Multidrug-resistant What is MDR-TB?

MDR-TB occurs when TB bacteria become resistant to

tuberculosis (MDR-TB) the two most powerful antibiotics normally used to treat
the illness. This means that these medicines will not work
effectively as they can no longer kill the TB bacteria.

What does it mean if I have MDR-TB?

MDR-TB is more difficult to treat than ordinary TB. The
medicines used against it have a greater number of side
effects and have to be taken for much longer, at least
18 months. If you have MDR-TB, you will be infectious for
longer, may feel more unwell and are more likely to be
admitted to hospital for treatment. However, if you take
all the medication for the full course there is a very high
chance of a successful cure.

What kind of drugs will I have to take?

You will be given a certain combination of drugs to
treat your MDR-TB, and on the following pages you can
find further information on these drugs. Like all other
medicines, they may have certain side effects, the most
common of which are listed. Please see your TB Nurse if
you are struggling with the side effects.

Before you start taking your TB drugs:

Tell your doctor about:
• all other medicines that you are taking including any that
you buy over the counter in a pharmacy
• any previous allergy to any other medicines
• if you are pregnant or breastfeeding.

Where can I go for support?

If you or a loved one is diagnosed with MDR-TB, there is
help available so you don’t feel alone.
• Your TB Nurse is there to support you through your
treatment. Please contact her/him if you have bad side
effects or there is anything you are unsure of regarding
your treatment.
• You may find it helps to speak to someone who knows
what you’re going through. Members of the TB Action
Group (TBAG), who have had TB themselves, are available
to chat with you and support you through your treatment.
Email info@tbalert.org or telephone 01273 234029 for
more details.
• www.thetruthabouttb.org is a useful website with
information on TB and treatment.

Your TB Nurse is:

Your Hospital Doctor is:

Contact No:

Email:

PROTECT YOUR FAMILY AND FRIENDS – TAKE ALL YOUR TB MEDICINES

 TB DRUGS YOU MAY BE GIVEN

GIVEN BY T
Amikacin/Capreomycin DOCTOR Bedaquiline 207

Before receiving amikacin or capreomycin tell Before taking bedaquiline tell your doctor about:
your doctor about: • any previous allergy to any other medicines
• any previous allergy to any other medicines • if you have ever had any kidney or liver disease
• if you have ever had any kidney disease • if you have ever had any heart problems
• if you have any hearing difficulties or tinnitus • if you have ever had any thyroid problems.
(ringing or buzzing in the ears)
Taking your bedaquiline
• if you suffer from a disorder called myasthenia
gravis (severe weakness of certain muscles). Bedaquiline is best taken with, or after, meals.
Tablets should be swallowed whole with water. Your
Receiving amikacin or capreomycin doctor or nurse will discuss with you the best time to
Amikacin and capreomycin are usually given as an take your bedaquiline. You should not drink alcohol
injection into a muscle, or into a vein either as an while taking this medicine.
injection or as a drip.
Side effects may include:
They are usually given once every day to begin with.
• headache
After two to three months, they may be given three
times a week. • dizziness
Side effects may include: • pain or swelling in the joints
• ringing in your ears, or loss of hearing • stomach upsets such as nausea (feeling sick),
vomiting and diarrhoea
• dizziness, or problems with your balance
• chest pain
• a decrease in the amount of urine you produce
• if you experience a racing heartbeat or your
• muscle weakness heartbeat suddenly becomes more noticeable
• trouble breathing (palpitations), or you faint, contact your doctor or
• skin rashes and itchiness. nurse immediately.

