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Does Irregular Intake Of Anti TB Drugs Lead To MDR TB?
Question: I am diagnosis with TB and took Ak4 on 8 and 9april and I had severe stomach upset and vomiting. Till 24 april my TB medicine was stopped and I was getting treat for food poision. After 24 april I started taking half medicine of AK4 till 28 april. Then I showed to gastroenterologist he changed my medicine to Rcin 450 and pyzina 500 and themebutol 1000 which i took on only for 1month but vomiting and loosemotion were not stopping so I was admitted to hospital on next day itself I.e 1May 2015 and I was admitted till 6May.Currently I am taking Isokin 300, pyzina 500, themebutol 800, Benadon 40mg, Pantocid and gastractiv.
Please let me know my medicine was stop two times due to side effects so what will cause for that and in every articles it mention medicine should not stop as it may cause MDR TB.
And I am not taking Rcin450 so without that tb can be cured.
And also without cough tb can be detected.
And if take forecox 2 tablet then again I will vomiting or loosemotion.
Regards,
XXXX
Please let me know my medicine was stop two times due to side effects so what will cause for that and in every articles it mention medicine should not stop as it may cause MDR TB.
And I am not taking Rcin450 so without that tb can be cured.
And also without cough tb can be detected.
And if take forecox 2 tablet then again I will vomiting or loosemotion.
Regards,
XXXX
Brief Answer:
You must take ATT regularly henceforth for satisfactory outcome.
Detailed Answer:
Hello XXXXXXX
Thanks for posting your query on HCM.
Yes, the ATT(Anti Tubercular treatment) that you are taking is irregular and this is one of the factors in developing MDR TB.
Having said that, I feel that your treating physician had no other choice as you were not able to tolerate the drugs. However you have not mentioned if it was only gastritis or liver toxicity which was causing vomiting. I`m sure doctors made an all out effort to treat gastritis and continue ATT simultaneously.
Coming to MDR TB, though irregular ATT may lead to development of MDR TB but not every case where treatment has been irregular, develops MDR TB. Your treatment has to be monitored for development of MDR TB.
Henceforth, you should take your medicines regularly without missing any dose as far as possible.
Cough is a symptom of lung TB. At times it may not be present but there are other symptoms that patient has and tests which help in diagnosis of TB.
R cin is an important drug in the treatment of TB but it has not been restarted probably because that may be causing the intolerance to ATT. However you are taking 3 other ATT drugs and as I have said, your treatment has to be monitored regularly.
Forcox is a brand having all ATT drugs. Since you are not tolerating ATT in full dosage, you will have problem if you take the full forecox.
The principle of TB treatment is multidrug regimen in adequate dosage for adequate duration to be taken regularly. You have to be under constant supervision of your treating physician. I suggest you consult a local pulmonologist for advice and correct treatment.
You must take ATT regularly henceforth for satisfactory outcome.
Detailed Answer:
Hello XXXXXXX
Thanks for posting your query on HCM.
Yes, the ATT(Anti Tubercular treatment) that you are taking is irregular and this is one of the factors in developing MDR TB.
Having said that, I feel that your treating physician had no other choice as you were not able to tolerate the drugs. However you have not mentioned if it was only gastritis or liver toxicity which was causing vomiting. I`m sure doctors made an all out effort to treat gastritis and continue ATT simultaneously.
Coming to MDR TB, though irregular ATT may lead to development of MDR TB but not every case where treatment has been irregular, develops MDR TB. Your treatment has to be monitored for development of MDR TB.
Henceforth, you should take your medicines regularly without missing any dose as far as possible.
Cough is a symptom of lung TB. At times it may not be present but there are other symptoms that patient has and tests which help in diagnosis of TB.
R cin is an important drug in the treatment of TB but it has not been restarted probably because that may be causing the intolerance to ATT. However you are taking 3 other ATT drugs and as I have said, your treatment has to be monitored regularly.
Forcox is a brand having all ATT drugs. Since you are not tolerating ATT in full dosage, you will have problem if you take the full forecox.
The principle of TB treatment is multidrug regimen in adequate dosage for adequate duration to be taken regularly. You have to be under constant supervision of your treating physician. I suggest you consult a local pulmonologist for advice and correct treatment.
Above answer was peer-reviewed by :
Dr. Pradeep Vitta
Thanks for reply.
Actually I showed to family doctor and then gastroenterology so then I showed to chest speaclist so one chest speaclist did brochsope and take out cough so first culture report of 48hrs came negative so he saying wait for 3weeks culture report and stop medicine. Then I showed to another chest speaclist so he is saying dont stop medicine and start taking forecox 2 tablet.
Please let me know
And one more thing my bronchoscope happen on Friday I.e 15 may and I was already 13 days of medicine taken so may be bacteria must have die.
