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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Pregnant, Having Latent TB. Taking Isoniazid, Ethambutol, Pyrazinamide. Should I Continue Pregnancy?

Hi, I am of 32 years and have latent TB .I am on ATT from last 3 months 20 days.For first two months took all four drugs-in, Isoniazid , Ethambutol and Pyrazinamide . From 27 May ,only two drugs- Rifampicin and Isoniazid which i have to take till 26 September(for four months). As of now (7.16.2012) ,I am 2 months 10 days pregnant. Any side effects? Shd i continue pregnancy.This is my first baby and i was waiting for this pregnancy. Please advise..
Tue, 23 Apr 2013
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OBGYN 's  Response
Hi,
First of all, treatment in latent tuberculosis can be interrupted during pregnancy and can be resumed 2-3 months after delivery unless there are risk factors like- HIV infection or a risk; those who are in close contact with a case of pulmonary TB or those who had a positive skin test in the past two years. As for INH and Rifampicin, they are considered to be safe in pregnancy. Pyrazinamide is the only drug that is preferably avoided in pregnancy. Since you are interested in continuing this pregnancy, I suggest that you temporarily hold treatment if there are no risk factors (after consulting your doctor) and get a fetal scan to know the viability and follow it up to know any fetal anomalies through your obstetrician.
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Pulmonologist Dr. Satyadeo Choubey 's  Response
Hi shivani,
Thanks for visiting HCM.
First of all I would have enquired, how you came to know that you have ''latent'' tuberculosis. Because if it is the case then just taking isoniazide or combination of isoniazide and rifampicin for 6 months would have been adequate.
Your doctor has prescribed you treatment as if you have got active tuberculosis.
Let me assure you that no anti-tubercular drug is contra-indicated in pregnancy and you can continue with your regimen to complete six months of treatment.
This is the WHO recommendation for treatment of tuberculosis in a pregnant patient and can be checked on its site.
Only thing is, you need to take tablet pyridoxine along with current medication to prevent isoniazide induced peripheral neuropathy...

Best wishes and congratulations
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Pregnant, Having Latent TB. Taking Isoniazid, Ethambutol, Pyrazinamide. Should I Continue Pregnancy?

Hi, First of all, treatment in latent tuberculosis can be interrupted during pregnancy and can be resumed 2-3 months after delivery unless there are risk factors like- HIV infection or a risk; those who are in close contact with a case of pulmonary TB or those who had a positive skin test in the past two years. As for INH and Rifampicin, they are considered to be safe in pregnancy. Pyrazinamide is the only drug that is preferably avoided in pregnancy. Since you are interested in continuing this pregnancy, I suggest that you temporarily hold treatment if there are no risk factors (after consulting your doctor) and get a fetal scan to know the viability and follow it up to know any fetal anomalies through your obstetrician.