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Adverse Events During TreatmentEspañol (Spanish)										Related Pages
										Patients on treatment for latent TB infection (LTBI) or TB disease should report any signs and symptoms of adverse drug reactions to their health care provider, including
Unexplained loss of appetite, nausea or vomiting, brown urine*, or jaundice (yellowing of skin or eyes)
Persistent tingling, numbness, or burning of hands or feet
Persistent weakness, fatigue, fever, or abdominal tenderness
Easy bruising or bleeding
Blurred vision or changed vision*Patients taking rifampin (RIF) or rifapentine (RPT) should be informed that they will notice an orange discoloration of urine and possibly other body fluids. This is normal.
Patients should provide a list of current medications to avoid drug interactions. Some interactions to note:
Isoniazid (INH) increases blood levels of phenytoin (Dilantin) and disulfiram (Antabuse)
RIF and RPT decrease blood levels of many drugs including oral contraceptives, warfarin and some other anticoagulants (“blood thinners”), sulfonylureas (used for diabetes), and methadone
RIF and RPT are contraindicated in HIV-infected individuals being treated with protease inhibitors (PIs) and most nonnucleoside reverse transcriptase inhibitors (NNRTIs)Healthcare providers treating patients with the combination regimen of isoniazid and rifapentine in 12 once-weekly doses (3HP) should
Inform the patient (parents/legal guardians of pediatric patient) about possible adverse effects and instruct them to seek medical attention when symptoms of possible adverse effects first appear.
Conduct monthly evaluations for the findings of treatment-associated adverse events (e.g., symptoms suggestive of systemic drug reactions, loss of appetite, vomiting, yellow eyes, tenderness of the liver, easy bruising, rash).
Order baseline liver chemistry blood tests (at least alanine or aspartate aminotransferase [ALT or AST, respectively]) for patients with specific conditions: HIV infection, liver disorders, postpartum period (≤3 months after delivery), regular alcohol usage, injection drug usage, or taking medications with known possible interactions with either isoniazid or rifapentine. Consider a baseline liver chemistry blood test for older patients on an individual basis, especially for those taking medications for chronic medical conditions.
Conduct blood tests at the next clinical visit for patients whose baseline testing is abnormal and for others at risk for liver disease. Discontinue 3HP if a serum ALT/AST concentration is ≥5 times the upper limit of normal in the absence of symptoms, or ≥3 times the upper limit of normal in the presence of symptoms.
Be vigilant for drug hypersensitivity reactions, particularly hypotension or thrombocytopenia.
In case of a possible severe adverse reaction (e.g., hypotension requiring intravenous fluid support), discontinue 3HP and provide supportive medical care.
In case of mild to moderate adverse reaction (e.g., dizziness), use conservative management (e.g., treat dizziness with rest, oral fluids), conduct clinical and laboratory monitoring, and consider continuing 3HP treatment under observation.Related LinksState TB Control Offices**For Patients**
TB – General Information (Fact sheet)
Questions and Answers About TB
TB Can Be Treated (Fact sheet)
Staying on track with TB medicine  (Pamphlet) (PDF – 511k)
12-Dose Regimen for Latent TB Infection-Patient Education Brochure
12-Dose Regimen for Latent TB Infection-Medication Tracker and Symptom Checklist [PDF – 156k]
What You Need to Know About Your Medicine for Latent Tuberculosis (TB) Infection-Fact Sheet Series
Isoniazid-specific Regimen
Rifampin-specific Regimen
Isoniazid and Rifapentine-specific Regimen**For Health Care Providers**
Latent Tuberculosis Infection: A Guide for Primary Health Care Providers
Treatment Guidelines
Update on Recommendations for Use of Once-weekly Isoniazid-Rifapentine Regimen to Treat Latent *Mycobacterium tuberculosis* Infection
The 12-Dose Regimen for Latent TB Infection Treatment: Fact Sheet for Clinicians
Frequently Asked Questions on the 12-Dose Regimen (3HP) for Latent TB Infection Treatment
Frequently Asked Questions on the 12-dose regimen for Latent TB Infection for Providers
Frequently Asked Questions on the 12-dose regimen for Latent TB Infection for Pharmacists
							
					
						Page last reviewed:  April 5, 2016					Content source: 	Division of Tuberculosis Elimination, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention homeTuberculosisBasic TB Factsplus iconHow TB SpreadsLatent TB Infection and TB DiseaseSigns & SymptomsTB Risk FactorsExposure to TBTB PreventionVaccinesTB & HIV CoinfectionTB and DiabetesTB TermsPersonal StoriesTesting & Diagnosisplus iconWho Should be TestedTesting for TB InfectionTesting in BCG-Vaccinated PersonsTB Screening and Testing of Health Care PersonnelTesting During PregnancyDiagnosing latent TB infection and TB diseaseTreatmentplus iconDeciding When to Treat Latent TB InfectionTreatment Regimens for Latent TB Infection (LTBI)Treatment for TB DiseaseAdverse EventsTB Treatment of Persons Living with HIVTB Treatment and PregnancyTB Treatment for ChildrenFrequently Asked QuestionsDrug-Resistant