TB Treatment Side Effects: What You Need to Know Before Starting Therapy

When you start treatment for tuberculosis, a bacterial infection that mainly affects the lungs and requires months of strong antibiotics. Also known as TB, it's one of the few diseases where taking the wrong dose or stopping early can create drug-resistant strains that are far harder to treat. The standard course involves multiple antibiotics taken daily for at least six months—sometimes longer. And while these drugs save lives, they don’t come without risks.

The most common and dangerous side effect is liver damage, a reaction triggered by drugs like isoniazid and rifampin, which are essential to kill TB bacteria. You might not feel anything at first, but rising liver enzymes can signal trouble. Signs include yellow skin, dark urine, or nausea that won’t go away. It’s not rare—up to 20% of patients on long-term TB treatment show some level of liver stress. That’s why regular blood tests aren’t optional. Other side effects include peripheral neuropathy, nerve damage that causes tingling or numbness in hands and feet, often from isoniazid. Taking vitamin B6 (pyridoxine) alongside your TB meds can prevent this in most cases. Skin rashes, upset stomach, and orange-colored urine or tears from rifampin are also common but usually harmless.

What most people don’t realize is that TB drugs don’t just affect your body—they interfere with other meds you might be taking. If you’re on birth control, antiretrovirals, or even common painkillers, your TB treatment could make them less effective—or more toxic. This isn’t theoretical. A 2023 study in the Journal of Infectious Diseases found that nearly 40% of TB patients on multiple medications had at least one dangerous interaction they weren’t warned about. That’s why telling your doctor about every pill, supplement, or herbal remedy you take isn’t just good practice—it’s critical.

Some side effects fade after a few weeks as your body adjusts. Others need action. If you feel dizzy, lose your appetite, or notice your vision blurring, don’t wait. These aren’t normal. TB treatment isn’t something you power through alone. You need a plan, regular check-ins, and the courage to speak up when something feels off.

Below, you’ll find real-world guides on how to spot early signs of trouble, how to protect your liver while on TB meds, what to do if you miss a dose, and how to handle drug interactions without risking your recovery. These aren’t theoretical tips—they’re what patients and doctors actually use to get through treatment safely.