Needing help with deciding on Rifampin vs Isoniazid for Latent TB?

[rosegardens]

Hello,

I have Latent TB, I am 59 years old health professional who worked in hospitals for many years. I'm so worried, I and I dread the idea of taking any of these medication, feels like a constant nightmare, and need to make the final decision now.

I tend to have a medication sensitivity and wondering whether I would tolerate Rifampin or Isoniazid better ?

Also in terms of safety, which medication would be a better choice?

Thank you so very much in advance, any information welcomed.

Sue

[Milo0413]

I just finished four long months on rifampin. In addition to all the severe aches and pains, I wasn't getting any meaningful sleep. The rheumatologist prescribed sleeping med and that helped. I checked out isoniazid and those side affects were scary. They all have side affects, so I just stayed the course with rifampin. Hopefully your side affects if any won't be too bad. Good luck !

[rosegardens in reply to Milo0413]

Hello Milo,

Thanks so much for your reply!! What a wonderful news you have finished your treatment! You must be relieved. Hope to stay in touch.

Best wishes, and take care,

Rosegarden

[Glosboss]

I don't know which would be the best for you, but if you try one and find it upsets you then you can revert to the other one. I had active TB and you really don't want that, so would definitely take what is offered. Good luck!

[rosegardens in reply to Glosboss]

Hello Glossboss,

Thanks very much for your reply, you are right I can change it over to another Isoniazid etc if can't tolerate rifampin. Thanks for warning me about the risk of active TB and how awful that would be. I hope you are now well, my very best wishes,

Rosegarden

[HelenC Partner TB Alert]

Hi rosegardens, I am sorry to hear you are worried about the best decision to make regarding latent TB treatment. I'm afraid I am not able to offer medical advice but I hope I can offer some support.

It is true that treatment for latent TB can come with unpleasant side effects - but it could give you peace of mind that you will not fall ill with active TB in the future. This becomes more likely as you age and your immune system naturally becomes weaker. However, it is not inevitable that it would happen and maintaining good health is a great defence against this.

As Glosboss said though, active TB is very unpleasant and requires more medication to treat than latent TB - it can also leave you with longterm health issues even after treatment though this is less likely if caught early.

You could consider starting the treatment and seeing how it goes - not everyone gets side effects. Also, side effects can be alleviated with measures such as maintaining a nutritious diet and by taking other medications.

Given all that, the best course of action is to do what you're doing now. Take the time to talk it through - including with your doctor - and decide what is best for you based on your health and lifestyle and attitude to risk.

Wishing you all the best - whatever you decide.

Helen

[rosegardens in reply to HelenC]

Hi Helen,

Thanks so much for taking the time to reply and provide support, Much appreciated.

I have taken on board all the points you have made, and I agree with them all. You are right about increasing risk with ageing. Also, I have my immune system somewhat compromised as I have Sjogren's.

many thanks a gain, it has been helpful,

Cheers,

Rosegarden

[rosegardens in reply to HelenC]

Hello Helen,

If I need to change it over to another TB medication because I couldn't tolerate the first one, there may be a gap between the treatments because my anticoagulant needs to be adjusted as well, there is no risk of developing resistance to TB med, because I have Latent TB. Is my understanding right?

Or if I can't tolerate any of the medications and my treatment is left uncompleted, does this cause any harm, in terms of developing resistance to TB medication?

My appointment with the ID specialist is in weeks time, I'll ask him, but in the meantime I'm so impatient to know this.. because I am thinking about what happens if I don't tolerate any of them, is it going to cause any harm because I haven't finish the treatment?

I know you cannot provide medical advice, I am just asking a general question...

Thanks so much in advance,

Rosegarden

[HelenC Partner TB Alert]

Hi Rosegarden,

Sorry to have missed this though I hope you have had a response from your ID consultant by now? I'm afraid I would not have been able to respond anyway as this is beyond my remit and expertise as a non-medical professional.

Have you decided to proceed?

Helen

[rosegardens in reply to HelenC]

Hello Helen,

Sorry for the delayed response, there has been too many things happening lately.

Thanks for checking on me, I appreciate your support.

Yes, we had to choose Isoniazid, as my ID specialist and cardiologist did not want me to stop Warfarin to take Rifampin. I have congenital cardiomyopathy and lately it was discovered that the bottom part of my heart not moving much.

It is my 12 th day on Isoniazid. Wish me luck, I'm so nerves. I'll give a blood test in 2 days -LFT and FBE to see.

can I ask you please, do other people who take these antibiotics for TB take any supplements to support the liver or any other strategies?

Many thanks in advance

Rosegarden

[HelenC Partner TB Alert in reply to rosegardens]

Hi Rosegarden,

Good to hear you have taken the bull by the horns. If you were to start feeling side effects it is quite likely you would be feeling them by now so this bodes well.

You must speak to your doctor or a pharmacist before starting any supplements as the wrong supplements in the wrong quantities can be toxic to the liver and/or may interact with TB medication.

I hope it all goes well.

Helen

[rosegardens in reply to HelenC]

Hi Helen,

Thank you so much for your reply, comments giving hope and advice; all taken on board.

Good to know you are there and I can reach out.

Thanks very much !

Rosegardens

[HelenC Partner TB Alert]

Hi Rosegardens, This leaflet tells you the common side effects of Isoniazid and any red flags to watch out for: thetruthabouttb.org/wp-cont...

[rosegardens]

Hi Helen,

Thank you very much. This booklet is so helpful.

Rosegardens

[Marocean]

I know it's been several months since you posted this; while I'm not in your specific situation, please let me know if you need any support as we all have our challenges and I'd like to provide any encouragement. Take care