Patient guide for preventing, managing side effects associated with anti-TB drugs

Introduction

Freedom from TB is possible with timely, regular, complete treatment, with reassurance and prevention and management of side effects of antitubercular drugs. It has been observed that many patients don't complete treatment due to misunderstanding about side effects. They develop resistance and suffer due to worsening of disease and require more costly and prolonged treatment. The following information provides information on preventing and managing side effects associated with antitubercular drugs.

Important information

• Not everyone gets side effects.
• If you get side effects, inform and consult your doctor/nurse
• Early action prevents side effects
• Some symptoms may be experienced due to other causes and need investigation
• Don't stop your drugs or restart them on your own.
• Don't share your drugs or advice treatment to others.
• Don't smoke or drink alcohol as it can worsen side effects

Main Adverse Reactions

Nausea/Vomiting

• Can be due to TB drugs causing stomach irritation
• Take drugs embedded in banana
• Avoid smoking and drinking alcohol
• Eat nutritious food
• Inform and consult your doctor / nurse

Loss of appetite  / Pain /discomfort in abdomen / Yellow skin, yellow eyes, dark colored urine

• Can be due to TB drugs
• May indicate harm to liver
• Inform and consult your doctor/nurse immediately

Note: Orange coloration of urine is due to Rifampicin

Tingling, burning, numbness in hands & feet

• Can be due to TB drugs causing neuropathy
• inform and consult your doctor / nurse
• Can be prevented by taking vitamin B6 on doctor's advice

Flu like symptoms: Chills, body ache, shortness of breath / Tiredness, dry cough /Loss of appetite

• Can be due to Rifampicin
• Usually mild and subsides on its own
• May be due to flu infection. Inform and consult your doctor / nurse

Itching and Rash

• Can be due to TB drugs causing skin reactions
• If rash develops in the mouth or nose or involves very large body area or is associated with fever; inform and consult your doctor / nurse immediately

Reduced vision / Any problem in the eye

• Can be due to Ethambutol
• Inform and consult your doctor / nurse immediately
• Usually resolves on stopping Ethambutol
• If Ethambutol is stopped, it needs to be replaced by another drug to fully treat TB

Pain in joints, muscles, tendons / Difficulty in movements

• Can be due to Pyrazinamide and Fluroquinolones
• Usually harmless
• Can be treated with pain killers
• Inform and consult your doctor / nurse immediately

Diminution or loss of hearing / Ringing in ears / Giddiness / Loss of balance

• Can be due to some TB drugs
• Inform and consult your doctor / nurse immediately

Slowness of activities / Swelling of face / Swelling in neck /Disproportionate weight gain

• Can be due to thyroid dysfunction caused by PAS or Ethionamide
• Inform and consult your doctor / nurse

Tiredness, Lethargy / Headache /Pale look /Palpitations

• Can be due to anemia caused by some TB drugs
• Inform and consult your doctor / nurse
• Needs to be evaluated and can be treated with nutritious food and appropriate drugs

Convulsion /Feeling low in mood/ Seeing abnormal things /Suicidal or abnormal thoughts

• Can be due to some TB drugs.
• Inform and consult your doctor / nurse immediately.

Source: Prevention and Management of ADR