Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
What Causes Vomiting, Loss Of Appetite And Fatigue When Diagnosed With TB?
Question: My mother (age 58) has been diagnosed with TB. She is experiencing severe side effects due to medicines, majorly vomiting, loss of appetite and tiredness. She had to be hospitalised due to vomiting and liver malfunction since these medicines started. The symptoms were relieved in hospital when the TB Drugs were stopped. She got discharged after a week and the TB medicines started again except for Pyzina. Today the doctor started the Pyzina again and within 2 hours of taking the drug she is throwing up again. She is also diabetic and her sugar levels are roughly between 130 - 190 on a given day. Her BP on last record was 107 - 180 for which Numlo has been adviced once daily.
Please help with some of my concerns.
1. Is there a substitute that we can try to replace Pyzina?
2. If not, how long does she expect to get these symptoms, a week, a month or till the term of the medicine?
3. Should we give her emeset 4 mg on regular basis, twice or thrice a day?
Her prescribed drugs are :
R-CINEX 450 MG TAB Twice a day
COMBUTOL 800MG TAB Once a day
PYZINA 500 MG TAB twice a day
BENADON TAB Once a day
Udili 300 Twice a day
S-Numlo Once a day
Glycomet Twice a day
Thank you for your advice in advance. Greatly appreciate it.
Please help with some of my concerns.
1. Is there a substitute that we can try to replace Pyzina?
2. If not, how long does she expect to get these symptoms, a week, a month or till the term of the medicine?
3. Should we give her emeset 4 mg on regular basis, twice or thrice a day?
Her prescribed drugs are :
R-CINEX 450 MG TAB Twice a day
COMBUTOL 800MG TAB Once a day
PYZINA 500 MG TAB twice a day
BENADON TAB Once a day
Udili 300 Twice a day
S-Numlo Once a day
Glycomet Twice a day
Thank you for your advice in advance. Greatly appreciate it.
Brief Answer:
Pyrazinamide cannot be replaced...Would be used only for 2 months!
Detailed Answer:
Hi and thank you so much for this query.
I am so sorry to hear about these side effects that your mom has. Unfortunately, pyrazinamide cannot be substituted. The good news is that this drug is often used for two months and dropped while she continues with rifampicin and isoniazid to a minimum of 6months.
I believe these side effects would lessen with continued treatment. This is usually not the most common side effect that we have to deal with and it is not life threatening as compared to others. Seen the implications of not treating her TB right, I strongly recommend that she looks at the benefits of the treatment and get the motivation to carry on.
I am okay with you giving her emesset 2-3times daily. Use it and stop as soon as the problem gets better.
I hope this helps. I wish you well. Thank you so much for using our services and feel free to ask for more information and clarifications if need be.
Pyrazinamide cannot be replaced...Would be used only for 2 months!
Detailed Answer:
Hi and thank you so much for this query.
I am so sorry to hear about these side effects that your mom has. Unfortunately, pyrazinamide cannot be substituted. The good news is that this drug is often used for two months and dropped while she continues with rifampicin and isoniazid to a minimum of 6months.
I believe these side effects would lessen with continued treatment. This is usually not the most common side effect that we have to deal with and it is not life threatening as compared to others. Seen the implications of not treating her TB right, I strongly recommend that she looks at the benefits of the treatment and get the motivation to carry on.
I am okay with you giving her emesset 2-3times daily. Use it and stop as soon as the problem gets better.
I hope this helps. I wish you well. Thank you so much for using our services and feel free to ask for more information and clarifications if need be.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hello Doctor,
Thank you for your concern and helpful advise. We will start the Emeset along with other line of treatment shared earlier.
We have two new borns at home. My mother maintains distance from them and other adults as well. The new borns have been vaccinated with BCG. Is there any other vaccination that we could get for adults or the new borns to prevent the communicable effects of TB?
Also if you could kindly advise any other symptoms that we should take seriously considering her being diabetic and her BP condition?
Any other precautions or advise is welcome as well.
Thanks again for your review of her case and support in curing her.
Regards, XXXXXXX
Thank you for your concern and helpful advise. We will start the Emeset along with other line of treatment shared earlier.
We have two new borns at home. My mother maintains distance from them and other adults as well. The new borns have been vaccinated with BCG. Is there any other vaccination that we could get for adults or the new borns to prevent the communicable effects of TB?
Also if you could kindly advise any other symptoms that we should take seriously considering her being diabetic and her BP condition?
Any other precautions or advise is welcome as well.
Thanks again for your review of her case and support in curing her.
Regards, XXXXXXX
Brief Answer:
She is probably no longer infectious!
Detailed Answer:
Hi,
Your mom is probably no longer infectious if she has taken this treatment for a minimum of 2 weeks. Also, how was the diagnosis made? Did they use x-rays of they reported the bacterial in sputum? If it were not identified on a sputum test, then she would be very less likely to be infectious.
