Tuberculosis (TB) medicines overview

When you have active TB, the bacteria are multiplying in your body making you feel sick. You may have symptoms such as cough, weight loss, night sweats and fever. Read more about tuberculosis (TB). TB medicines help to clear TB disease. With treatment, TB can almost always be cured.

You will need to take a combination of TB medicines to clear the infection

• The most common treatment for active TB is isoniazid in combination with 3 other antibiotic medicines – rifampicin, pyrazinamide and ethambutol.
• Each of these antibiotics works in different ways to kill the TB bacteria. TB bacteria are slow to die and a combination is needed for at least 6 months to kill the bacteria. Some people may need to be treated for longer.
• If the medicines are used separately, the TB bacteria can quickly become resistant to these antibiotics.

It’s very important you finish the course of antibiotics

• TB bacteria die very slowly so it's very important that you take the full course of your treatment to be cured.
• You'll need to take treatment for least 6 months – some people may need to be treated for longer.
• People usually begin to feel better 2 to 4 weeks after starting treatment. Even if you feel better after a few weeks on the TB medicines, it doesn't mean all the TB bacteria are dead.
• You can’t catch TB from a person who has been taking the antibiotics for 2 weeks or more.

If you don't take your TB medicines the right way, or stop taking the medicines early:

• Your TB infection may become worse.
• Your infection may become harder to treat and the medicines you are taking may no longer work. This is called drug-resistant TB. Read more about drug resistant TB below.
• You may need to take other medicines that cause more side effects and are less able to remove the infection.
• You may spread the infection to others.

You may need to have tests while you are taking TB medicines

Depending on your medicine plan, your doctor may ask for blood, phlegm, or urine tests while you are having treatment. These tests will show if your TB medicines are working and how your body is handling the medicine. You may also need to have chest X-rays.

If you have latent TB, it means that you have a TB infection but no active disease or symptoms. The TB bacteria remain inactive (dormant) in a small area of your lungs. This type of infection may stay for years. Read more about latent TB.

• Only some people with latent TB are given TB medicines to prevent infection, eg, people with weakened immune systems.  
• The most common therapy is a daily dose of the antibiotic isoniazid for 6 to 9 months.
• This treatment kills bacteria that could cause problems if the disease becomes active.
• You're not contagious(not able to pass TB on to others) if you have latent TB.

Everyone finds it difficult to remember to take long courses of treatment. If you forget to take a dose of your TB medicines now and again, it may not be a big problem. However, if you forget often your TB may not be fully treated.

Here are some ways to help you remember to take your TB medicine.

• It's important to get into a routine – take your medicine at the same time every day.
• Each day when you take your medicine mark it off on a calendar or set a reminder on your phone.
• Get a weekly pill dispenser that has a section for each day of the week. Put your medicines in it.
• Ask someone close to you to check in daily to make sure you've taken your medicine. Read more tips to remember to take your medicines. 
• If you plan to travel, talk to your healthcare provider and make sure you have enough medicine to last while you're away.

Ask your healthcare provider what you should do if you forget to take your medicines.

Sometimes you may need help sticking to the long-term treatment plan. There's a programme called Directly Observed Therapy (DOT) that might help. See below for more information about DOT.

Sometimes drug-resistant TB occurs when bacteria become resistant to the usual medicines used to treat it. This means that the antibiotics can no longer kill the TB bacteria. Multidrug-resistant TB (MDR-TB) is caused by TB bacteria that are resistant to at least isoniazid and rifampicin, the 2 TB medicines used to treat most people with TB disease.

Treating and curing drug-resistant TB takes much longer – usually 2 years. It's very important that people with MDR-TB disease take their medicines exactly as prescribed. 

Tuberculosis is a notifiable disease in Aotearoa  New Zealand. This means that if you have TB, your doctor will need to let the Public Health Service know. Someone from your local public health team may contact you to help you with your TB treatment. They will also help people with MDR-TB to finish their treatment, and to follow up any close contacts or whānau who may need testing. Public health nurses supervise TB treatment in the community. Treatment of MDR-TB is always done by once or twice daily directly observed therapy (DOT).

What is directly observed therapy (DOT)?

• Directly observed therapy (DOT) means that a supervisor watches you swallow your medicine for all doses over the course of treatment.
• This ensures that people with TB take the correct medicines, the correct dose, and at the correct times.
• DOT may happen while you are in hospital (inpatient) or in the community (outpatient).
• The DOT supervisor may be a health worker or a trained community member.
• Read more about multi-drug resistant TB(external link).