First Line Drugs For Tuberculosis Treatment – Recommended Doses

Antitubercular drugs are mainstay of treatment of tuberculosis. The major drugs used and effective are called first line drugs. Following are the first line drugs in tuberculosis

• Isoniazid
• Rifampin
• Pyrazinamide
• Ethambutol
• Streptomycin

These five drugs are responsible for control and containment of tubercular disease, among other factors.

The drugs are given on basis of patient weight and dosage may vary in different individuals. The dosage also differ depending on the regimen given. There are three regimen that traditionally have been used for treatment

• Daily
• Twice Weekly
• Thrice Weekly

Dosage In Children

Daily Regimen

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

Dosage In 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

Daily Regimen

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

Note

• Doses based on weight must be adjusted as the patient’s weight changes
• Pyrazinamide and streptomycin should not be used to treat pregnant women.
• Ethambutol is not recommended for children who are too young to be monitored for changes in their vision.
• Daily dose of streptomycin should not exceed 0.75 g for patients over 50 years of age.

The World Health Organization does not recommend twice weekly regimens because of the greater risk of treatment failure from missed doses.