She would need great deal of healthy diet to enhance treatment/ Also, regular exercise, a positive state of mind and a supportive family would be needed to help her go through these difficult days. The chances of her having poor sugars would be higher and so you would need to put an eye on her treatment closely.
Please, she may keep a distance from the children but she should not feel stigmatized because of her disease.....Please. Be loving and caring to her as always if not more. After a month on treatment, there should be no room for any more precautions about this.
I wish your mom well. Keep me updated and more so about her vomiting for the moment.
She is probably no longer infectious!
Detailed Answer:
Hi,
Your mom is probably no longer infectious if she has taken this treatment for a minimum of 2 weeks. Also, how was the diagnosis made? Did they use x-rays of they reported the bacterial in sputum? If it were not identified on a sputum test, then she would be very less likely to be infectious.
She would need great deal of healthy diet to enhance treatment/ Also, regular exercise, a positive state of mind and a supportive family would be needed to help her go through these difficult days. The chances of her having poor sugars would be higher and so you would need to put an eye on her treatment closely.
Please, she may keep a distance from the children but she should not feel stigmatized because of her disease.....Please. Be loving and caring to her as always if not more. After a month on treatment, there should be no room for any more precautions about this.
I wish your mom well. Keep me updated and more so about her vomiting for the moment.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you Dr. Ivo for your concern and advise. Appreciate it.
We did get a positive for TB both in x-ray and sputum. She has not been able to take two weeks of continuous medication yet due to vomiting effects of medicines. After getting discharged from hospital a couple of days ago, her doctor started Pyzina again just 2 days back post seeing her liver test reports. Yesterday, we consulted her treating physician and he advised to stop the Pyzina again for a week. We have added Emeset and Domstal TDS along with other medicines from today. If I understand correctly Pyzina is an important drug for the treatment and her body is unable to cope up with it. She had a vomit occurrence yesterday and today afternoon as well after which she feels relieved. Important thing to note is that she didn't even eat Pyzina tab today but still she did vomit once already. Her doctor advised to get the SOPT, SGPT and Uric acid test done again post which next course of action would be decided tomorrow.
She's been sick for more than 3 months now so certainly her morale is low but we are trying to give her the care and sentimental boast frequently. Her diet is also much lower than usual so we are substituting it with Whey protein supplement.
Since she is unable to respond to medicines positively, she is concerned and that makes all of us equally concerned. Knowing these symptoms would you like to try another line of treatment which I can politely discuss with her treating physician as well. Thank you again.
We did get a positive for TB both in x-ray and sputum. She has not been able to take two weeks of continuous medication yet due to vomiting effects of medicines. After getting discharged from hospital a couple of days ago, her doctor started Pyzina again just 2 days back post seeing her liver test reports. Yesterday, we consulted her treating physician and he advised to stop the Pyzina again for a week. We have added Emeset and Domstal TDS along with other medicines from today. If I understand correctly Pyzina is an important drug for the treatment and her body is unable to cope up with it. She had a vomit occurrence yesterday and today afternoon as well after which she feels relieved. Important thing to note is that she didn't even eat Pyzina tab today but still she did vomit once already. Her doctor advised to get the SOPT, SGPT and Uric acid test done again post which next course of action would be decided tomorrow.
She's been sick for more than 3 months now so certainly her morale is low but we are trying to give her the care and sentimental boast frequently. Her diet is also much lower than usual so we are substituting it with Whey protein supplement.
Since she is unable to respond to medicines positively, she is concerned and that makes all of us equally concerned. Knowing these symptoms would you like to try another line of treatment which I can politely discuss with her treating physician as well. Thank you again.
Brief Answer:
Pyrazinamide cannot be easily substituted!
Detailed Answer:
Hi,
I am so sorry to hear about this continued vomiting. Though all seems to be pointing to pyrazimanide as the possible cause of this, this is not often the most commonly reported side effect of pyrazinamid. Is she having any pains? This is because anti Tb medications can cause gastritis that may explain these symptoms and rather need a drug to address that/ let me know if she has nay pain.
The next line of management is not really designed for side effects but rather for TB resistant to these drugs. Most of them still make use of these medications with the addition of some others.
My advise is to try and figure out the cause of this vomiting. I have a strong sense that that is not entirely explained by her medications ans pyrazinamide in particular.
I wish your mom well and hope to hear from you on her progress.
Pyrazinamide cannot be easily substituted!
Detailed Answer:
Hi,
I am so sorry to hear about this continued vomiting. Though all seems to be pointing to pyrazimanide as the possible cause of this, this is not often the most commonly reported side effect of pyrazinamid. Is she having any pains? This is because anti Tb medications can cause gastritis that may explain these symptoms and rather need a drug to address that/ let me know if she has nay pain.
The next line of management is not really designed for side effects but rather for TB resistant to these drugs. Most of them still make use of these medications with the addition of some others.
My advise is to try and figure out the cause of this vomiting. I have a strong sense that that is not entirely explained by her medications ans pyrazinamide in particular.
I wish your mom well and hope to hear from you on her progress.
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
