision. Contact the doctor as soon as you notice or even suspect any problems with your vision.
  • Other rare side effects include pain in the joints or itchiness and rashes.

Key points to note:

  • Inform the doctor of your past medical history and about any medications you are taking.
  • Take your medications as directed. Do not stop taking them, even when you feel better. Not taking your medicine exactly as prescribed by your doctor can lead to the TB bacteria becoming resistant to the medication.
  • Some medications, such as Rifampicin, must be taken on an empty stomach as they interact with food.
  • Avoid alcohol during the period of your TB treatment.
  • Mild stomach upsets may occur at the beginning of treatment but they usually get better over a few days. If they don’t get better or affect your daily activities, contact your doctor.
    NB: No medication is completely free of side effects but their occurrence varies from person to person and most people do not experience any problems.

Retšelisitsoe Nkhahle is a Mosotho pharmacist based in Botswana. She is pursuing an Msc in pharmacy

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