Clofazimine Cycloserine

Before taking clofazimine tell your doctor about: Before taking cycloserine tell your doctor about:
• any previous allergy to any other medicines • any previous allergy to any other medicines
• any allergy to peanuts or soya • if you suffer from epilepsy or a condition which
• if you have ever had any kidney disease. makes you likely to have convulsions
Taking your clofazimine • if you have ever had any mental health problems
such as depression, anxiety or psychosis
Clofazimine is best taken with meals, or with
milk to prevent stomach upset. Your doctor or nurse • if you have ever had any kidney disease.
will discuss with you the best time to take your Taking your cycloserine
clofazimine.
Cycloserine is best taken before you eat food. If you
While taking clofazimine, you should avoid strong do take it with food, avoid large fatty meals. Your
sunlight and wear sunscreen. The drug may make doctor or nurse will discuss with you the best time to
your skin more sensitive to sunlight than normal,
take your cycloserine.
causing a rash or severe sunburn.
You must take pyridoxine (vitamin B6) while taking
Side effects may include: this medicine.
• pink, red or brownish-black colouration of the skin
Side effects may include:
and body secretions. This should go away after
stopping the medicine, but may take a long time • skin rashes and itchiness
• skin rashes and itchiness • sleepiness
• stomach upsets such as nausea (feeling sick), • confusion
vomiting and diarrhoea • agitation, depressed mood, or changes in behaviour
• bloody or black stools or diarrhoea. or personality.
 TB DRUGS YOU MAY BE GIVEN

DLM
Delamanid 50
Ethambutol

Before taking delamanid tell your doctor about: Before taking ethambutol tell your doctor about:
• any previous allergy to any other medicines • any previous allergy to any other medicines
• if you have ever had any kidney or liver disease • if you have any colour blindness or visual disturbances.
• if you have ever had any heart problems. Taking your ethambutol
Taking your delamanid Ethambutol can be taken before or after you eat food.
Your doctor or nurse will discuss with you the best
Delamanid is best taken with meals. Tablets should time to take your ethambutol.
be swallowed whole with water. Your doctor or nurse
will discuss the best time to take your delamanid. Side effects may include:
• reversible visual disturbances (blurred and red/green
Side effects may include: colour disturbance), which are rare. If you notice this,
• stomach upsets such as nausea (feeling sick), stop taking your tablets and inform your doctor or
vomiting and diarrhoea nurse immediately. Your doctor or nurse will arrange
• dizziness for you to have an eye test before you start taking
ethambutol
• if you experience a racing heartbeat or your
• skin rashes and itchiness.
heartbeat suddenly becomes more noticeable
(palpitations), or you faint, contact your doctor or
nurse immediately.

Linezolid ZYVOX
600mg

Levofloxacin, moxifloxacin V 0
40
or ofloxacin L M Before taking linezolid tell your doctor about:
• any previous allergy to any other medicines
• if you are taking any other medicines, in particular
Before taking levofloxacin, moxifloxacin or
decongestants or those used to treat depression or
ofloxacin tell your doctor about:
Parkinson’s disease
• any previous allergy to any other medicines • if you have high blood pressure
• if you have ever had any liver disease • if you have an overactive thyroid gland
• if you have ever had any heart problems • if you have a tumour of the adrenal glands or
carcinoid syndrome
• if you have ever had any problems with your tendons
• if you have ever had any kidney or liver disease
related to treatment with quinolone antibiotics
• if you suffer from epilepsy or a condition which
• if you suffer from epilepsy or a condition which makes you likely to have convulsions
makes you likely to have convulsions. • if you are anaemic, or bruise and bleed easily.
Taking levofloxacin moxifloxacin or ofloxacin Taking your linezolid
These can be taken before or after you eat food. Your Linezolid can be taken before or after meals. Your
doctor or nurse will discuss the best time to take your doctor or nurse will discuss the best time to take
tablets. You should not drink milk, or take antacids, your linezolid. Avoid eating large amounts of mature
vitamin supplements or sucralfate within two hours of cheeses, yeast extracts or soya bean extracts (such
taking levofloxacin and moxifloxacin. as soy sauce), or drinking large amounts of alcohol.
Side effects may include: Side effects may include:
• stomach upsets such as nausea (feeling sick), • stomach upsets such as nausea (feeling sick),
vomiting and diarrhoea vomiting and diarrhoea; or a metallic taste
• jaundice (yellowing of the skin or eyes). If you notice • skin rashes and itchiness
this, please stop taking your TB tablets and seek • bloody or black stools or diarrhoea
medical attention immediately • pain, numbness, tingling or weakness in your
• skin rashes and itchiness fingers or toes
• headaches
• pain, swelling or tearing of a tendon (in the back of • unexplained bruising or bleeding
your ankle, elbow, etc), muscle or joint pain • visual disturbances (blurred vision, colour
• if you experience a racing heartbeat or your disturbance), which are rare. If you notice this, stop
heartbeat suddenly becomes more noticeable taking your tablets and inform your doctor or nurse
(palpitations), or you faint, contact your doctor or immediately. Your doctor or nurse will arrange for you
nurse immediately. to have an eye test before you start taking linezolid.
 TB DRUGS YOU MAY BE GIVEN

