First Line Drugs for Tuberculosis

First line drug treatment for tuberculosis is the main treatment for this disease. First line medication includes major drugs used for treating tuberculosis. These drugs effectively control the TB from spreading in the body and suppress tubercular disease. The first line treatment for tuberculosis includes the following drugs:

• Isoniazid
• Rifampin
• Pyrazinamide
• Ethambutol
• Streptomycin

[Read: Tuberculosis Control and Prevention]

The first line drugs for the treatment of tuberculosis are prescribed on the basis of the patient’s weight. Usually, the dosage of these drugs is standardized for three or four body weight scales such as 30–39 kg, 40–54 kg, 55–70 kg and over 70 kg. Dosage varies in different individuals on the basis of the given regimen. These anti-tuberculosis drugs follow three regimens that have been used for treatment, which include daily, twice weekly and thrice weekly. The usually recommended dosage for children and adults as per the three regimens is given below:

Recommended Doses of First-Line Anti-Tuberculosis Drugs for Children

Daily dosage

• Isoniazid 10-20 mg/kg
• Rifampin 10-20 mg/kg
• Pyrazinamide 15-30 mg/kg
• Ethambutol 15-25 mg/kg
• Streptomycin 20-40 mg/kg

Twice Weekly Regimen

• Isoniazid 20-40 mg/kg
• Rifampin 10-20 mg/kg
• Pyrazinamide 50-70 mg/kg
• Ethambutol  50 mg/kg
• Streptomycin 25-30 mg/kg

Thrice-Weekly Regimen

• Isoniazid 20-40 mg/kg
• Rifampin 10-20 mg/kg
• Pyrazinamide 50-70 mg/kg
• Ethambutol 25-30 mg/kg
• Streptomycin 25-30 mg/kg

Recommended Doses of First-Line Anti-Tuberculosis Drugs for Adults

Daily Regimen

• Isoniazid 5 mg/kg
• Rifampin 10 mg/kg
• Pyrazinamide 15-30 mg/kg
• Ethambutol  15-25 mg/kg
• Streptomycin 12-18 mg/kg

Twice-Weekly Regimen

• Isoniazid 5 mg/kg
• Rifampin 10 mg/kg
• Pyrazinamide 50-70 mg/kg
• Ethambutol  50  mg/kg
• Streptomycin 25-30 mg/kg

Thrice-Weekly Regimen

• Isoniazid 15 mg/kg
• Rifampin 10 mg/kg
• Pyrazinamide 50-70 mg/kg
• Ethambutol  25-30 mg/kg
• Streptomycin 25-30 mg/kg

Things to remember while taking First-Line Drugs for Tuberculosis

1. Doses prescribed as per patient’s weight must be adjusted if his or her weight changes.
2. Drugs such as Pyrazinamide and Streptomycin are not recommended for treating pregnant women.
3. Drug named Ethambutol is not recommended for infants or toddlers, who are monitored for changes in their vision.
4. Patients over 50 years of age should not take dosage of streptomycin of more than 0.75g.
5. Ensure that the anti-TB drugs, which you  take are quality assured.

The World Health Organization (WHO) does not recommend twice-weekly regimens as this regimen has greater risk of treatment failure due to missed doses.

Read more articles on Tuberculosis.