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Excess fatigue at night and pain abdomen due to TB medication

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hello , my name is Susan, currently lives in Sydney brother in- law has a tuberculosis and he lives in the Philippines..Doctor in the Philppines prescribed to this following medication...Isoniazid 75 mg. and Risfampitin 150 mg.he has been taken it for almost 3 months now..but his side effects are abdominal pain and over fatigue at night only...they took him back to the doctor but the doctor told him its just normal the syptoms are just the side effect from the medication..
and he has to continue taking the medication till december...could you please tell me if there is any way that he can change his medication?

Category: Family Physician-GP

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Category: HIV- AIDS Specialist
 23 Doctors Online

Hello Susan,

Thank you for asking your query at DoctorSpring.

Change or substitution of TB medication should be considered only if the adverse effects are very serious like sever liver dysfunction or life threatening allergic reaction. I do understand fatigue and the abdominal discomfort could be troubling, but unfortunately he will have to move on with it. Fatigue should improve with nutritious food and rest. Abdominal pain could be due to Drug induced gastritis for which he might be getting anti ulcer / PPI drugs like Omeprazole.

Any unnecessary discontinuation or change in the drug will put your brother in risk for a resistant TB infection called MDRTB (Multi drug resistant TB). That is the reason why change in medication is not recommended. All the medications are of 6 months duration (min) and has its own side effects. Rifamipicin and Isoniazid are the most commonly used and efficient ones among them.
So changing drugs will put you 1) risk for MDRTB 2) slow resolution 3)More treatment duration 4) other side effects may occur
Most of the patients suffer from some kind of side effects. But that should not deter them from taking the drug for successful completion of the treatment. Your brother in law needs motivation and support from you and I feel you should not encourage the idea of ‘changing’ medication at all !

I hope this helps
Please feel free to ask follow-up questions.
Thank you

Dr. Jaydeep Tripathy
Category: HIV- AIDS Specialist
MBBS from Sri Ramachandra University in December 2011
M.Med (Family Medicine) - TNMGR University, Chennai
MBA-MPH in Public Health in March 2016, SRM University
Finished AFIH in March 2016, SRM University
MRCP ( UK ), Internal Medicine, Royal College of Physicians, June 2016
Fellowship in Diabetology from Martin Luther University in January 2017

Currently Resident Physician, in MD Radiodiagnosis - Kamakshi Memorial Hospital, Chennai
Dr. Jaydeep Tripathy and 4 other Medical Specialists are ready to help you

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