Questions and Answers About TB, 2009
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Active TB Disease
How is active TB disease treated?
There is good news for people with active TB disease! It can
almost always be treated and cured with medicine. But the medicine
must be taken as directed by your doctor or nurse.
If you have active TB disease, you will need to take several
different medicines. This is because there are many bacteria to be
killed. Taking several medicines will do a better job of killing all
of the bacteria and preventing them from becoming
resistant to the medicines.
The most common medicines used to treat TB are
If you have active TB disease of the lungs or throat, you are
probably infectious. You need to stay home from work or school so
that you don't spread TB bacteria to other people. After taking your
medicine for a few weeks, you will feel better and you may no longer
be infectious to others. Your doctor or nurse will tell you when you
can return to work or school or visit with friends.
Having active TB disease should not stop you from leading a
normal life. When you are no longer infectious or feeling sick, you
can do the same things you did before you had active TB disease. The
medicines that you are taking should not affect your strength,
sexual function, or ability to work. If you take your medicines as
directed by your doctor or nurse, they should kill all the TB
bacteria. This will keep you from becoming sick again.
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What are the side effects of TB medicines?
If you are taking medicines for TB, you should take it as
directed by your doctor or nurse. The medicines may cause side
effects. Some side effects are minor problems. Others are more
serious. If you have a serious side effect, call your doctor or
nurse immediately. You may be told to stop taking your medicine or
to return to the clinic for tests.
The side effects listed below are serious. If you have any of
these symptoms, call your doctor or nurse immediately:
- no appetite
- nausea
- vomiting
- yellowish skin or eyes
- fever for 3 or more days
- abdominal pain
- tingling fingers or toes
- skin rash
- easy bleeding
- aching joints
- dizziness
- tingling or numbness around the mouth
- easy bruising
- blurred or changed vision
- ringing in the ears
- hearing loss
The side effects listed below are minor problems. If you have any
of these side effects, you can continue taking your medicine.
- Rifampin can turn urine, saliva, or tears orange. The doctor
or nurse may advise you not to wear soft contact lenses because
they may get stained.
- Rifampin can make you more sensitive to the sun. This means
you should use a good sunscreen and cover exposed areas so you
don't burn.
- Rifampin makes birth control pills and implants less
effective. Women who take rifampin should use another form of
birth control.
- If you are taking rifampin as well as methadone (used to
treat drug addiction), you may have withdrawal symptoms. Your
doctor or nurse may need to adjust your methadone dosage.
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Why do I need to take TB medicine regularly?
TB bacteria die very slowly. It takes at least 6 months for the
medicines to kill all the TB bacteria. You will probably start
feeling well after only a few weeks of treatment. But beware! The TB
bacteria are still alive in your body. You must continue to take
your medicines until all the TB bacteria are dead, even though you
may feel better and have no more symptoms of active TB disease.
If you don't continue taking your medicines or you aren't taking
all your medicines regularly, this can be very dangerous. The TB
bacteria will grow and you will remain sick for a longer time. The
bacteria may also become resistant to the medicines you are taking.
You may need new, different medicines to kill the TB bacteria if the
old medicines no longer work. These new medicines must be taken for
a longer time and usually have more serious side effects.
If you become infectious again, you could give TB bacteria to
your family, friends, or anyone else who spends time with you. It is
very important to take your medicines as directed by your doctor or
nurse.
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What is directly observed therapy (DOT)?
The best way to remember to take your medicines is to get
directly observed therapy (DOT). If you get DOT, you will meet with
a health care worker every day or several times a week. You will
meet at a place you both agree on. This can be the TB clinic, your
home or work, or any other convenient location. You will take your
medicines at this place while the health care worker watches.
DOT helps in several ways. The health care worker can help you
remember to take your medicines and complete your treatment. This
means you will get well as soon as possible. With DOT, you may need
to take medicines only 2 or 3 times each week instead of every day.
The health care worker will make sure that the medicines are
working as they should. This person will also watch for side effects
and answer questions you have about TB.
Even if you are not getting DOT, you must be checked at different
times to make sure everything is going well. You should see your
doctor or nurse regularly while you are taking your medicines. This
will continue until you are cured.
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How can I remember to take my medicines if
I am not on DOT?