Actually I showed to family doctor and then gastroenterology so then I showed to chest speaclist so one chest speaclist did brochsope and take out cough so first culture report of 48hrs came negative so he saying wait for 3weeks culture report and stop medicine. Then I showed to another chest speaclist so he is saying dont stop medicine and start taking forecox 2 tablet.
Please let me know
And one more thing my bronchoscope happen on Friday I.e 15 may and I was already 13 days of medicine taken so may be bacteria must have die.
Brief Answer:
Personally I would suggest to continue ATT.
Detailed Answer:
You have not mentioned what symptoms you had and what was the basis of the diagnosis of TB.
At times doctors may have different views about a clinical situation. Based on your symptoms , general condition and various test reports, doctor must have decided to start you on ATT. Since I am not seeing you in person, it is not possible to comment on differing views of doctors.
You are right, after 13 days of ATT, some bacteria may have died and result of bronchoscopy may be negative.
Are you improving after starting ATT ie have your symptoms that you had earlier become less? You are now into 3rd week of taking ATT. If there is clinical improvement in your condition, personally I would suggest to continue ATT.
If you are now tolerating ATT, it`s advisable to take full dose ie 2 tablets of forcox(You have not mentioned your age, weight etc as dose of TB drugs is body weight dependent).
I hope this answers your query.
Personally I would suggest to continue ATT.
Detailed Answer:
You have not mentioned what symptoms you had and what was the basis of the diagnosis of TB.
At times doctors may have different views about a clinical situation. Based on your symptoms , general condition and various test reports, doctor must have decided to start you on ATT. Since I am not seeing you in person, it is not possible to comment on differing views of doctors.
You are right, after 13 days of ATT, some bacteria may have died and result of bronchoscopy may be negative.
Are you improving after starting ATT ie have your symptoms that you had earlier become less? You are now into 3rd week of taking ATT. If there is clinical improvement in your condition, personally I would suggest to continue ATT.
If you are now tolerating ATT, it`s advisable to take full dose ie 2 tablets of forcox(You have not mentioned your age, weight etc as dose of TB drugs is body weight dependent).
I hope this answers your query.
Above answer was peer-reviewed by :
Dr. Pradeep Vitta
I was feeling week since long and vomiting started and once in vomiting blood came.so my doctor did xray and ctc scan and I told me I have tb starting stage.about medicine since 4may I use to iskin 300, pyzina 500 twice and thembutol 800.today I started forcox 2 tablets.also taking pantocid and gastractiv.taking pantocid twice a day and gastractiv thrice a day before food will have issue?.and how much gap should be there between forcox and pantocid.my age is 29 and weight 50kg.if vomiting start again should I stop medicine again and go back to previous combinatio. How much time it take body to shoot medicine
Brief Answer:
Continue forcox 2 tablets daily.
Detailed Answer:
Having gone through the further details provided by you, it is advised that you should continue the ATT.
If you can tolerate, it`s better to take full dosage ie 2 tablets of forcox. Take it first thing in the morning after getting up and freshening up on empty stomach. Take pantocid 20 minutes before breakfast.
If you start vomiting again, do not stop the medicine. Go back to your doctor, he may examine you, do a LFT and give you some medicine to control the vomiting.
Continue forcox 2 tablets daily.
Detailed Answer:
Having gone through the further details provided by you, it is advised that you should continue the ATT.
If you can tolerate, it`s better to take full dosage ie 2 tablets of forcox. Take it first thing in the morning after getting up and freshening up on empty stomach. Take pantocid 20 minutes before breakfast.
If you start vomiting again, do not stop the medicine. Go back to your doctor, he may examine you, do a LFT and give you some medicine to control the vomiting.
Above answer was peer-reviewed by :
Dr. Shanthi.E
Hi, as you know I have take 3 medicine since 4 may and on 21 may started forecox 2 tablets.and my bronchoscope happened on 15 may and culture report came negative and also 3weeks culture report on 6 XXXXXXX is also came negative..so my doctor told from 15June he will give only 2medicine after seening chest xray .but I have not completed 2months and should i calculated 2mths from 4may or should I calculated from 21may.please let me know I really tension as what to do, I don't want tb to happen came
And I readed that medicine liver problem , kidney problem and also monthly period also doesn't happen.even after stopping medicine.what should I do to avoid these complications or what should I eat so period is not affected.
Can I drink aloe vera juice with the medicine as it is very good for stomach but it will not have adverse effect as I am taking medicine also.
Kindly sugges.
And I readed that medicine liver problem , kidney problem and also monthly period also doesn't happen.even after stopping medicine.what should I do to avoid these complications or what should I eat so period is not affected.
Can I drink aloe vera juice with the medicine as it is very good for stomach but it will not have adverse effect as I am taking medicine also.
Kindly sugges.
