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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
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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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