TBResearchplus iconTB Epidemiologic Studies Consortiumplus iconResearch ProjectsPublicationsTB Trials Consortiumplus iconStudy DescriptionsBackgroundBehavioral & Social Science ResearchHealth Care Settingsplus iconTB Infection Control in Health Care SettingsResources for TB Screening and Testing of Health Care Personnelplus iconFrequently Asked QuestionsTB in Specific Populationsplus iconHealth DisparitiesAsian PersonsBlack or African American PersonsHispanic or Latino PersonsChildrenPregnancyCorrectional FacilitiesPeople Experiencing HomelessnessInternational TravelersLaboratory Informationplus iconDrug Susceptibility TestingFalse-Positive Investigation ToolkitInterim Laboratory Biosafety Guidance for XDR  tuberculosis strainsModel Performance Evaluation Program (MPEP)Rapid Molecular Testing to Detect Drug-Resistant TB in the USplus iconExecutive SummaryIntroductionBackground on Tests for Molecular Detection of DRGeneral Considerations and Principles for a Molecular DR Testing ServicePossible Scenarios and Scope of Testing for a Molecular DR Testing ServiceResearch NeedsGeneral Recommendations of the Expert PanelCommunication Plan for the ReportRecommendationsReferencesPanel Members and CDC ParticipantsAppendix 1Appendix 2Appendix 3The Uses of Nucleic Acid Amplification Tests for the Diagnosis of TBplus iconGeneral ConsiderationsGeneral Recommendations of the Expert PanelRecommendations to ACET, CDC, DTBEData & Statisticsplus iconTB Incidence in the United StatesReported TB in the US, 2022 Surveillance Reportplus iconNational DataReporting Area DataRisk FactorsDemographicsTB Treatment and Case OutcomesDrug-Resistant TBMolecular SurveillanceTuberculosis in the United States, 2022 (Slide Set)Archived Surveillance Reports and Slide Sets2021 State and City ReportArchived State and City ReportsProfessional Resources & Toolsplus iconTools for Healthcare ProvidersResources for TB Programsplus iconStrengthening Civil Surgeons’ Capacity to Improve LTBI Surveillance and Outcomes Among Status AdjustersNotice of Funding Opportunity (NOFO)Program EvaluationTB Centers of ExcellenceTB Elimination AllianceTB Genotypingplus iconConventional TB GenotypingWhole Genome SequencingTB GIMSAnalytic ToolsLatent Tuberculosis Infection ResourcesPublications & Productsplus iconPatient and Public MaterialsFact SheetsGuidelinesplus iconControl & EliminationDrug-Resistant TBInfection Control & PreventionLaboratory & GenotypingTB & HIVTB in Specific PopulationsTesting & DiagnosisTreatmentVaccines & ImmunizationsArchived TB GuidelinesGuides & Toolkitsplus iconAggregate ReportsCDC TB Surveillance TrainingCore CurriculumEffective TB Interviewing for Contact InvestigationEthnographic GuidesFalse-Positive Investigation ToolkitForging Partnerships to Eliminate TuberculosisGuide to Application of GenotypingLTBI: A Guide for Primary Health Care ProvidersMantoux Tuberculin Skin Testing ProductsReport of Verified Case of Tuberculosis (RVCT)Self-Study ModulesTB Contact Investigation Interviewing Skills CourseTB eDOT ToolkitUnderstanding the TB Cohort Review ProcessNewslettersplus iconTB Notes, No. 4, 2023TB Notes, No. 3, 2023TB Notes. No. 2, 2023TB Notes. No. 1, 2023TB Notes, No. 4, 2022TB Notes, No. 3, 2022TB Notes, No. 2, 2022TB Notes, No. 1, 2022TB Notes, No. 4, 2021TB Notes, No. 3, 2021TB Notes, No. 2, 2021TB Notes, No. 1, 2021Pamphlets, Brochures, Bookletsplus iconQuestions and AnswersPatient Education SeriesTuberculosis - Get the FactsTuberculosis - The Connection between TB and HIV12-Dose Regimen for Latent TB Infection-Patient Education BrochurePostersplus iconMantoux Tuberculin Skin Test Wall ChartWorld TB DayThink TBStop TBTake on TBReports & Articlesplus iconDTBE Authored Journal ArticlesTuberculosis Laboratory Aggregate ReportsSlide Setsplus iconIntroduction to TuberculosisEpidemiology of Tuberculosis Among Non-U.S.​–Born Persons in the United States, 1993–2016Self-Study Modules on Tuberculosis, 1-5 Slide SetsThe Tuberculosis (TB) in Correctional Settingsplus iconFacilitator GuideIntroduction to TB GenotypingEpidemiology of Tuberculosis in Correctional Facilities, United States, 1993-2017Prevention and Control of Tuberculosis in Correctional and Detention FacilitiesGuidelines for Preventing the Transmission of M. TB in Health care SettingsInvestigation of Contacts of Persons with Infectious TBEpidemiology of Pediatric Tuberculosis in the United StatesTargeted Tuberculosis Testing and Treatment of Latent Tuberculosis InfectionElectronic Tools & ResourcesWeb-Based Courses & Webinarsplus iconTB 101 for Health Care WorkersContent SyndicationInfographicsplus iconSocial Media GraphicsCustomizable Take on TB Infographic with InstructionsEventsWorld TB Dayplus iconU.S. TB ChampionsHistoryFeaturesplus iconTB Risk FactorsTreating Latent TB Infection with Short-Course RegimensWorld Tuberculosis (TB) Day 2021World Tuberculosis (TB) Day 2020Linksplus iconState TB Control OfficesAbout Usplus iconMission Statement and Activitiesplus iconDTBE Strategic PlanNational TB Program ObjectivesOrganization ChartAdvisory Groupsplus iconFederal TB Task Force To receive email updates about this page, enter your email address: Email Address			What's this?				Submit


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