Updated
Reviewed
Feb. 17, 2022

Tables

Table 3. Dosing Recommendations for Anti-TB Drugs for Treatment of Active Drug-Sensitive TB

Table 3. Dosing Recommendations for Anti-TB Drugs for Treatment of Active Drug-Sensitive TB
TB Drug ARV Drugs Daily Dose
Isoniazid All ARVs 5 mg/kg (usual dose 300 mg)
Rifampina,b

Note: DTG, RAL, and MVC doses need to be adjusted when used with rifampin.		 HIV PIs, DOR, ETR, RPV, BIC, CAB, or EVG/c Not recommended
TAF Use with cautionc at dose indicated below.
All other ARV drugs 10 mg/kg (usual dose 600 mg)
Rifabutina

Note: DOR and RPVd doses need to be adjusted when used with rifabutin.		 PI with COBI, TAF, RPV (IM), BIC, EVG/c-containing regimens Not recommended
DTG, RAL, DOR, EFV, RPV (PO onlyd) 5 mg/kg (usual dose 300 mg)
HIV PIs with RTV 150 mge
EFV 450–600 mg
Pyrazinamide All ARVs Weight-Based Dosing
  • Weighing 40–55 kg: 1,000 mg (18.2–25.0 mg/kg)
  • Weighing 56–75 kg: 1,500 mg (20.0–26.8 mg/kg)
  • Weighing 76–90 kg: 2,000 mg (22.2–26.3 mg/kg)
  • Weighing >90 kg: 2,000 mgf
Ethambutol All ARVs Weight-Based Dosing
  • Weighing 40–55 kg: 800 mg (14.5–20.0 mg/kg)
  • Weighing 56–75 kg: 1,200 mg (16.0–21.4 mg/kg)
  • Weighing 76-90 kg: 1,600 mg (17.8–21.1 mg/kg)
  • Weighing >90 kg: 1,600 mgf

a For more detailed guidelines on use of different ARV drugs with rifamycin, clinicians should refer to the Drug-Drug Interactions section of the Adult and Adolescent Antiretroviral Guidelines.

b Higher doses may be needed in the treatment of TB meningitis. Expert consultation is advised.

c This combination has not been tested in patients to confirm pharmacokinetic and virologic efficacy among patients taking full dose ART and TB regimens.

d Intramuscular long-acting RPV is not recommended with rifabutin. PO RPV can be used but the dose should be increased to 50 mg daily.

e Acquired rifamycin resistance has been reported in patients with inadequate rifabutin levels while on 150 mg twice weekly, dosing together with RTV-boosted PIs. May consider therapeutic drug monitoring (TDM) when rifabutin is used with an RTV-boosted PI and adjust dose accordingly.

f Monitor for therapeutic response and consider TDM to assure dosage adequacy in patients weighing >90 kg.

For information regarding the evidence ratings, refer to the Rating System for Prevention and Treatment Recommendations in the Introduction section of the Adult and Adolescent Opportunistic Infection Guidelines.

Key: ARV = antiretroviral; BIC = bictegravir; CAB = cabotegravir; COBI = cobicistat; DOR = doravirine; DTG = dolutegravir; EFV = efavirenz; ETR = etravirine; EVG/c = elvitegravir/cobicistat; MVC = maraviroc; PI = protease inhibitor; PO = oral; RAL = raltegravir; RPV = rilpivirine; RTV = ritonavir; TAF = tenofovir alafenamide; TB = tuberculosis; 

Tables

Table 3. Dosing Recommendations for Anti-TB Drugs for Treatment of Active Drug-Sensitive TB

Table 3. Dosing Recommendations for Anti-TB Drugs for Treatment of Active Drug-Sensitive TB
TB Drug ARV Drugs Daily Dose
Isoniazid All ARVs 5 mg/kg (usual dose 300 mg)
Rifampina,b

Note: DTG, RAL, and MVC doses need to be adjusted when used with rifampin.		 HIV PIs, DOR, ETR, RPV, BIC, CAB, or EVG/c Not recommended
TAF Use with cautionc at dose indicated below.
All other ARV drugs 10 mg/kg (usual dose 600 mg)
Rifabutina

Note: DOR and RPVd doses need to be adjusted when used with rifabutin.		 PI with COBI, TAF, RPV (IM), BIC, EVG/c-containing regimens Not recommended
DTG, RAL, DOR, EFV, RPV (PO onlyd) 5 mg/kg (usual dose 300 mg)
With HIV PIs with RTV 150 mge
EFV 450–600 mg
Pyrazinamide All ARVs Weight-Based Dosing
  • Weighing 40–55 kg: 1,000 mg (18.2–25.0 mg/kg)
  • Weighing 56–75 kg: 1,500 mg (20.0–26.8 mg/kg)
  • Weighing 76–90 kg: 2,000 mg (22.2–26.3 mg/kg)
  • Weighing >90 kg: 2,000 mgf
Ethambutol All ARVs Weight-Based Dosing
  • Weighing 40–55 kg: 800 mg (14.5–20.0 mg/kg)
  • Weighing 56–75 kg: 1,200 mg (16.0–21.4 mg/kg)
  • Weighing 76-90 kg: 1,600 mg (17.8–21.1 mg/kg)
  • Weighing >90 kg: 1,600 mgf

a For more detailed guidelines on use of different ARV drugs with rifamycin, clinicians should refer to the Drug-Drug Interactions section of the Adult and Adolescent Antiretroviral Guidelines.

b Higher doses may be needed in the treatment of TB meningitis. Expert consultation is advised.

c This combination has not been tested in patients to confirm pharmacokinetic and virologic efficacy among patients taking full dose ART and TB regimens.

d Intramuscular long-acting RPV is not recommended with rifabutin. PO RPV can be used but the dose should be increased to 50 mg daily.

e Acquired rifamycin resistance has been reported in patients with inadequate rifabutin levels while on 150 mg twice weekly, dosing together with RTV-boosted PIs. May consider therapeutic drug monitoring (TDM) when rifabutin is used with an RTV-boosted PI and adjust dose accordingly.

f Monitor for therapeutic response and consider TDM to assure dosage adequacy in patients weighing >90 kg.

For information regarding the evidence ratings, refer to the Rating System for Prevention and Treatment Recommendations in the Introduction section of the Adult and Adolescent Opportunistic Infection Guidelines.

Key: ARV = antiretroviral; BIC = bictegravir; CAB = cabotegravir; COBI = cobicistat; DOR = doravirine; DTG = dolutegravir; EFV = efavirenz; ETR = etravirine; EVG/c = elvitegravir/cobicistat; MVC = maraviroc; PI = protease inhibitor; PO = oral; RAL = raltegravir; RPV = rilpivirine; RTV = ritonavir; TAF = tenofovir alafenamide; TB = tuberculosis; 

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