From the FDA Drug Label
Pretomanid Tablets: • Administer Pretomanid Tablet 200 mg orally (1 tablet of 200 mg), once daily, for 26 weeks with food.
Pretomanid Tablets: • Pretomanid Tablet 200 mg orally once daily for 26 weeks. Administer Pretomanid Tablets whole with water.
The dose of pretomanid is 200 mg orally once daily for 26 weeks, administered with food 1, 1, 1.
From the Research
The standard dose of pretomanid is 200 mg (one tablet) taken orally once daily with food for 26 weeks (6 months) as part of the BPaL regimen for drug-resistant tuberculosis. This regimen combines pretomanid with bedaquiline and linezolid, and has been shown to have a favorable outcome in 84-93% of patients with extensively drug-resistant tuberculosis (XDR-TB) or pre-XDR-TB 2. The BPaL regimen has been reported to have 90% efficacy against highly drug-resistant tuberculosis, and the incidence of adverse events has been found to be lower with a linezolid dose of 600 mg daily for 26 weeks compared to other doses and durations 2. Pretomanid works by inhibiting mycolic acid biosynthesis, disrupting the cell wall of Mycobacterium tuberculosis, and also by generating reactive nitrogen species that have antimicrobial activity under anaerobic conditions, making it particularly effective against drug-resistant TB strains 3. Patients should be monitored for side effects including liver problems, peripheral neuropathy, and myelosuppression during treatment.
Some key points to consider when prescribing pretomanid include:
- The importance of taking the medication at the same time each day to maintain consistent blood levels
- The need to avoid alcohol while taking this medication
- The potential for adverse events, including liver problems, peripheral neuropathy, and myelosuppression, and the need for regular monitoring
- The effectiveness of the BPaL regimen in treating drug-resistant tuberculosis, with a favorable outcome in 84-93% of patients 2, 4
- The potential benefits of using pretomanid in combination with other drugs, such as bedaquiline and linezolid, to improve treatment outcomes for patients with drug-resistant tuberculosis 5, 6.