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Answer to your Health Question

Question (06/25/2013):

Title: How long should I take Isoniazid and Rifampin or Rifampicin .

Thank you so much for your answer sir.

I have one more question.... Now my friend has been taken Antituberculosis treatment for the past 15 months.

In that 15 months first 3 months she took 4 drugs after that the doctor gave only 2 drugs (isoniazid (INH) and rifampicin (RMP)).

If the patient takes these 2 drugs for 18 months (have to take 3 more months).

If she takes these 2 drugs together will these 2 drugs cause resistant TB?

And I have one more doubt all these drugs can cause liver problem?

She is taking liv52 tablet also... Please answer to my question



Dear Ashokkumar,

Thank you very much for your question.

Since the bacteria may exist in a resting (nongrowing) state for long periods, therapy with isoniazid (and other antituberculosis drugs) must be continued for a long time (usually 6 to 12 months).

Isoniazid may cause severe and sometimes fatal liver damage.

Rifampin has been shown to produce liver dysfunction.

A three-drug regimen consisting of rifampin, isoniazid, and pyrazinamide (e.g., RIFATER®) is recommended in the initial phase of short-course therapy which is usually continued for 2 months. The Advisory Council for the Elimination of Tuberculosis, the American Thoracic Society, and the Centers for Disease Control and Prevention recommend that either streptomycin or ethambutol be added as a fourth drug in a regimen containing isoniazid (INH), rifampin and pyrazinamide for initial treatment of tuberculosis unless the likelihood of INH resistance is very low.

Following the initial phase, treatment should be continued with rifampin and isoniazid (e.g., RIFAMATE®) for at least 4 months. Treatment should be continued for longer if the patient is still sputum or culture positive, if resistant organisms are present, or if the patient is HIV positive.

Extensively drug-resistant tuberculosis (XDR-TB) is defined as TB that has developed resistance to at least rifampicin and isoniazid (resistance to these first line anti-TB drugs defines Multi-drug-resistant tuberculosis, or MDR-TB).

Some of the studies with Liv 52 and the results do not seem to be consistent. Some studies show positive outcomes for Liv52 while others do not show Liv52 to be beneficial in liver disease.

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