P-aminosalicylic acid Prothionamide

Before taking p-aminosalicylic acid tell your Before taking prothionamide tell your
doctor about: doctor about:
• any previous allergy to any other medicines • any previous allergy to any other medicines
• if you have ever had any kidney or liver disease • if you have ever had any liver disease
• if you have ever had any thyroid problems • if you have ever had any thyroid problems
• if you have ever had a gastric ulcer. • if you suffer from epilepsy or a condition which
makes you likely to have convulsions
Taking your p-aminosalicylic acid
• if you have ever had any mental health problems
P-aminosalicylic acid must be stored in your
such as depression, anxiety or psychosis.
refrigerator. Your doctor or nurse will discuss with you
the best time to take your p-aminosalicylic acid. Taking your prothionamide
Do not use if the packets have become swollen, or if Prothionamide is best taken with, or after, meals.
the granules have lost their tan colour and are a dark Your doctor or nurse will discuss with you the best
brown or purple colour. time to take your prothionamide. You must take
Sprinkle the granules over apple sauce or yogurt, or pyridoxine (vitamin B6) while taking this medicine.
swirl in juice (tomato, grape, grapefruit, cranberry, Side effects may include:
apple or orange). Do not chew the granules.
• stomach upsets such as nausea (feeling sick),
The skeleton of the granules may be seen in your vomiting and diarrhoea
faeces. This is normal.
• a metallic taste in your mouth
Side effects may include: • jaundice (yellowing of the skin or eyes). If you notice
• stomach upsets such as nausea (feeling sick), this, please stop taking your TB tablets and seek
vomiting and diarrhoea medical attention immediately
• jaundice (yellowing of the skin or eyes). If you notice • agitation, depressed mood, or changes in behaviour
this, please stop taking your TB tablets and seek or personality.
medical attention immediately
• skin rashes and itchiness.

GP
www.tbalert.org
Pyrazinamide 504

TB Alert is the UK’s national tuberculosis charity,

Before taking pyrazinamide tell your doctor about: supporting patients and helping to save lives
• any previous allergy to any other medicines from TB. We work in the UK, India, Zambia, Malawi
• if you have ever had any liver disease. and Zimbabwe.

Taking your pyrazinamide Our The Truth About TB programme in the UK

focuses on:
Pyrazinamide can be taken before or after you eat
food. Your doctor or nurse will discuss with you the • raising public and professional awareness about
best time to take your pyrazinamide. TB and providing support to patients during
their treatment
Side effects may include: • bringing together statutory health services,
• stomach upsets such as nausea (feeling sick), voluntary organisations and people affected by
vomiting and diarrhoea TB to plan and deliver better TB services
• flu like symptoms such as chills, fever, dizziness • developing policy and advocating for the
and bone pain resources to improve the care of patients and the
• jaundice (yellowing of the skin or eyes). If you notice prevention and control of TB.
this, please stop taking your TB tablets and seek Any information in this handout regarding the
medical attention immediately diagnosis and treatment of TB is intended to give
• skin rashes and itchiness general information on the subject only. Questions
• pain or swelling in the joints. and concerns should be directed to your
healthcare professional.
TB Alert is a company limited by guarantee, registered in England No 3606528. Registered Charity No 1071886.