Regimen, Duration and Dosage for Isoniazid [H] Mono/Poly DR-TB Regimen
ContentIsoniazid (H) mono/ poly Drug-resistant TB (DR-TB) regimen has the following regimen, duration and dosage of drugs.
Regimen: (6 or 9) Lfx R E Z
Dosage
- The dosage of drugs would vary as per the weight of the patients.
- Adult patients (≥ 18 years) would be classified in weight bands of <16 kg, 16-29 kg, 30-45 kg, 46-70 kg and 70 kg. The drug dosages by these weight bands are shown in the table below.
- All drugs in the regimen are to be given on a daily basis under observation.
Table: Drugs used in H Mono/ Poly DR-TB Regimen by Weight bands for Adults. Source: Guidelines for PMDT, India, 2021, p79.
SR. NO
DRUGS
16-29 KG
30-45 KG
46-70 KG
>70 KG
1
Rifampicin (R)
300 mg
450 mg
600 mg
750 mg
2
Ethambutol (E)
400 mg
800 mg
1200 mg
1600 mg
3
Pyrazinamide (Z)
750 mg
1250 mg
1750 mg
2000 mg
4
Levofloxacin (Lfx)
250 mg
750 mg
1000 mg
1000 mg
Duration
- H mono/ poly DR-TB regimen is for 6 or 9 months with no separate Intensive Phase (IP)/ Continuation Phase (CP).
- In exceptional situations of unavailability of loose drug R or E or Z, the use of 4 FDC (HREZ) with Levofloxacin (Lfx) loose tablets may be considered as an option rather than not starting the H mono/ poly DR-TB patients on treatment.
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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Adverse Drug Events: H Mono/Poly DR-TB Regimen
Contenthe potential adverse drug events that can occur when using drugs in the H mono/ poly DR-TB regimen are tabulated below:
Table: Possible Adverse Events due to Drugs in H Mono/ Poly DR-TB Regimen; Source: Guidelines for PMDT, India, 2021, p83.
ADVERSE DRUG EVENTS SUSPECTED DRUG(S) Hepatitis Rifampicin (R), Pyrazinamide (Z) QT prolongation Fluoroquinolone (FQ), Clofazimine (Cfz) Rash, allergic reaction and anaphylaxis Any drug Gastrointestinal symptoms Z, Ethambutol (E), Cfz, FQs Giddiness FQ, Z Arthralgia Z, FQ Peripheral neuropathy FQ, E Depression FQ Psychotic symptoms FQ Seizures FQ Tendonitis and tendon rupture FQ Vestibular toxicity (tinnitus and dizziness) FQ Optic neuritis E, Linezolid (Lzd), Cfz Metallic taste FQ Superficial fungal infection and thrush FQ 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.
- Technical and Operational Guidelines for TB in India, 2016.
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