Why is this medication prescribed?

Pretomanid is an antibiotic medication used in combination with bedaquiline and linezolid to treat adults with extensively drug-resistant (XDR) tuberculosis (TB) when other treatment options are not available. XDR-TB is a form of tuberculosis that is resistant to multiple drugs, making it more challenging to treat.

The combination of pretomanid, bedaquiline, and linezolid is often referred to as the BPaL regimen. This combination therapy is specifically designed for the treatment of drug-resistant TB, and it is typically used in cases where conventional treatment options have failed.

How should this medicine be used?

Here are general guidelines for using pretomanid:

• Prescription and Guidance: Pretomanid should only be used under the supervision and prescription of a qualified healthcare professional who specializes in the treatment of TB. They will consider your medical history, the severity of the TB infection, and other factors to determine the appropriate treatment plan.
• Combination Therapy: Pretomanid is usually part of a combination therapy, often alongside bedaquiline and linezolid. The combination of these drugs is designed to be effective against drug-resistant TB.
• Oral Administration: Pretomanid is typically taken orally (by mouth). Follow your healthcare provider’s instructions regarding when and how to take the medication. It is important to take the medication with food.
• Consistency: Take pretomanid consistently and do not skip doses. Completing the entire course of treatment is crucial for the effectiveness of the therapy and to prevent the development of further drug resistance.
• Monitoring: Your healthcare provider will monitor your progress during the course of treatment. This may involve regular check-ups, laboratory tests, and imaging studies to assess the response to the medication and to manage any potential side effects.
• Adverse Effects: Be aware of potential side effects and report any unusual or severe reactions to your healthcare provider promptly. Common side effects may include nausea, vomiting, headache, and changes in liver function.
• Precautions: Inform your healthcare provider about any other medications, supplements, or medical conditions you have. Some medications may interact with pretomanid, so it’s important to provide a comprehensive list of all the substances you are taking.

It is crucial to strictly adhere to your healthcare provider’s recommendations and complete the entire course of treatment. Failure to do so may result in treatment failure, the development of further drug resistance, and the persistence or worsening of the TB infection. If you have any questions or concerns about your treatment, discuss them with your healthcare provider for personalized advice.

Other uses for this medicine

As for other uses, pretomanid is specifically developed and approved for the treatment of drug-resistant tuberculosis. It is not typically prescribed for other conditions. The combination therapy with pretomanid, bedaquiline, and linezolid is designed to address cases of TB that are resistant to multiple standard treatments.

What special precautions should I follow?

Special precautions to consider when using pretomanid include:

• Medical History: Inform your healthcare provider about your complete medical history, including any pre-existing conditions, allergies, or previous adverse reactions to medications.
• Medication Interactions: Provide a list of all medications, including prescription and over-the-counter drugs, as well as any supplements or herbal products you are taking. Some medications may interact with pretomanid, potentially affecting its efficacy or leading to adverse effects.
• Liver Function Monitoring: Pretomanid may affect liver function, so regular monitoring of liver enzymes may be necessary during treatment. Report any signs of liver problems, such as jaundice (yellowing of the skin or eyes), dark urine, or persistent nausea.
• Peripheral Neuropathy: Linezolid, one of the drugs in the BPaL regimen, is associated with peripheral neuropathy (nerve damage). Inform your healthcare provider if you experience numbness, tingling, or weakness in your extremities.
• Pregnancy and Breastfeeding: Inform your healthcare provider if you are pregnant, planning to become pregnant, or breastfeeding. The safety of pretomanid in pregnancy and breastfeeding is not well-established, and the potential risks and benefits should be carefully considered.
• Adverse Effects: Be aware of potential side effects of pretomanid and the other drugs in the combination therapy. Common side effects may include gastrointestinal symptoms, headaches, and changes in liver function.

Always follow your healthcare provider’s instructions and attend scheduled follow-up appointments to monitor your response to treatment and manage any potential side effects. If you have any concerns or experience unusual symptoms while taking pretomanid, contact your healthcare provider promptly.

It’s important to note that information may have changed since last update, so consulting a healthcare professional for the most recent and personalized guidance is crucial.

What special dietary instructions should I follow?

Special Dietary Instructions:

• Food Intake: Pretomanid is usually taken with food. Follow your healthcare provider’s instructions regarding when and how to take the medication with respect to meals.
• Avoid Alcohol: It’s generally advisable to limit or avoid alcohol consumption while taking medications like pretomanid, especially since liver function may be affected. Discuss alcohol use with your healthcare provider.

What should I do if I forget a dose?

