Question
Is it safe to take TB medication with my ARVs?
14 December 2011. Related: All topics, Complications and coinfections, South Africa, Starting treatment, TB.
Hi. I am HIV positive and on ART for 10 months.
My viral load is undetectable and my CD4 count is 180.
Last month I was suffering form breathing problems. Then I went to the doctor and and found fluid in my lungs. They removed that and now they prescribed me TB medicines along with ART.
My ART meds are: Tavin EM (tenofovir and emtricitabine) in the morning; Atazor R (atazanavir and ritonovir (evening).
I also take ZOCOn 150 (1 tab in a weak) and sepmax (one tab afternoon).
My TB medicine is: (1) Ributin150 1 tab alternate day before breakfast; (2) Wysolone 20 after bf for 15 days; (3) Benadon (half tab after bf); (4) pyrazinamide (750 2 tab after lunch); (5) Combutol (1000 1 tab after dinner).
My question is, along with ART medicine, is this combination good for me or is it going to harm me? Please let me know.
Answer
Thank you for your question
I appreciate that it must be difficult for you having to take so many meds at the moment. This will only be for a short time though until the TB is treated.
The TB meds you are taking are recommended for TB. It will therefore not harm you as it is meant to cure the TB. The meds are also routinely prescribed even for people taking HIV meds (called ART), as is your case.
One of your meds, the Wysolone, is or treating breathing difficulties, which is one of the things you mentioned in your email.
Although the TB drugs can be tough and have some side effects, you will only need to take them for about 6 to 12 months, depending on the combination. This is the standard for first line regimen which you are on. It is therefore really important that you take thee meds carefully. This means taking them as prescribed by your doctor.
Missing TB meds can cause drug resistance and even MDR TB (multidrug resistant TB). Treatment for MDR TB is longer and has much nastier side effects, so it is best to adhere to your first line regimen in order to cure the TB and ensure that you don’t develop MDR TB. If you have just started taking the TB meds, you should start to feel better within in 2-3 weeks.
Good luck with completing the remaining meds.
Best wishes.
Further info
TB and HIV coinfection (from the i-Base training manual)
https://i-base.info/ttfa/5-ois-and-coinfections/7-tuberculosis-tb
UK (BHIVA) guidelines on HIV and TB coinfection.
https://www.bhiva.org/TB-guidelines
Hi Maria, I am sorry to hear about these side effects. Unfortautnely Tb treatment is known to be difficult to tolerate given the side effect profile of the drugs that you need to take. It is important to recognise that this is temporary and you will not need to take them lifelong.
Have you been given any other drug alongside isoniazid to help with these symptoms? Usually a drug called Pyrodoxine is given to help prevent the tingling sensation that you are experiencing.
As isoniazid is an antibiotic it is important that you do continue with the course and don’t stop early. Stopping early can lead to the treatment being less effective in the future and not working as well for both yourself and other people. Have you been able to speak with your doctor about these symptoms? have you tried any pain medication to help alleviate this?
Hi my TB suppress pills were changed from solonex to winthrop isoniazid but I have terrible side effect from these as my arms and hands are going numb and tingly and burning and now my legs ate starting. If I stop using these will there be a problem the clinic doesn’t have solonex at the moment but I can’t stand this pain anymore. My arm meds is acriptega. Thanx
Hi Pinky, what is the name of the ARVs you are taking? and is this 8:30/9 AM OR PM that you are taking Solonex?
Hi I am taking arvs and solonex but I ask the nurse if I should have time of taking solonex and said no as this was to prevent TB I started taking arvs on 23rd of November this year and solonex on the 19 of December I take them at any time after 8:30 or 9 can that be a problem ?
But I take my arvs at 05:00 am sharp please advise
Hi Musa, there will be no interactions between these treatments when taking them at the times you have mentioned.
If you take solonex in the morning at 6 am
ARVs evening at 8 what’s cause side effect only on in for few days
Hi Promise, can you tell me the names of the ARVs you are taking?
Hi I’m taking my ARVs and solonex some time in the morning it’s okay