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Time to take TB meds



Can we take TB medicines (Rifampicine, Ethambutol, Pyrazinamide and Isoniazide) any time of the day as long as on empty stomach (1 hour before eating or 2 hours after eating) or the morning is the best time to take it? It seems that I cannot tolerate this medicine if taking in the morning although after eating and I want to know what time of the day is the optimal time for taking them to obtain optimal result.


The most important thing for you to do is to not miss any doses of your medication.  For medications that you take every day, it is usually best if you can take them around the same time every day.  This way, you can maintain a steady medication level in your body.    Taking them at the same time every day may also help you not to forget. So, if you do not tolerate your medications in the morning, then you can set a different time to take them daily.

For tuberculosis medications, particularly isoniazid and rifampin, it is best to take them on an empty stomach (one hour before meals or two hours after meals.).  This helps the body absorb more of the drug.  But if the medications cause you to have an upset stomach, then you can try them with some food and see if it helps.  Ethambutol can be taken with some food if it is upsetting your stomach. Pyrazinamide can also be taken with some food followed by a glass of water.    

If you are taking your medication by directly observed therapy (DOT), where a healthcare worker provides you with a daily dose of your TB pills and observes you taking them, they will usually try and schedule the meetings at the same time daily.  It is best to take all of your medications at one time for them.  If you are experiencing an upset stomach, try taking some food.      

If you are taking the medications by yourself, and you forget to take your pills, take them as soon as you remember. It is also important to continue taking your medication as prescribed by your doctor and to not stop taking them when you start feeling better.

For more information:

Go to the Tuberculosis health topic, where you can:

Response by:

Shu-Hua   Wang, MD, MPH&TM Shu-Hua Wang, MD, MPH&TM
Clinical Assistant Professor of Infectious Diseases
Clinical Assistant Professor of The Division of Epidemiology
College of Medicine
The Ohio State University

Larry S Schlesinger, MD Larry S Schlesinger, MD
Molecular Virology, Immunology and Medical Genetics
Microbiology Administration
Environmental Health Sciences
College of Medicine
The Ohio State University