Skip directly to search Skip directly to A to Z list Skip directly to navigation Skip directly to site content Skip directly to page options
CDC Home

Managing Drug Interactions in the Treatment of HIV-Related Tuberculosis

Return to Table of Contents

Recommendations

Co-treatment of multidrug-resistant tuberculosis and HIV

Multidrug resistant tuberculosis (tuberculosis resistant to rifampin and isoniazid) is a growing public health threat and may be particularly lethal among patients infected with HIV.2  Although knowledge of the metabolic pathways of some second-line drugs (e.g. ethionamide, cycloserine, para-amino salicylate) is incomplete because many of these drugs were developed and licensed decades ago, it is believed (based on knowledge of chemical structure, metabolic pathways, and/or metabolism of related agents) that most of these drugs do not have significant drug-drug interactions with antiretrovirals. The second-line aminoglycoside antituberculosis drugs (capreomycin, kanamycin, and amikacin) are primarily renally excreted as unchanged compounds and are unlikely to have metabolic drug interactions with antiretrovirals.  Fluoroquinolones (like ofloxacin, moxifloxacin, or levofloxacin) are also unlikely to have significant drug interactions with antiretrovirals.  Since patients with multidrug-resistant tuberculosis do not receive rifampin, the risk of clinically-significant drug interactions is markedly reduced. However, overlapping toxicities such as nephrotoxicity, QT prolongation on the electrocardiogram, psychiatric side effects, and gastrointestinal intolerance may limit options for co-treatment of HIV and multidrug-resistant tuberculosis.


 
Contact Us:
  • Centers for Disease Control and Prevention
    Division of Tuberculosis Elimination (DTBE)
    1600 Clifton Rd., NE
    MS E10
    Atlanta, GA 30333
  • 800-CDC-INFO
    (800-232-4636)
    TTY: (888) 232-6348
  • Contact CDC–INFO
USA.gov: The U.S. Government's Official Web PortalDepartment of Health and Human Services
Centers for Disease Control and Prevention   1600 Clifton Road Atlanta, GA 30329-4027, USA
800-CDC-INFO (800-232-4636) TTY: (888) 232-6348 - Contact CDC–INFO
A-Z Index
  1. A
  2. B
  3. C
  4. D
  5. E
  6. F
  7. G
  8. H
  9. I
  10. J
  11. K
  12. L
  13. M
  14. N
  15. O
  16. P
  17. Q
  18. R
  19. S
  20. T
  21. U
  22. V
  23. W
  24. X
  25. Y
  26. Z
  27. #