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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suffering From TB, Jaundice. Taking Medications. Further Treatment?

my wife is suffering from tuberculosis of small intenstile - before few day ago she has started r-cinex 450mg , combutol 800 mg but within few days she got jaundice problem so doctor has stopped the same and after recovery from jaundice doctor has started streptomycine. now what will be the further treatment ? kindly guide
Wed, 8 May 2013
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General & Family Physician 's  Response
Hi,
thanks for posting the question to H.C.M.Forum.
Once again I would say please don't stop the treatment of tuberculosis in any condition ,if it started once, not even in jaundice.
Multi-drug resistant tuberculosis ( MDRT) is the most dangerous disease and due to misuse of anti tubercular treatment ,this disease develops ,so please don't misuse.
Any way in my opinion please stop streptomycin injection and start four drug regime.

Rifampicin=======225 mg
Isoniazid=======150 mg
Pyrazinamide=====750 mg
Ethambutol======400 mg
If weight more than 50 kg use two tabs 2 hours after meal.
If weight less than 50 kg 1.5 tabs.
Use plenty of vitamins with these drugs and of course use liver preparation along with anti tubercular treatment.
Good luck
Dr. HET
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Internal Medicine Specialist Dr. Akhilesh Dubey's  Response
Hi,
Welcome to HCM,
Your wife is having Tuberculosis of small intestine, which is certainly treatable.
It is known that antitubercular drugs are toxic to liver and many times we have to stop treatment if jaundice is more and too much vomiting.
Common drugs which are liver toxic are INH,Rifampicin and Pyrazinamide.
Once these drugs are stopped jaundice will improve and the drugs which not toxic to live can be started like Streptomycin and Ethambutol.
Then once bilirubin comes to normal level antitubercular drugs can be introduced one by one to see if that particular drug is tolerated or not.
If 3rd drug is tolerated say INH then after some time Rifampicin may be added to see if it is tolerated. and then treatment can continue with these 4 drugs for 2 months.
There are new drugs like Levofloxacin which can be tried as alternative to prevent emergence of resistance.
That is why multiple drugs are used in case of Tuberculosis.After 2 months treatment can continue with 2 or 3 drugs for further 6 months.
Take care
Good Luck.
Dr.Akhilesh Dubey M.D.


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Suffering From TB, Jaundice. Taking Medications. Further Treatment?

Hi, thanks for posting the question to H.C.M.Forum. Once again I would say please don t stop the treatment of tuberculosis in any condition ,if it started once, not even in jaundice. Multi-drug resistant tuberculosis ( MDRT) is the most dangerous disease and due to misuse of anti tubercular treatment ,this disease develops ,so please don t misuse. Any way in my opinion please stop streptomycin injection and start four drug regime. Rifampicin=======225 mg Isoniazid=======150 mg Pyrazinamide=====750 mg Ethambutol======400 mg If weight more than 50 kg use two tabs 2 hours after meal. If weight less than 50 kg 1.5 tabs. Use plenty of vitamins with these drugs and of course use liver preparation along with anti tubercular treatment. Good luck Dr. HET