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TB Drug Calculator

Reference: Am J Resp Crit Care Med, Vol 167 (2003), pp606-7 (+erratum); MMWR 9 Dec 2011 60(48), pp1650-3 (+erratum). Program ©2007, 2010, 2012, 2014, 2016 Cameron Kaiser, MD, MPH.

Disclaimer: This program, although based on published American Thoracic Society and Centers for Disease Control guidelines for antituberculosis drug dosing, is not affiliated with or endorsed by the CDC, the ATS or its membership, and should not be used to replace appropriate clinical judgment or expert consultation with a physician experienced in the management of TB cases. This application is distributed in the hope that it will be useful, but without any express or implied warranty, including regarding merchantability or fitness for a particular purpose. You alone are solely responsible for any error committed, or any misapplication of data presented.

Instructions (READ FIRST!): This dosing calculator generates typical doses for most anti-tuberculosis drugs, based on and rounded to closest known available standard strengths (such as capsules, elixirs, tablets, etc.) and capped at suggested maximums. mg/kg is provided. IV/IM doses are rounded to the nearest quarter-volume for ease in administration and pill splitting is not assumed by this calculator except if "scored" is listed for pediatric dosing; thus, very small doses may be difficult to achieve with standard available strengths and doses that should require cross-checking to avoid potential overdoses are flagged in bold red. In these cases, more precise dosing or pharmacy consultation is recommended, especially for neonates or very young children. Similarly, medications, or dosing administrations, under conditions requiring expert consultation before proceeding are not computed and simply shown with a CONSULT recommendation instead.

Ethionamide, PAS and cycloserine doses below are target doses. These medications should be ramped and divided doses are strongly advised. This calculator does not compute streptomycin or clofazimine doses.

For individuals weighing less than 40kg (88lb), the calculator will use pediatric values; pediatric patients over 40kg should be dosed as adults according to the ATS, which is observed by this calculator. You may force pediatric or adult dosing; see the dosage report generated to change settings.

This revised version of the Drug Calculator also computes rifapentine (RPT) doses in compliance with the new isoniazid/rifapentine regimen for latent (LTBI) treatment as released by the US CDC. INH/RPT treatment for LTBI should only be administered to eligible patients over 12 years of age, under directly observed therapy (DOT) at this time. Pediatric-weight RPT under these conditions will appear with a CONSULT recommendation unless overridden.

Drug selection and length of treatment are not addressed by this calculator and should be based on local protocol, resistance profile, coincident medical comorbidity and clinical presentation. Only daily and biweekly dosing is computed for the most common drugs I use locally; if you have other suggestions, please send me your comments.

Weight (IBW if possible):

Drug dosages computed for:
first line: isoniazid (INH), rifampin (RIF), ethambutol (EMB), pyrazinamide (PZA), rifabutin (RFB), rifapentine (RPT) (LTBI only);
second/third line: levofloxacin and moxifloxacin; amikacin/kanamycin, capreomycin, ethionamide (ETH), p-aminosalicylic acid (PAS), cycloserine (CS), linezolid (LZ)

Cameron Kaiser, MD, MPH