Which TB treatment may require additional supplementation due to a side effect?

Isoniazid is a first-line antitubercular medication that is commonly used in the treatment of tuberculosis (TB). One significant side effect associated with isoniazid is its potential to cause pyridoxine (vitamin B6) deficiency. This deficiency can lead to peripheral neuropathy, which is characterized by feelings of tingling, numbness, or pain in the extremities.

To mitigate this risk, patients taking isoniazid are often supplemented with pyridoxine. The supplementation helps to prevent the development of neuropathy and allows for the effective continuation of TB treatment without compromising patient comfort or health. In clinical practice, it is standard to prescribe vitamin B6 alongside isoniazid to combat this specific side effect and improve patient outcomes.

In contrast, the other medications listed do not typically necessitate such supplementation for their commonly associated side effects. For example, rifampin may cause liver enzyme elevation, but this does not usually require additional supplementation. Ethambutol can lead to visual disturbances, and pyrazinamide may cause liver toxicity, but again, they do not have the same specific requirement for supplementation as isoniazid does for pyridoxine.