Key points
- If you have inactive tuberculosis (TB), also called latent TB infection, treating it is the best way to protect you from getting sick with active TB disease.
- Treatment for inactive TB can take three, four, six, or nine months depending on the treatment plan.
- Talk to your health care provider about which treatment is best for you.
Treatment overview
TB germs can live in your body for years without making you feel sick. This is called inactive TB.
Even if you do not feel sick, inactive TB can become active TB disease at any time and make you sick. If you have inactive TB, treating it is the best way to protect you from getting sick with active TB disease.
Prevent active TB disease
CDC estimates up to 13 million people in the United States live with inactive TB.
Without treatment, 1 in 10 people with inactive TB will get sick with active TB disease. TB disease can spread to others and be deadly.
People who are taking certain medications or have certain health conditions that weaken the immune system (such as diabetes, cancer, or HIV) are much more likely to develop active TB disease if infected. It is especially important for people with these risk factors to complete treatment for inactive TB disease.
Treatment options
There are several safe and effective treatment plans recommended in the United States for inactive TB. A treatment plan (also called treatment regimen) for inactive TB is a schedule to take TB medicines to kill all the TB germs. Your treatment plan for inactive TB will include:
- The types of TB medicines to take,
- How much TB medicine to take,
- How often to take the TB medicines,
- How long to take the medicines,
- How to monitor yourself for any side effects of your TB medicine, and
- The health care provider(s) who will support you through the treatment process.
You and your health care provider will discuss which treatment plan is best for you.
Treatment for inactive TB can take three, four, six, or nine months depending on the treatment plan. TB germs are strong, and it can take a long time for them to die. It is important to take and finish all TB medicines exactly as your health care provider recommends.
The treatment plans for inactive TB use different combinations of medicines that may include:
- Isoniazid
- Rifampin
- Rifapentine
Three- and four-month treatment plans
These plans are preferred because they are shorter and may be easier to complete:
- 3HP: Three months of once-weekly isoniazid (H) plus rifapentine (P)
- 4R: Four months of daily rifampin (R)
- 3HR: Three months of daily isoniazid (H) plus rifampin (R)
Six- and nine-month treatment plans
If the three- or four-month treatment plans are not right for you, or not available, your health care provider may recommend other treatment plans:
- 6H: Six months of isoniazid (H)
- 9H: Nine months of isoniazid (H)
Before starting treatment
Tell your health care provider about all medicines you are taking.
- Some medicines can interact with the TB medicines and cause a possible side effect or reaction after taking medicine.
- Some oral contraceptives (birth control pills) may not work as well when you take them with medicines for inactive TB.
- TB medicines can sometimes interfere with birth control pills and possibly make the birth control pills less effective.
- If you are taking birth control pills, talk with your health care provider before beginning any new medicines.
- TB medicines can sometimes interfere with birth control pills and possibly make the birth control pills less effective.
Tell your health care provider if you are or think you may be pregnant, or are breastfeeding before you start any TB medicines.
For most pregnant people, treatment for inactive TB can be delayed until after the baby is born.
Drinking alcoholic beverages while taking medicines for TB can be dangerous and may hurt your liver.
Alcoholic beverages include wine, beer, or liquor. Ask your health care provider about things to avoid while taking medicines for inactive TB.
Side effects
Most people can take their TB medicines without any problems. However, like all medicines, the medicines you take for inactive TB can have side effects.
People react differently to medicines. Tell your health care provider about anything you think is wrong.
Some side effects are minor.
For example, any TB medicine can cause a skin rash. Other TB medicines may cause an upset stomach or nausea. Taking your TB medicine with food can help your body absorb the medicine better.
The rifampin or rifapentine medicines may cause some body fluids to turn an orange color, such as:
- Urine (pee),
- Saliva,
- Tears,
- Sweat, and
- Breast milk.
This is normal and harmless. The color may fade over time. Also, your health care provider may tell you not to wear soft contact lenses because they may get permanently stained.
If you have any of these side effects, you can continue taking your medicine.
Other side effects are more serious.
If you have a serious side effect, call your health care provider immediately. You may be told to stop taking your medicines or to return to the clinic for tests. Serious side effects include:
- Liver injury
- Abdominal pain
- Nausea and vomiting
- Skin and eyes turning yellow (also called jaundice)
- Abdominal pain
- Dizziness or lightheadedness
- Loss of appetite
- Flu-like symptoms
- Tingling or numbness in your hands or feet
If you are taking isoniazid, you may have tingling or numbness in your hands and feet. Your health care provider may add vitamin B6 to your treatment plan to prevent this.
