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Drug dosing for treatment of drug-susceptible tuberculosis (rifapentine-moxifloxacin-based regimen) in patients ≥12 years

Drug dosing for treatment of drug-susceptible tuberculosis (rifapentine-moxifloxacin-based regimen) in patients ≥12 years
Drug Preparations Daily dose
(administered as a single dose)
Isoniazid* Oral:
  • Tablet: 100 mg, 300 mg
  • Oral solution: 50 mg/5 mL

IM, IV:

  • Solution for injection: 100 mg/mL
 300 mg for 17 weeks
Rifapentine Oral:
  • Tablet: 150 mg
 1200 mg for 17 weeks
Moxifloxacin Oral:
  • Tablet: 400 mg

IV:

  • Solution for injection: 400 mg/250 mL
 400 mg for 17 weeks
Pyrazinamide Oral:
  • Tablet: 500 mg
 Dosing based on patient weight:
  • ≥40 to 55 kg: 1000 mg
  • ≥56 to 75 kg: 1500 mg
  • >76 kg: 2000 mg
  • The regimen summarized in this table is intended for patients with age ≥14 years, weight ≥40 kg, and CrCl ≥30 mL/min.
  • Antituberculous agents are used in multidrug combination regimens. The shortened 4-month regimen consists of an intensive phase (8 weeks of rifapentine, isoniazid, pyrazinamide, and moxifloxacin administered once daily), followed by a continuation phase (9 weeks of rifapentine, isoniazid, and moxifloxacin administered once daily). Refer to the UpToDate clinical topic for discussion.

IM: intramuscular; IV: intravenous; CrCl: creatinine clearance.

* Pyridoxine (vitamin B6) 25 to 50 mg/day is given with isoniazid to individuals at risk for neuropathy (eg, pregnant women, individuals with HIV infection, diabetes, alcoholism, malnutrition, chronic renal failure, or advanced age). For patients with peripheral neuropathy, experts recommend increasing pyridoxine dose to 100 mg/day.

¶ Dosing based on actual weight in patients within the stated weight categories (up to 90 kg)[1-3]. Because optimal antituberculous drug dosing has not been established for patients >90 kg or obese (BMI >30), they should undergo serum concentration monitoring (refer to UpToDate text).

References:
  1. Dorman SE, Nahid P, Kurbatova EV, et al. Four-month rifapentine regimens with or without moxifloxacin for tuberculosis. N Engl J Med 2021; 384:1705.
  2. Nahid P, Dorman SE, Alipanah N, et al. Official American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America clinical practice guidelines: Treatment of drug-susceptible tuberculosis. Clin Infect Dis 2016; 63:e147.
  3. Saukkonen JJ, Duarte R, Munsiff SS, et al. Updates on the treatment of drug-susceptible and drug-resistant tuberculosis: An official ATS/CDC/ERS/IDSA clinical practice guideline. Am J Respir Crit Care Med 2025; 211:15.
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