Not everyone infected with TB germs gets sick, so there are two conditions: inactive TB (also called latent TB infection) and active TB disease. Both can be treated.
- Inactive TB can turn into active disease at any time, even if you feel fine; treating it is the best way to keep that from happening.
- Active TB disease is treated with medicine.
TB germs are tough and take a long time to die, so take every TB medicine exactly as prescribed. Finishing treatment protects you, your family and friends, and your community.
Image from CDC's page.
Treatment plans
Several safe, effective treatment plans (regimens) are used in the United States. Yours will set out:
- which TB medicines to take, how much, how often and for how long;
- how to watch for side effects;
- which health care providers will support you.
| Length | Medicines may include | |
|---|---|---|
| Inactive TB | 3, 4, 6 or 9 months | isoniazid, rifampin, rifapentine |
| Active TB disease | 4, 6 or 9 months | ethambutol, isoniazid, moxifloxacin, rifampin, rifapentine, pyrazinamide |
| Drug-resistant TB | months or years | special medicines, depending on the resistance; treated by a TB expert |
For clinicians: Clinical Treatment of Tuberculosis.
Before you start
- Tell your provider about all your medicines — some interact with TB drugs. TB medicines can make birth control pills less effective; talk to your provider before starting.
- Tell your provider if you are or may be pregnant, or are breastfeeding.
- Avoid alcohol: drinking while on TB medicines can be dangerous and may harm your liver.
Side effects
Most people take TB medicines without problems, but everyone reacts differently — tell your provider about anything that seems wrong.
Minor (keep taking your medicine):
- a skin rash, from any TB medicine;
- upset stomach or nausea — taking medicine with food can help;
- orange urine, saliva, tears, sweat or breast milk from rifampin or rifapentine — normal and harmless, fading over time; your provider may advise against soft contact lenses, which can be stained for good.
Serious — call your provider at once:
- liver injury: abdominal pain, nausea and vomiting, yellow skin and eyes (jaundice);
- dizziness or lightheadedness;
- loss of appetite;
- flu-like symptoms;
- tingling or numbness in the hands or feet — with isoniazid, your provider may add vitamin B6 to prevent it.
Special groups: treatments exist for children (chosen by age, weight and other factors), for people with HIV (with medicines compatible with HIV treatment — plan with your provider if the pill load is hard), and for pregnant women (with medicines recommended in pregnancy, and monitoring of you and your baby).
Finishing treatment
Take all your TB medicines exactly as prescribed — don't miss doses or stop early; that can be very dangerous.
Directly observed therapy (DOT) is the best way to stay on track: a health care worker watches you take your medicine — daily or several times a week, in person or by video on a phone, tablet or computer — and checks it's working. See CDC's video DOT recommendations.
Taking it on your own? Some tips:
- take your pills at the same time every day — before breakfast, at a coffee break, after brushing your teeth;
- set an alarm, or leave a note on the mirror or refrigerator;
- ask family or a friend to remind you;
- mark a calendar, or use a weekly pill box kept by your bed or in your bag;
- use a medicine tracker — CDC has printable ones for the 3HP, 4R and 3HR regimens for inactive TB.
Keep all medicine out of children's reach. Forgot a dose? Skip it, take the next scheduled dose, and tell your provider.
During and after
- Your provider will ask about side effects and may test your blood, sputum or urine — and, for active disease, take more chest X-rays — to see how the medicines are working. With conditions such as HIV or diabetes, you may have tests before and after treatment.
- Keep a written record that you finished treatment: TB blood and skin tests may stay positive afterward, and the record will help if you're tested again.
- Most healthy people never need TB treatment again — but treatment kills only the germs in your body now; exposure to someone with active TB could bring new ones.
Getting support
Tell your provider if you have side effects, or need help to take your medicine — including food, clean water or transportation. Your provider or state or local TB program may have resources, and public and private health plans may cover treatment costs.
- Family and friends can remind you, offer emotional support, and help with groceries if you must stay away from others during treatment for active disease.
- We Are TB and Somos TB (in Spanish) are communities of TB survivors, patients and families offering peer support; CDC also shares personal stories.
Resources: Staying on Track with Tuberculosis Medicine, What You Need to Know About Tuberculosis, Questions and Answers About TB.
Sources
Based on "Treating Tuberculosis," Centers for Disease Control and Prevention; a work of the United States government in the public domain.
Licence: CC0 1.0 (public domain) · Adapted from www.cdc.gov
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