Brief Answer:
You should count from 04 May as you have been taking 3 medicines since then
Detailed Answer:
You should start counting from 04 May as you have XXXXXXX taking 3 medicines regularly from 4 may 2015.
Yes there are side effects to these drugs and incidence is slightly higher than usual but since you are tolerating them well, you should not worry and I am sure your doctor is checking you for the same from time to time. Once the medicine course is complete there are no special precautions, just eat a balanced healthy diet.
I cannot say anything about aloe vera but I do not advise my patients to take any such thing and as it is TB drugs have to be taken on empty stomach.
You should count from 04 May as you have been taking 3 medicines since then
Detailed Answer:
You should start counting from 04 May as you have XXXXXXX taking 3 medicines regularly from 4 may 2015.
Yes there are side effects to these drugs and incidence is slightly higher than usual but since you are tolerating them well, you should not worry and I am sure your doctor is checking you for the same from time to time. Once the medicine course is complete there are no special precautions, just eat a balanced healthy diet.
I cannot say anything about aloe vera but I do not advise my patients to take any such thing and as it is TB drugs have to be taken on empty stomach.
Above answer was peer-reviewed by :
Dr. Shanthi.E
Thanks for reply but what about as my doctor is sayingr about medicine to be reduce to less but my 2mths not completed. In my 3 medicine refiampin is not included so they ware chance of releapse.i iron is 50% less then normal and vitamin d 3 also. Should I take medicine for that also.
My monthly period didnt happen so should show to chest specialist or gynecologica.
My monthly period didnt happen so should show to chest specialist or gynecologica.
Brief Answer:
You must complete at least 2 and preferably 3 months of these 3 drugs
Detailed Answer:
Dear XXXXXXX
First of all sorry for the delay in replying as I got busy with some urgent work.
As I have already told you that you must complete at least 2 and preferably 3 months of these 3 drugs before they are reduced in view of irregular treatment and no Rifampicin to reduce the possibility of developing MDR TB. You must discuss it with your treating physician.
I have time and again told you that you should not unnecessarily worry about developing MDR TB. There is only a high risk in your case. It does not mean that you are definitely going to develop MDR TB. Low iron and vit D do not indicate that you have MDR TB. Take treatment for that after consulting your treating physician. I`m sure your doctor is monitoring you for MDR TB.
Delay in periods can be because of disease or it`s treatment or some other cause. Consult a gynaecologist for that.
You must complete at least 2 and preferably 3 months of these 3 drugs
Detailed Answer:
Dear XXXXXXX
First of all sorry for the delay in replying as I got busy with some urgent work.
As I have already told you that you must complete at least 2 and preferably 3 months of these 3 drugs before they are reduced in view of irregular treatment and no Rifampicin to reduce the possibility of developing MDR TB. You must discuss it with your treating physician.
I have time and again told you that you should not unnecessarily worry about developing MDR TB. There is only a high risk in your case. It does not mean that you are definitely going to develop MDR TB. Low iron and vit D do not indicate that you have MDR TB. Take treatment for that after consulting your treating physician. I`m sure your doctor is monitoring you for MDR TB.
Delay in periods can be because of disease or it`s treatment or some other cause. Consult a gynaecologist for that.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
I am sorry I didn't understood what should I need to discuss with my physican about no rifampin.
As I am taking 3medicine ie isoniazid, pyrazinamide and ethambul since 4may and since 21may I am taking 2tablet of forecox which contain rifampicin.
After bronoscope which was done on 15may my smear and culture report came negative and 3 weeks culture report also came negative then I should take medicine for 3mths
As I am taking 3medicine ie isoniazid, pyrazinamide and ethambul since 4may and since 21may I am taking 2tablet of forecox which contain rifampicin.
After bronoscope which was done on 15may my smear and culture report came negative and 3 weeks culture report also came negative then I should take medicine for 3mths
Brief Answer:
Pl consult your treating physician.
Detailed Answer:
You are not sure what you medicine you are taking. All along you have been saying that you are not taking Rifampicin(Rcin) and now you say you are taking rifampicin.
It is best that you consult your treating physician otherwise you will be confused and treatment may not be appropriate.
You are asking same questions again and again which I have already answered.
Only a doctor who is attending to you can answer all your queries otherwise you are welcome to my clinic if you have any doubts.
Pl consult your treating physician.
Detailed Answer:
You are not sure what you medicine you are taking. All along you have been saying that you are not taking Rifampicin(Rcin) and now you say you are taking rifampicin.
It is best that you consult your treating physician otherwise you will be confused and treatment may not be appropriate.
You are asking same questions again and again which I have already answered.
Only a doctor who is attending to you can answer all your queries otherwise you are welcome to my clinic if you have any doubts.
Above answer was peer-reviewed by :
Dr. Neel Kudchadkar
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