TB treatment: Practical Guide for Patients

Finding out you have tuberculosis (TB) can feel scary. The good news: most TB is treatable when you follow the right plan. This page explains how TB treatment works, what medicines are used, how long therapy lasts, and what to watch for.

How TB treatment works

Active TB is usually treated with a combination of antibiotics to kill bacteria and prevent resistance. Standard first-line drugs are isoniazid, rifampin, ethambutol, and pyrazinamide. Doctors typically start all four for the first two months, then continue isoniazid and rifampin for another four months, making a standard six-month course.

For latent TB infection — when you have the bacteria but no symptoms — treatment options include a nine-month course of isoniazid or a shorter regimen such as 12 weekly doses of rifapentine plus isoniazid, or four months of daily rifampin. Your provider will choose based on your health, liver function, and drug interactions.

What to expect and safety tips

Directly Observed Therapy (DOT) is often used: a health worker watches you take medicines to make sure doses aren’t missed. Missing doses raises the chance of treatment failure and drug-resistant TB.

Common side effects include nausea, abdominal pain, and fatigue. Rifampin can turn bodily fluids orange and interacts with many medicines, including birth control and some heart drugs. Isoniazid can affect the liver; doctors may check liver enzymes before and during treatment. Ethambutol can affect vision, so report blurred vision or color changes immediately.

If you drink alcohol or take other liver-impacting drugs, mention it. Pregnant people can still get TB treatment, but the regimen might be adjusted. Never stop medications without talking to your provider.

For multidrug-resistant TB (MDR-TB), treatment is longer and uses second-line drugs such as bedaquiline, linezolid, or fluoroquinolones. MDR-TB care often involves specialists, hospital support, and closer monitoring for side effects.

Diagnosis and monitoring use tests like chest X-rays, sputum samples, and TB culture or molecular tests. Latent TB is found with a skin test (TST) or blood test (IGRA). Regular follow-up visits check symptoms, side effects, and drug levels if needed.

Public health matters: TB is contagious. Health departments often help with contact tracing, free testing, and DOT services. If you have cough, fever, night sweats, weight loss, or recent TB exposure, get tested and avoid public places until you know your status.

Questions to ask your provider: which drugs you’ll take, side effects to watch, how long treatment lasts, and who to call for problems. Treating TB takes commitment, but with proper care you can recover and stop spreading infection. Reach out to your local clinic or TB program for help starting or staying on treatment.

Store medicines in a cool dry place out of reach of children. Keep a pill box or phone reminders to avoid missed doses. If side effects happen, write them down with the date and call your clinic; early reporting avoids problems. Support groups and social services can help with transport, housing, and food while you complete treatment.