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Dosages of M/XDR-TB Drugs for Adult in Longer Oral M/XDR-TB Regimen
Learning ObjectivesDosages of M/XDR-TB Drugs for Adult in Longer Oral M/XDR-TB Regimen
It is important to know the dosages of Multi (M)/ Extensively Drug-resistant TB (XDR-TB) drugs for adults on a longer oral M/XDR-TB regimen.
The table below shows the M/XDR-TB regimen drugs for adults weight band-wise, used in longer oral M/XDR-TB regimen customized for India by national experts.
| Sr.No | Drugs | 16-29 kg | 30-45 kg | 46-70 kg | >70 kg |
|---|---|---|---|---|---|
| 1 | Levofloxacin (Lfx) | 250 mg | 750 mg | 1000 mg | 1000 mg |
| 2 | Moxifloxacin (Mfx) | 200 mg | 400 mg | 400 mg | 400 mg |
| 3 | High dose Mfx (Mfxh) | 400 mg | 600 mg | 600 mg | 600 mg |
| 4 | Bedaquiline (Bdq) |
Week 0–2: Bdq 400 mg daily Week 3–24: Bdq 200 mg 3 times per week |
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| 5 | Clofazimine (Cfz) | 50 mg | 100 mg | 100 mg | 200 mg |
| 6 | Cycloserine (Cs)3 | 250 mg | 500 mg | 750 mg | 1000 mg |
| 7 | Linezolid (Lzd) | 300 mg | 600 mg | 600 mg | 600 mg |
| 8 | Delamanid (Dlm) |
50 mg twice daily (100 mg) for 24 weeks in 6-11 years of age 100 mg twice daily (200 mg) for 24 weeks for ≥12 years of age |
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| 9 | Amikacin (Am)1 | 500 mg | 750 mg | 750 mg | 1000 mg |
| 10 | Pyrazinamide (Z) | 750 mg | 1250 mg | 1750 mg | 2000 mg |
| 11 | Ethionamide (Eto)3 | 375 mg | 500 mg | 750 mg | 1000 mg |
| 12 | Na - PAS (60% weight/ vol)2,3 | 10 gm | 14 gm | 16 gm | 22 gm |
| 13 | Ethambutol (E) | 400 mg | 800 mg | 1200 mg | 1600 mg |
| 14 | Imipenem-Cilastatin (Imp-Cln)3 | 2 vials (1g + 1g) bd (to be used with Clavulanic acid) | |||
| 15 | Meropenems (Mpm)3 | 1000 mg three times daily (alternative dosing is 2000 mg twice daily) (to be used with Clavulanic acid) | |||
| 16 | Amoxicillin-Clavulanate (Amx-Clv) (to be given with Carbapenems only) | 875/125 mg bd | 875/125 mg bd | 875/125 mg bd | 875/125 mg bd |
| 17 | Pyridoxine (Pdx) | 50 mg | 100 mg | 100 mg | 100 mg |
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1For adults more than 60 years of age, the dose of Second-line Injectable (SLI) should be reduced to 10 mg/kg (max up to 750 mg). 2In patients of Para Amino Salicylic Acid (PAS) with 80% weight/ volume the dose will be changed to 7.5 gm (16-29 kg); 10 gm (30-45 Kg); 12 gm (46-70 kg) and 16 gm (>70 kg). 3Drugs can be given in divided doses in a day in the event of intolerance. |
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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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