Antituberculosis (TB) and medicines

Introduction

 

Antituberculosis is a class of medicines used to treat tuberculosis (TB). TB is caused by the bacteria, Mycobacterium tuberculosis and usually affects the lungs but it may also affects other parts of the body such as gut, spine, bone and brain.

TB is spread through the air from one person to another. The bacteria are passed through the air when a person who has TB disease coughs, laughs, sings, or sneezes.  If another healthy person inhales this, he/she may get TB as well.

Figure 1: TB transmission (Source: CDC)

Treatment strategy

What to do if you want to be cured from TB?

• You have to start taking the medicines right away because it may get harder to cure your TB if you delay the treatment and you may spread the bacteria to others.
• The treatment duration for lung TB is six months. If you habe TB of bone, spine or joint, the duration would be six to nine months while TB of brain requires treatment up to one year.
• Upon starting the treatment, your healthcare provider will make sure the antitubercolisis medicine is working for you. Therefore, you must go for follow-up appointments with your doctor and do the tests as required. 

Types of antituberculosis medicines                

• Usually, you will be required to take four types of oral antituberculosis medicines. This is because a combination of medicines will do a better job of killing the bacteria and prevent emergence of resistance.

The common antituberculosis medicines are:

• Medicines are dosed according to your body weight, i.e. the heavier you are, the higher the dose.
• The good news is we have Akurit-4®, which is a fixed-dose combination of the four antituberculosis medicines in one formulation. So, instead of taking four types of medicines, you only need to take one type. This actually reduces the number of medicines that you need take per day.

 

Importance of compliance

1. Do you have to take the antituberculosis medicines every day for months?

 

Yes.

It takes long time to completely kill all the TB bacteria. You probably will feel better after a few weeks on treatment but this doesn’t mean you can stop taking the medicines. It is very important to be compliant to your treatment to ensure that you are disease free and prevent formation of resistance TB bacteria.

2. How can you ensure compliance?

When you are started on TB medicines, you will be given a TB book. The TB book will be used to monitor your compliance.

Direct Observed Therapy (DOT) is the best way to ensure compliance, where you will be taking the medicine under the supervision of a healthcare provider or family member.

3. How can you remember to take you medicines if you are not on DOT?

1. 

Common adverse effects

 

• When you started taking antituberculosis medicines, you will notice that your urine, saliva, tears and sweat turn orange colour. This is caused by rifampicin and you shouldn’t worry as it is harmless. Just be alert as your clothes and contact lenses may get stained.
• Otherwise, most people are able to complete their TB treatment without any problem.
• However, if you experience any of the following symptoms, please inform you doctor right away:

• 

• There are other possible interactions that you need to take note:

• 1. • Rifampicin reduces the effectiveness of oral contraceptive pills and implants. Therefore, women who are on TB treatment should use another contraceptive method, e.g. condom.
     • You may experience withdrawal symptoms if you are taking rifampicin and methadone. Don’t worry as your doctor will adjust your methadone dosage accordingly.

Rujukan

1. Ministry of Health Malaysia (2012). Clinical Practice Guidelines for the Management of Tuberculosis, 3rd edition.
2. Centers for Disease Control and Prevention (CDC). Tuberculosis. http://www.cdc.gov/tb/

Last Reviewed	:	17 June 2015
Translator	:	Anitha Ramadas
Reviewer	:	Yam Chiew Fong