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Adverse Drug Reactions due to Longer oral M/XDR-TB Regimen
Learning ObjectivesAdverse Drug Reactions due to Longer oral M/XDR-TB Regimen
The table below showcases the adverse drug events that may be caused by drugs used for longer oral Multi (M)/ Extensively Drug-resistant TB (XDR-TB) regimen. In these situations, replacement drugs are used instead of these drugs.
|
ADVERSE DRUG EVENTS |
DRUGS |
|---|---|
|
QT prolongation |
Bedaquiline (Bdq), Fluoroquinolone (FQ), Clofazimine (Cfz) |
| Rash, allergic reaction and anaphylaxis |
Any drug |
|
Gastrointestinal symptoms |
Ethionamide (Eto), P-Aminosalicylic Acid (PAS), Pyrazinamide (Z), Ethambutol (E), Bdq, Cfz, Linezolid (Lzd), FQs |
|
Diarrhoea and/or flatulence |
PAS, Eto |
|
Hepatitis |
Z, Eto, PAS, Bdq |
|
Giddiness |
Amikacin (Am), Eto, FQ and/or Z |
|
Haematological abnormalities |
Lzd |
|
Hypothyroidism |
Eto, PAS |
|
Arthralgia |
Z, FQ, Bdq |
|
Peripheral neuropathy |
Lzd, Cycloserine (Cs), Am, FQ, rarely Eto, E |
|
Headache |
Bdq, Cs |
|
Depression |
Cs, FQ, Eto |
|
Psychotic symptoms |
Cs, Isoniazid (H), FQ |
|
Suicidal ideation |
Cs, Eto |
|
Seizures |
Cs, H, FQ |
|
Tendonitis and tendon rupture |
FQ |
|
Nephrotoxicity (renal toxicity) |
Am |
|
Vestibular toxicity (tinnitus and dizziness |
Am, Cs, FQs, Eto, Lzd |
|
Hearing loss |
Am |
|
Optic neuritis |
E, Lzd, Eto, Cfz |
|
Metallic taste |
Eto, FQs |
|
Electrolyte disturbances (Hypokalaemia and Hypomagnesaemia |
Am |
|
Gynaecomastia |
Eto |
|
Alopecia |
Eto |
|
Superficial fungal infection and thrush |
FQ |
|
Lactic acidosis |
Lzd |
|
Dysglycaemia and Hyperglycaemia |
Eto |
Resources
- Guidelines for Programmatic Management of Drug-resistant Tuberculosis in India, March 2021.
- WHO Consolidated Guidelines on Tuberculosis: Module 4 - Treatment: Drug Resistant TB Treatment, 2020.
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