If You Forget a Dose:

• Take it as Soon as Possible: If you forget to take a dose, take it as soon as you remember. However, if it’s almost time for your next scheduled dose, skip the missed dose and continue with your regular dosing schedule.
• Do Not Double Dose: Do not take a double dose to make up for a missed one. Taking extra doses can increase the risk of side effects without providing additional benefits.
• Inform Your Healthcare Provider: If you miss a dose, inform your healthcare provider at your next appointment. They can provide guidance based on your specific situation.

What side effects can this medication cause?

Pretomanid, like any medication, may cause side effects. It is important to note that the combination therapy, which includes pretomanid along with bedaquiline and linezolid (known as the BPaL regimen), can contribute to the overall side effect profile. Common side effects associated with pretomanid and the BPaL regimen may include:

• Gastrointestinal Issues: Nausea, vomiting, and abdominal pain are common side effects. Taking pretomanid with food may help alleviate these symptoms.
• Headache: Some individuals may experience headaches while taking pretomanid.
• Liver Function Changes: Pretomanid can affect liver function, leading to changes in liver enzyme levels. Regular monitoring of liver function may be necessary during treatment.
• Peripheral Neuropathy: Linezolid, one of the drugs in the BPaL regimen, is associated with peripheral neuropathy (nerve damage), which can cause symptoms such as numbness, tingling, or weakness in the extremities.
• Hematological Effects: Linezolid, another component of the regimen, can affect blood cell counts, leading to conditions like anemia, thrombocytopenia (low platelet count), and leukopenia (low white blood cell count).
• QT Prolongation: Bedaquiline, another drug in the regimen, is associated with QT interval prolongation on electrocardiograms, which can increase the risk of cardiac arrhythmias.
• Psychiatric Effects: Bedaquiline has been associated with psychiatric adverse effects, including depression and anxiety.

It’s important to keep in mind that the benefits of this medication, particularly in treating extensively drug-resistant tuberculosis (XDR-TB), are weighed against the potential risks of side effects. Healthcare providers carefully consider the individual’s medical history and closely monitor patients during treatment to manage and address any side effects that may arise.

If you are prescribed pretomanid or the BPaL regimen, your healthcare provider will provide specific information about potential side effects, how to manage them, and when to seek medical attention. If you experience any unusual or severe symptoms, it’s crucial to contact your healthcare provider promptly. This information is based on the knowledge available last update, and there may have been developments or updates. Always consult with your healthcare provider for the most current and personalized information.

What should I know about storage and disposal of this medication?

Storage and Disposal of Pretomanid:

• Storage:
  • Store pretomanid according to the specific instructions provided by your healthcare provider or pharmacist.
  • Typically, medications should be stored in a cool, dry place away from direct sunlight and heat.
  • Follow any specific storage temperature recommendations provided with the medication.
• Disposal:
  • Dispose of unused or expired pretomanid according to local regulations.
  • Do not flush medications down the toilet or throw them in the trash unless instructed to do so. Follow specific disposal instructions provided by your healthcare provider or local pharmacy.

In case of emergency/overdose

In the case of an emergency or suspected overdose, contact your local emergency services (such as 911 in the United States) immediately. Additionally:

• Poison Control Center: Contact your local poison control center for guidance on overdose management. In the United States, the Poison Help hotline is 1-800-222-1222.
• Seek Medical Attention: Go to the nearest emergency room or call emergency services if you or someone else has taken more than the prescribed dose of pretomanid.

What other information should I know?

• Follow Healthcare Provider’s Instructions: Take pretomanid exactly as prescribed by your healthcare provider. Do not alter the dosage or stop taking the medication without consulting your healthcare provider.
• Regular Monitoring: Attend all scheduled follow-up appointments as directed by your healthcare provider. Regular monitoring is essential to assess your response to treatment and manage any potential side effects.
• Inform Healthcare Provider: Inform your healthcare provider about all medications, supplements, and over-the-counter drugs you are taking, as well as any changes in your health during the course of treatment.
• Pregnancy and Breastfeeding: Inform your healthcare provider if you are pregnant, planning to become pregnant, or breastfeeding. The safety of pretomanid during pregnancy and breastfeeding is not well-established, and the risks and benefits should be discussed.
• Adverse Reactions: Report any unusual or severe side effects to your healthcare provider promptly. This includes symptoms such as severe nausea, vomiting, liver problems, or any other unexpected reactions.

Always refer to the specific guidance provided by your healthcare provider or pharmacist regarding the use, storage, and disposal of pretomanid. Additionally, keep in mind that the information provided here is based on knowledge, and there may have been updates or changes since then. Consult with your healthcare provider for the most current and personalized information.