Table of contents:
- What are the side effects of anti-tuberculosis drugs (OAT) that may arise?
- 1. Isoniazid
- 2. Rifampicin
- Drug-induced hepatitis or drug induced hepatitis (DIC)
- What if you experience side effects from TB medicine?
- Important things to know before starting treatment
Southeast Asia, including Indonesia, is the largest contributor to pulmonary TB cases and deaths by tuberculosis (TBC). In order for TB to be completely cured, you must regularly take anti-TB drugs (OAT) which are usually prescribed for 6-12 months. The standard treatment given for TB treatment consists of a combination of antibiotics such as rifampin, isoniazid, pyrazinamide, ethambutol and streptomycin. So, are there any side effects of these TB or OAT drugs when they have to be taken for a long time?
What are the side effects of anti-tuberculosis drugs (OAT) that may arise?
The healing period for TB is different for each patient, this depends on the patient's health condition and the severity of the TB symptoms experienced. However, to ensure complete recovery, patients must undergo TB treatment for 6-9 months. The rules for taking TB medicine will be adjusted to the health condition and the severity of the disease.
The side effects of TB medicines can vary from patient to patient. Some of the side effects of OAT may be mild and can go away on their own. However, it is not uncommon for sufferers to experience severe side effects.
Isoniazid, rifampin and pyrazinamide have a strong potential to cause damage to the liver. Ethambutol and streptomycin have not been reported to cause similar damage. However, this liver damage can be fatal if not detected early.
The following is a breakdown of the side effects of the two most commonly used antituberculosis (OAT) drugs:
1. Isoniazid
The use of the TB drug isoniazid can cause side effects that are mild, such as headaches, accelerated heart rate, dry mouth. Digestive disorders such as nausea, vomiting, pain in the gut, or constipation most often experienced by patients during the TB treatment period.
In addition, there are also side effects of the heavier isoniazid drug, such as:
- Hypersensitivity: fever, chills, inflammation of the lymph nodes, inflammation of the blood vessels.
- Hepatotoxic or inflammation of the liver: jaundice, risk of severe hepatitis.
- Decreased metabolism: deficiency of vitamin B6, hyperglycemia, protein in the urine (proteinurea).
- Blood problems: aplastic anemia, decreased platelet levels.
2. Rifampicin
The side effects of the tuberculosis drug rifampicin are most commonly similar to flu symptoms. In addition, side effects in the form of hepatotoxicity also have the potential to occur due to the consumption of these OATs.
In addition, you may also experience side effects in the form of discoloration of body fluids due to the drug rifampicin. Your sweat, tears, or urine will likely turn red (not blood). This side effect occurs due to the dye found in this TB medicine.
Rashes and itching are common and usually go away on their own. However, contact your doctor immediately if the rash and itching are accompanied by peeling of the skin.
Tell your doctor immediately if you experience side effects of TB medicine, such as these:
- Joint pain accompanied by swelling
- Eyes turn yellow
- Change in the amount of urine
- Increasing thirst
- Bloody urine
- Vision changes
- Heartbeat that is so fast
- Bruising or bleeding easily
- Have a persistent fever and sore throat (a sign of a new infection)
- Mood swings such as confusion, and experiencing hallucinations or delusions that are seen or heard (psychosis)
- Seizures
To note, these two drugs also have contraindications with birth control pills, diabetes drugs, and high blood pressure drugs.
Drug-induced hepatitis or drug induced hepatitis (DIC)
Drug-induced hepatitis (DIC) is known as a liver disorder due to the use of hepatotoxic drugs, aka drugs that cause damage to liver function.
DIC (drug-induced hepatitis) is one of the most common side effects of TB drugs, such as isoniazid and rifampicin. Of the 7% side effects of OAT which are often reported, 2% of them are cases of jaundice due to inflammation. Meanwhile, the other 30% is hepatic fulminant or liver failure. Both are drug-induced hepatitis.
Side effects such as DIC are often found in the first 2 months of TB treatment. Symptoms that are often shown from this disease are nausea, vomiting, abdominal pain, and discoloration of the skin and white eyes to yellow (jaundice).
Jaundice is caused due to a disturbance of bilirubin metabolism in the liver. DIC is difficult to distinguish from hepatitis caused by viral infection. That is why, laboratory tests are needed to diagnose this disease.
Unlike ordinary hepatitis, the side effects of DIC will get better by itself if the use of tuberculosis drugs is stopped.
People who take TB drugs are more at risk of experiencing side effects in the form of hepatitis if:
- Have genetic risk factors.
- Being older than 60 years).
- Experiencing malnutrition.
- Have HIV co-infection (other infections) or have HIV / AIDS.
- Have a previous history of liver disease, such as hepatitis.
- Drinking alcohol.
What if you experience side effects from TB medicine?
If you start to feel the side effects of OAT as mentioned above, it's a good idea to consult a doctor. Usually the doctor will change the dose or change the anti-tuberculosis drug (OAT) that best suits your condition.
Doctors will usually stop the drug temporarily if clinical signs and symptoms such as drug-induced hepatitis are found. But sometimes, this disease can occur without showing symptoms, in this case the doctor uses a benchmark laboratory examination.
Do not immediately stop treatment without consulting a doctor. Doing so can put you at risk for drug-resistant TB (MDR-TB).
This condition makes the bacteria resistant to TB drugs so that the symptoms that appear are getting worse. MDR TB is also more difficult to treat.
Important things to know before starting treatment
To avoid further side effects of antituberculosis (OAT) drugs, it's a good idea to undergo liver and kidney function tests first before starting treatment.
According to the TB Alert website, this is important because there is a possibility that TB drugs cannot interact with kidney and liver disease drugs. Therefore, the doctor can prescribe a combination of other drugs and prevent side effects.
In addition, HIV sufferers are infected with bacteria M. tuberculosisare more prone to experiencing the far more serious side effects of tuberculosis drugs. Therefore, HIV sufferers who are taking antiretroviral drugs together with tuberculosis drugs must be closely monitored by a doctor to prevent fatal side effects. They may also need to adjust the dosage, depending on their body condition.