Tuberculosis (TB) remains one of the deadliest infectious diseases globally — the WHO estimates 10.6 million people fell ill with TB in 2022 and 1.3 million died, including 167,000 with HIV co-infection. The disease is caused by Mycobacterium tuberculosis, a slow-growing intracellular bacillus that primarily affects the lungs but can involve almost any organ system. Modern short-course TB therapy is fully curative — but only when used correctly: the right drug combination, at the right dose, for the full duration, under specialist supervision. This page lists the anti-tuberculous medications stocked at MedsBase. It is not a self-treatment guide for active TB.
The 4-drug RIPE regimen
The WHO standard regimen for new, drug-susceptible pulmonary tuberculosis is six months in two phases:
Intensive phase — 2 months: Rifampicin + Isoniazid + Pyrazinamide + Ethambutol (RIPE), all four drugs daily.Continuation phase — 4 months: Rifampicin + Isoniazid (RH), continued daily.
Longer regimens (9–12 months) apply to TB meningitis, bone and joint TB, and disseminated disease. Treatment is supervised — directly observed therapy (DOT) is recommended in most national programmes to ensure adherence and to prevent the emergence of multidrug-resistant TB (MDR-TB).
Why combination therapy is mandatory
Single-agent treatment of active TB inevitably selects for resistant organisms. The bacterial load in a cavitating pulmonary lesion is enormous (up to 109 bacilli) and naturally occurring resistance mutations exist at low frequency for every drug. Using one drug kills the susceptible majority and leaves the resistant minority to multiply — treatment failure with a now-untreatable strain. Combination therapy works because the probability of one organism being simultaneously resistant to multiple drugs is vanishingly small. This is why every page in this category carries an explicit warning that single-agent purchase is appropriate μόνο for ongoing supervised regimen continuation, latent TB infection (4-month rifampicin monotherapy), or specific non-TB indications such as leprosy, MAC, or meningococcal prophylaxis.
Multidrug-resistant TB — a warning
MDR-TB — resistance to at least rifampicin and isoniazid — affected an estimated 410,000 people worldwide in 2022. MDR-TB requires longer treatment (9–20 months) with second-line agents including fluoroquinolones (levofloxacin, moxifloxacin), linezolid, bedaquiline, and clofazimine. MDR-TB is the predictable downstream result of partial, irregular, or single-agent treatment of drug-susceptible TB. Cure is possible but harder, more expensive, and more toxic than first-line therapy — the case for getting the initial regimen right and completing it.
Anti-TB medications stocked at MedsBase
This category currently lists two of the four first-line agents:
R-Cin — rifampicin 300/450/600 mg (Cipla). The most important sterilising drug in TB therapy. Also used as 4-month monotherapy for latent TB infection (4R regimen), in multibacillary leprosy multi-drug therapy, for meningococcal contact prophylaxis, and in serious staphylococcal bone, joint, or prosthetic-device infections. Rifampicin is a major CYP3A4 / CYP2C9 / CYP2C19 inducer — it reduces the effectiveness of dozens of co-administered medicines including oral contraceptives, warfarin, DOACs, statins, methadone, transplant immunosuppressants, antiretrovirals, and many others. Always disclose every concurrent medication before starting. Causes orange-red discolouration of urine, sweat, tears, and saliva (harmless but permanently stains soft contact lenses).Combutol — ethambutol HCl 200/400/800 mg (Lupin). A bacteriostatic agent whose role in the regimen is to suppress the emergence of resistance to the bactericidal partner drugs. Also a core agent for Mycobacterium avium complex (MAC) infection in HIV. The defining toxicity is dose-dependent optic neuritis: loss of visual acuity and red-green colour discrimination, usually reversible if the drug is stopped at the first symptom but potentially permanent if it is not. Baseline ophthalmology assessment + monthly visual checks are mandatory. Renal-dose adjustment is essential.
The other two first-line agents — isoniazid και pyrazinamide — are not currently stocked at MedsBase. Patients on a full RIPE regimen will need to source these from another supplier, a hospital pharmacy, or their national TB programme. National TB programmes in most countries provide first-line TB drugs free of charge.
Mandatory monitoring during TB therapy
Liver function — baseline and at least monthly. Rifampicin, isoniazid, and pyrazinamide are all hepatotoxic; the combined regimen produces clinically significant hepatitis in roughly 5% of patients. Stop the regimen and seek review for jaundice, dark urine, or right-upper-quadrant pain.Visual acuity and colour vision — baseline and monthly while on ethambutol. Stop ethambutol the same day at any new visual complaint.Sputum smear and culture — the main efficacy marker for active pulmonary TB; conversion to negative culture by 2 months indicates a good response.Renal function and serum uric acid — ethambutol clearance is renal; pyrazinamide raises uric acid and can precipitate gout.HIV status — TB-HIV co-infection alters the regimen, the drug interactions, and the prognosis. Every patient with active TB should be offered HIV testing.
Who this category is not for
If you have suspected active TB (chronic cough > 3 weeks, weight loss, night sweats, blood-stained sputum) you need a TB specialist, sputum testing, susceptibility testing, contact tracing, and combination therapy under directly observed treatment — not single-drug self-treatment. Untreated or partially treated active TB is contagious, kills roughly half of those infected, and is the most common driver of MDR-TB. Use this page for refills and continuation of an existing supervised regimen, for latent TB infection treatment, or for the specific non-TB indications listed on each product page.
