| Anti-Mycobacterial Medications |
| Drug | Mechanism of Action | Adverse Effects | Notes |
| Rifamycins (rifampin and rifabutin) | Inhibits DNA-dependent RNA polymerase | HepatotoxicityRed or orange body fluidsCYP450 inducerCutaneous flushing | Rifabutin has less CYP450 effect, thus favored for HIV patientsMutations occur due to decreased binding to RNA polymeraseResistance occurs rapidly if used as monotherapy |
| Isoniazid | Inhibits synthesis of mycolic acids | HepatotoxicityInhibits CYP450Drug-induced systemic lupus erythematosusVitamin B6 deficiencyperipheral neuropathysideroblastic anemiaco-administer with pyridoxine (B6) to reduce side effects | May be used as monotherapy for prophylaxis and latent TBMutations occur due to underexpression of enzyme required to convert drug into active metabolite |
| Pyrazinamide | Unknown but may work through host phagolysosomes | HepatotoxicityHyperuricemiaArthralgias | – |
| Ethambutol | Inhibits arabinosyltransferase and disrupts cell wall carbohydrate polymerization | Optic neuropathy red-green color blindness | Drug resistance due to increased production of arabinosyltransferase |
| Dapsone | Inhibits dihydropteroate synthesis (anti-folate) | MethemoglobinemiaHemolysis (G6PD deficiency patients) | – |
| Clofazimine | Disrupts DNA | Gastrointestinal upsetDry skinPink/brown skin and body fluid dyspigmentation | – |
| Streptomycin | Interacts with 30S ribosomal subunit | TinnitusVertigoAtaxiaRenal toxicity | Second-line treatment for M. tuberculosis |
