Hesperian Health Guides

Treat TB with Medicines

In this chapter:

TB medicines can make hormonal methods of family planning (like birth control pills) less effective. Women being treated for TB should use a different family planning method.

TB can almost always be cured by taking the right medicines in the right amounts for the full length of the treatment.

The basic treatment for someone who has TB for the first time has 2 parts, and always includes taking more than 1 medicine. At first, a person takes 4 medicines for 2 months. Then sputum is tested. If it is negative, the person begins part 2, which includes taking 2 drugs for another 4 months (a total of 6 months of treatment). When the treatment is finished, the sputum should be checked again to make sure the person has been cured.

TB medicines include isoniazid, rifampicin or rifapentine, pyrazinamide, and ethambutol. TB treatments vary from country to country. See a health worker to talk about recommendations of the TB program in your country.

If sputum is still positive after 2 months of treatment, test the person’s TB germs to see if they are resistant to the medicines.

After the first 2 months of treatment, it is sometimes possible to take medicines 3 times a week, instead of every day, but not if you have HIV or if there is resistance to TB medicines in your area. Talk to a health worker to see if you can get this kind of treatment.

If you are being treated for TB:

  • Take all the medicine for as many months as directed. If you stop too soon, you may infect others, the illness will come back, and your TB may become resistant (see below).
  • Learn which side effects are normal and which are serious for the medicines you are taking. If you have serious side effects, stop taking the medicines and see a health worker immediately.
  • Get plenty of rest and eat as well as possible. If you can, stop working until you begin to feel better.
a woman holding her hand in front of her mouth as she coughs
  • Avoid spreading TB germs to others. If possible, sleep separately from those who are not sick with TB for one month after starting medicines. Cover your mouth when coughing and spit sputum into a piece of paper. Throw it into a latrine or toilet, or burn it.
  • If you give birth during treatment, your sputum should be tested. If it is negative, your baby should be given a BCG (Bacille Calmette-Guerin) vaccine, but no medicines. If your sputum is positive, your baby will need medicines. You do not need to be separated from your baby or to stop breastfeeding. Cover your mouth with a handkerchief when breastfeeding.
  • If possible, go to an experienced health worker to coordinate treatment for your TB and HIV if you have both infections. Because more medications are being taken, there is a greater possibility of side effects.
  • Stop smoking.

Resistance to TB Medicines

If a person is infected by someone with drug-resistant TB, the germs causing their sickness will also be resistant.

Health workers should always ask if a person has been treated for TB before. If they have, it is more likely they now have drug-resistant TB.

If a person does not take enough of the right medicines or stops taking medicines before the treatment is finished, not all the TB germs will be killed. The strongest germs will survive and multiply, and then the medicine may be unable to kill them. This is called resistance.

TB that has become resistant to both isoniazid and rifampicin is very difficult to cure. Treatment takes 20 to 24 months, is often less successful, and is much more expensive than treatment for ordinary TB. A person with multi-drug-resistant (MDR) or extremely-drug-resistant (XDR) TB can spread the disease to others for several months after beginning treatment.

Anyone whose sputum is still positive after 2 months of treatment may have MDR or XDR TB. See a health worker trained in treating TB to get other medicines.

This page was updated:13 Nov 2023