What are the common anti-tuberculosis drugs and their adverse reactions?
Dec 03, 2025
Source: Cainiu Health
Dr. Ren Yi
Introduction
Common anti-tuberculosis drugs generally include isoniazid tablets, rifampicin capsules, pyrazinamide tablets, ethambutol tablets, and streptomycin injection. Isoniazid tablets have potent bactericidal effects against actively replicating Mycobacterium tuberculosis and are a core drug in treatment. Adverse reactions include peripheral neuritis, hepatotoxicity, gastrointestinal disturbances, and hematological abnormalities; therefore, regular monitoring of liver function and neurological symptoms is required.
Common anti-tuberculosis drugs generally include isoniazid tablets, rifampicin capsules, pyrazinamide tablets, ethambutol tablets, and streptomycin injection. A detailed analysis is as follows:
1. Isoniazid tablets: Highly effective in killing actively replicating Mycobacterium tuberculosis, isoniazid is a core drug in tuberculosis treatment. Adverse reactions include peripheral neuritis, liver damage, gastrointestinal symptoms, and hematological abnormalities. Regular monitoring of liver function and neurological symptoms is required.
2. Rifampicin capsules: Exerts its effect by inhibiting bacterial RNA polymerase. When used in combination with isoniazid, it enhances therapeutic efficacy. Common adverse effects include gastrointestinal discomfort, hepatotoxicity, and orange-red discoloration of bodily secretions. Drug interactions should be noted—for example, reduced effectiveness of oral contraceptives.
3. Pyrazinamide tablets: Has unique bactericidal activity against intracellular tuberculosis bacteria in acidic environments, commonly used during the intensive phase of treatment. Main adverse effects include hyperuricemia and liver injury. Serum uric acid levels and liver function should be monitored during therapy.
4. Ethambutol tablets: Acts as a bacteriostatic agent by inhibiting bacterial RNA synthesis and must be used in combination with other anti-TB drugs. The primary adverse effect is optic neuritis, manifesting as blurred vision or color vision disturbances. Baseline visual acuity testing is recommended before initiating treatment.
5. Streptomycin injection: Highly effective against extracellular tuberculosis bacteria, often used in drug-resistant TB or infections involving special sites. Adverse effects include ototoxicity and nephrotoxicity. Hearing and renal function should be monitored regularly. It is contraindicated in elderly patients and pregnant women.
During treatment, patients must strictly follow medical instructions, undergo regular follow-up tests including liver and kidney function, complete blood count, and sputum examination for acid-fast bacilli, and closely monitor for adverse reactions. A balanced diet, avoidance of smoking and alcohol, and adequate sleep are recommended. Seek prompt medical review if any abnormal symptoms occur.
