Question: My son has been diagnosed with lymph node TB. He was having swollen glands in his neck ,his MANTOUX test was positive, his AUTOMATED E.S.R( Westergren’s method) was 68 , haemoglobin was 9.2 and was running low grade (101 F) occasional fever in the evening. He is 12 and half years old and weighs 31 kg. Doctor recommended him a tab of forecox 150 (content : ethambutol Hydrocloride 275 mg, isoniazid 100 mg, pyrazinamide 500 mg, rifampicin 150 mg) empty stomach in the morning. He started taking tablet from 22nd Apr 2015. After 17 days , doctor checked him and found that he was subjectively better and his gland had subsided and his weight increased from 30.5 to 33.5 Kg. So doctor advised him to take two tablets of forecox 150 because dosage was on lower side.
After taking two tablets , my son was having fullness in his stomach for first two days then he started experiencing nausea and vomiting sensation whenever he was trying to eat. After seeing this, Doctor suggested to take one and half tab of forecox 150. But reducing the dosage didn’t help and he started having motions also and he was not eating at all. After experimenting with different quantity of dosage for few days, he is again back on one tablet. He has followed the schedule till now

22nd Apr – 8th May (17 day) : 1 tab of forecox 150
9th May – 11th May (3 days) : 2 tab of forecox 150
12th May – 16th May (5days) : 1.5 tab of forecox 150
17th May -18th May (2 days) : 1 tab of forecox 150
19th May -23rd May (5 days) : 1.5 tab of forecox 150
24th May – 26th May (3 days) : 1 tab of forecox 150

Now his condition is better but he is still not eating well. Doctor says that we will monitor his condition for a few more days by giving him only one tablet of forecox 150 . After 10 days, the dosage can be increased gradually. As of now, his body is not able to take more dosage. He has gone through few tests again on 22nd May 2015. His gland has become normal. His hemoglobin is increased from 9.5 to 10.2 and AUTOMATED E.S.R test is showing value dropping from 68 to 28. His liver test was also fine. Still we have observed that usually in the evenings his energy level reduces and he does not want to eat anything. But currently the main concerns are –
(1) His appetite has reduced and his haemoglobin is still very low
(2) His weight is dropping because he is not eating well. ( 33.5 to 30.5 kg in last 14 days)
(3)Also, we are afraid that low dosage and frequent variations in the quantity can create resistance .

Kindly let me know how we can reduce the side effect of forcox150 and whether low dosage can create any resistance in future .Also it would be of great help if you could suggest the ideal diet for his quick recovery.

Thanking you in anticipation for an early response. God bless you.

Regards
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