Pretomanid - Oral

Pretomanid is an antibiotic. It is used together with other medicines to treat a lung infection known as tuberculosis (TB) that has become resistant to many other antibiotics.

Take Pretomanid exactly as directed by your doctor or according to the instructions on the label. Do not take more or less than instructed by your doctor.

Take this medicine together with food or immediately after a meal. Swallow the tablet whole with a glass of water.

Try to take it at the same time each day.

The dose of Pretomanid will be decided by your doctor. Your doctor will advise you on the treatment timeframe depending on the severity of your infection and response to the medication.

Take this medicine at regular intervals. Do not skip any doses. You must complete the entire course of this medicine. If you don’t, the infection will not be properly controlled.

Any missed doses are recommended to be made up at the end of the treatment.

DO NOT double a dose under any circumstances.

If you often forget to take your medicine, let your doctor and pharmacist know.

Do not take Pretomanid if you ever had an allergic reaction (e.g. rashes, breathlessness, swollen eyes) to this medicine or to a similar group of antibiotics called nitroimidazoles.

Inform your doctor if you have the following conditions:

• history of prolonged QT interval (heart rhythm disorder)
• heart failure (weakness and inability of the heart to pump blood)
• hypothyroidism (underactive thyroid gland)
• low levels of calcium, magnesium or potassium in the blood
• liver disease

Let your doctor know if you are pregnant or breastfeeding.

Why is it important to keep my appointments with the doctor?

Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.

• ECG (test used to record the electrical activity of the heart) must be done before treatment to know if this medicine is suited for you to take.
• Routine tests (e.g. liver function, complete blood count, electrolyte levels [e.g. calcium, magnesium, and potassium], eye examination) may be done while you are being treated with this medicine. Your doctor will advise you about how often you need to have these tests.
• Regular monitoring for signs and symptoms of liver damage (e.g. nausea, abdominal pain, loss of appetite, tiredness, dark coloured urine, swelling in the legs and ankles, yellowing of the skin or eyes), and changes in vision may also be needed.

What must I do to prevent spreading TB to other people?

TB is spread through the air, especially when you cough, sneeze or laugh. Always cover your mouth when you cough, sneeze or laugh. If you use tissue paper, seal it in a plastic bag before you throw it away. If you need to be around people for a long time, be sure to wear a mask that covers your mouth and nose to minimise the risk of passing the disease to other people.

You may still be able to infect others while undergoing treatment for TB. Your doctor may tell you to stay at home to avoid passing the disease to other people. You may need to sleep in a bedroom separate from your family members.

Be sure to finish the course of medication according to your doctor's instructions.

Pretomanid may cause dizziness or changes in vision. If affected, do not drive or take part in any activity in which you need to be alert or need to see clearly.

Other side effects include any of the following: headache, nausea, vomiting, diarrhoea, constipation, indigestion, abdominal pain, decreased appetite, joint pain, back pain, muscle pain, acne, skin itching and difficulty sleeping.

Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:

• rashes, breathlessness, swelling of the face, eyes or mouth
• yellowing of the skin or eyes, abdominal pain, dark coloured urine, tiredness, swelling in the legs and ankles

This medicine may cause the level of your red blood cells, white blood cells and platelets to drop.

Red blood cells carry oxygen around your body. A fall in the level of red blood cells may make you feel tired and worn out.

White blood cells help your body to fight infections. A fall in the level of your white blood cells may put you at higher risk for infections, such as coughs, colds and flu, which may lead to more serious infections. Avoid crowded places and people who are sick. Inform your doctor if you have a fever, cough, or flu that does not go away.

Platelets help your blood to clot when there is a cut in the skin. A fall in the level of your platelets may put you at risk of bleeding more than usual. Do not take part in activities where you may fall or get injured, such as contact sports. Inform your doctor if you get any unusual bruising (large bruises or several bruises, especially if the bruises appeared on their own) or bleeding that takes a long time to stop (for example, too much bleeding when you floss or brush your teeth).

Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.

Inform your doctor and pharmacist if you are taking any of these medicines:

• other medicines to treat TB e.g. rifampicin, rifamycin, rifapentine, rifabutin
• medicines for HIV infection e.g. efavirenz, etravirine
• medicines for epilepsy (fits or seizures) e.g. carbamazepine, phenytoin
• medicines for cancer e.g. methotrexate, paclitaxel
• medicines for high blood pressure e.g. verapamil, valsartan
• blood-thinning medicines e.g. warfarin, dabigatran
• certain antibiotics e.g. benzylpenicillin, ciprofloxacin
• cholesterol-lowering medicines e.g. rosuvastatin
• indometacin (medicine for pain and inflammation)
• St. John’s wort (herbal medicine)

This list does not include all medicines that may interact with Pretomanid.

Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements, and medicines that you buy without a prescription.

Avoid alcohol.

Store in a cool, dry place away from the reach of children.

Medicines must not be used past the expiry date.