Merck Manual

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Drugs Used to Treat Tuberculosis

Drugs Used to Treat Tuberculosis



Side Effects

First-line drugs*


By mouth

Liver injury in 1 person in 1,000, resulting in fatigue, loss of appetite, nausea, vomiting, and jaundice

Sometimes numbness in the limbs ( peripheral neuropathy Polyneuropathy )

Rifampin (and the related drugs rifabutin and rifapentine)

By mouth

Liver injury, particularly when rifampin is combined with isoniazid (but the effects go away when people stop the drug)

Reddish orange discoloration of urine, tears, and sweat

Rarely a low white blood cell or platelet count


By mouth

Liver injury, digestive upset, and sometimes gout


By mouth

Sometimes blurred vision and decreased color perception (because the drug affects the optic nerve)

Second-line drugs

Aminoglycosides, such as streptomycin, amikacin, and kanamycin

By injection into a muscle

Kidney injury, dizziness, hearing loss (due to damage to nerves of the inner ear), rash, and fever

Fluoroquinolones, such as levofloxacin, moxifloxacin

By mouth

Inflammation or rupture of tendons

Nervousness, tremors, and seizures


By injection into a muscle

Side effects similar to those of aminoglycosides (but capreomycin is often tolerated better if treatment is needed for a long time)

*First-line drugs are usually the first choice for treatment.

Second-line drugs are usually used when the bacteria causing tuberculosis have become resistant to first-line drugs or when people cannot tolerate one of the first-line drugs.