The only way to get well is to take your medicines exactly as
directed by your doctor or nurse. This may not be easy! You will be
taking your medicines for a long time (6 months or longer), so you
should get into a routine. Here are some ways to help you remember
to take your medicines:
- Take your pills at the same time every day — for example,
you can take them before eating breakfast, during a coffee
break, or after brushing your teeth.
- Ask a family member or a friend to remind you to take your
pills.
- Mark off each day on a calendar as you take your medicine.
- Put your pills in a weekly pill dispenser. Keep it by your
bed or in your purse or pocket.
NOTE: Remember to keep all medicine out of reach
of children. |
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If you forget to take your pills one day, skip that dose and take
the next scheduled dose. Tell your doctor or nurse that you missed a
dose. You may also call your doctor or nurse for instructions.
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How can I keep from spreading TB?
The most important way to keep from spreading TB is to take all
your medicines, exactly as directed by your doctor or nurse. You
also need to keep all of your clinic appointments! Your doctor or
nurse needs to see how you are doing. You may need another chest
x-ray or a test of the phlegm you may cough up. These tests will
show whether the medicines are working. They will also show whether
you can still give TB bacteria to others. Be sure to tell the doctor
about anything you think is wrong.
If you are sick enough with active TB disease to go to a
hospital, you may be put in a special room. These rooms use air
vents that keep TB bacteria from spreading to other rooms. People
who work in these special rooms must wear a special face mask to
protect themselves from TB bacteria. You must stay in the room so
that you will not spread TB bacteria to other people. Ask a nurse
for anything you need that is not in your room.
If you are infectious while you are at home, there are things you
can do to protect yourself and others near you.
- Take your medicines as directed. This is very important!
- Always cover your mouth with a tissue when you cough,
sneeze, or laugh. Put the tissue in a closed bag and throw it
away.
- Do not go to work or school. Separate yourself from others
and avoid close contact with anyone. Sleep in a bedroom away
from other family members.
- Air out your room often to the outside of the building (if
it is not too cold outside). TB spreads in small closed spaces
where air doesn't move. Put a fan in your window to blow out
(exhaust) air that may be filled with TB bacteria. If you open
other windows in the room, the fan also will pull in fresh air.
This will reduce the chances that TB bacteria will stay in the
room and infect someone who breathes the air.
Remember, TB is spread through the air. People cannot get
infected with TB bacteria through handshakes, sitting on toilet
seats, or sharing dishes and utensils with someone who has TB.
After you take the medicines for about 2 or 3 weeks, you may no
longer be able to spread TB bacteria to others. If your doctor or
nurse agrees, you will be able to go back to your daily routine,
including returning to work or school. Remember, you will get well
only if you take your medicines exactly as directed by your doctor
or nurse.
Think about people who may have spent time with you, such as
family members, close friends, and coworkers. The local health
department may need to test them for TB infection. TB is especially
dangerous for children and HIV-infected persons. If infected with TB
bacteria, these people need medicine right away to keep from
developing active TB disease.
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Sometimes the TB bacteria are resistant to the medicines used to
treat TB disease. This means that the medicine can no longer kill
the bacteria. Multidrug-resistant TB, or MDR TB, is caused by
bacteria that are resistant to two of the most important TB
medicines: INH and RIF.
A more serious form of MDR TB is called extensively
drug-resistant TB (XDR TB). XDR TB is a rare type of TB that is
resistant to nearly all medicines used to treat TB disease.
If you do not take your medicines as directed by your doctor or
nurse, the TB bacteria may become resistant to a certain medicine.
Also, people who have spent time with someone sick with MDR TB or
XDR TB can become infected with these drug-resistant bacteria.
Drug resistance is more common in people who
- have spent time with someone with drug-resistant TB disease
- do not take their medicines as directed by their doctor or
nurse
- develop active TB disease again, after having taken TB
medicines in the past
- come from areas where drug-resistant TB is common
People with MDR TB or XDR TB must be treated with special
medicines. These medicines are not as good as the usual medicines
for TB, and they may cause more side effects. Also, people with MDR
TB and XDR TB must see a TB expert who can closely observe their
treatment to make sure it is working. Treatment takes much longer
than regular TB. And, people with MDR TB and XDR TB are at greater
risk of dying from the disease.
Last Modified: 02/10/2009
Last Reviewed: 05/18/2008 Content Source: Division of Tuberculosis Elimination
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
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