Special considerations
Children
Treatment is recommended for children with inactive TB to prevent them from developing TB disease. Depending on the TB treatment plan a health care provider prescribes, treatment for inactive TB may take three months, four months, or longer. Health care providers will consider a child's age, weight, and other factors when prescribing treatment.
People with HIV
People with HIV who also have inactive TB can be treated. If you have HIV and inactive TB, it is very important that you complete treatment for inactive TB to prevent the development of active TB disease.
Tell your health care provider if you have HIV. Your health care provider will make sure your TB medicines do not interfere with your HIV medicines.
Pregnant people
In most cases, people who are diagnosed with inactive TB during pregnancy can delay treatment for inactive TB until two to three months post-partum.
If you have a high risk of developing TB disease once infected, your health care provider may recommend starting treatment for inactive TB right away. Your health care provider will choose TB medicines that are recommended for use during pregnancy and monitor you and your baby during treatment for inactive TB.
Completing treatment
If you are diagnosed with inactive TB, there are several short and convenient treatment options available that can help protect you from getting sick with active TB disease. Your health care provider will work with you to make sure you can complete your treatment.
You may take your medicine on your own, through directly observed therapy (DOT), or a combination of both.
If you take TB medicines on your own
If you take your TB medicines on your own, here are tips to help you to remember to take your TB medicines:
- Take your pills at the same time every day—for example, you can take them before eating breakfast, during a regular coffee break, or after brushing your teeth.
- Set an alarm for the time you need to take your medicine.
- Write yourself a note as a reminder to take your medicine. Put it in a place where you can see it, like on your bathroom mirror or on your refrigerator.
- Ask a family member or a friend to remind you to take your pills.
- Mark off each day on a calendar as you take your medicine.
- Put your pills in a weekly pill dispenser that you keep by your bed or in your purse or pocket.
- Use a medicine tracker to organize and manage your pills. CDC has printable medicine trackers available for people taking treatment for inactive TB:
NOTE: Remember to keep all medicine out of reach of children.
If you forget to take your pills one day, skip that dose and take the next scheduled dose. Tell your health care provider that you missed a dose. You may also call your health care provider for instructions.
Talk to your health care provider if you have any questions or concerns about treatment for inactive TB.
Directly observed therapy (DOT) is the best way to remember to take your TB medicines.
Through DOT, you will meet with a health care worker every day or several times a week. These meetings may be in-person or virtual (through a smartphone, tablet, or computer). The health care worker will watch you take your TB medicines and make sure that the TB medicines are working as they should.
Your health care provider will monitor your treatment.
Your health care provider will meet with you at least monthly to check if you are:
- Taking the medicine as prescribed,
- Developing any signs and symptoms of active TB disease, and
- Having any side effects from the medicines.
They may ask you questions about how you are feeling taking the medicines. Your health care provider will help to make sure the TB medicines are working the right way and see how your body is handling the medicine.
Keep a record of your treatment.
Even after you finish taking all of your medicine for inactive TB, you may still have a positive test result on future TB blood tests or TB skin tests.
Ask your health care provider for a written record that you have finished treatment for inactive TB. This will be helpful if you are asked to have another TB test in the future.
Most healthy people will not need to be treated for inactive TB ever again.
However, the treatment you completed only kills the TB germs in your body now. If you are around someone with active TB disease, there is a chance that you can get new TB germs in your body.
Getting support
It is very important to take and finish all TB medicines exactly as prescribed by your health care provider. Talk to your health care provider if you have any questions or concerns about treatment for inactive TB. Tell your health care provider if you:
- Have side effects from the TB medicine.
- Need help taking your TB medicine.
- This includes food, clean water, or transportation.
- This includes food, clean water, or transportation.
If you need additional assistance or support in completing treatment for TB
Talk to your health care provider.
Your health care provider may be able to share resources with you. The state or local TB program may be able to provide support or have resources to help you.
Did you know?
Ask your family or friends for support.
If you need support while completing treatment for inactive TB, ask your family or friends. A family member or friend can help you to remember to take your TB medicines. It can be hard taking TB medicine for several months. A family member or friend can provide emotional support.
Connect with other TB survivors.
We are TB, and Somos TB for Spanish-speakers, is a community of TB survivors, people being treated for TB, and their family members, committed to the common goal of eliminating TB. The group provides comprehensive peer support for current TB patients and TB clinics.
You can learn about people's experiences of being diagnosed and treated for inactive TB through CDC's Tuberculosis Personal Stories.
Resources
Staying on Track with Tuberculosis Medicine Booklet
Questions and Answers About Tuberculosis Booklet