Dosing regimens for the treatment of latent tuberculosis* in solid organ transplant candidates and recipients

	Nonpregnant adults
Isoniazid^¶	Standard regimen: 300 mg PO daily for 9 months Alternate regimens: 300 mg PO daily for 6 months 900 mg PO twice weekly^Δ for 6 to 9 months
Isoniazid and rifapentine^◊	Isoniazid (orally once weekly for 12 doses; direct observation is preferred): 15 mg/kg, rounded up to the nearest 50 or 100 mg; 900 mg maximum Rifapentine (orally once weekly for 3 months; direct observation is preferred): 10 to 14 kg: 300 mg 14.1 to 25 kg: 450 mg 25.1 to 32 kg: 600 mg 32.1 to 49.9 kg: 750 mg >50 kg: 900 mg maximum
Rifampin^◊	600 mg PO daily for 4 months
Isoniazid and rifampin^◊	Isoniazid 300 mg PO daily for 3 months Rifampin 600 mg PO daily for 3 months

PO: by mouth.
* For discussion of clinical approach to selecting a regimen for treatment of latent tuberculosis, refer to the UpToDate topic on treatment of latent tuberculosis infection in solid-organ transplantation.
¶ Pyridoxine supplementation (25 to 50 mg PO daily for adults) should be considered for patients on prolonged isoniazid; this is especially important for patients with conditions that can predispose to neuropathy (including diabetes, uremia, alcoholism, malnutrition, and HIV infection), as well as in the setting of pregnancy and seizure disorders.
Δ Twice-weekly regimens must be administered with directly observed therapy.
◊ Rifamycins should be avoided or used cautiously for the treatment of latent tuberculosis after transplant with close attention to drug-interactions, dose adjustments for immunosuppressive medications, and monitoring for potential drug toxicities.

Data from: Guidelines for the treatment of latent tuberculosis infection: Recommendations from the national tuberculosis controllers association and CDC, 2020. MMWR 2020: 69:1.

Graphic 65944 Version 30.0

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Dosing regimens for the treatment of latent tuberculosis* in solid organ transplant candidates and recipients