Mention new drugs approved for treatment of tuberculosis.
Reading File
Finding Sources
Searching PubMed
tuberculosis AND (bedaquiline OR delamanid OR pretomanid)
Searching the Web
WHO tuberculosis new medicines bedaquiline delamanid pretomanid approval regulatory status
Reading File
Finding Sources
Finding Sources
Finding Sources
The important newer anti-tuberculosis drugs are mainly used for drug-resistant TB, especially multidrug-resistant or rifampicin-resistant TB (MDR/RR-TB):
| Drug | Class and action | Main role | Key adverse effects / cautions |
|---|---|---|---|
| Bedaquiline | Diarylquinoline. Inhibits mycobacterial ATP synthase. | Core drug for MDR/RR-TB; used in short all-oral regimens. FDA approved in 2012. | QT prolongation, hepatotoxicity; important CYP3A4 drug interactions. |
| Delamanid | Nitro-dihydro-imidazo-oxazole prodrug. Inhibits mycolic-acid synthesis. | Option in longer individualized MDR/RR-TB regimens. Approved in several countries/Europe, but not FDA-approved in the US. | QT prolongation; use with ECG monitoring, particularly with other QT-prolonging drugs. |
| Pretomanid | Nitroimidazooxazine. Inhibits mycolic-acid synthesis under aerobic conditions and has activity against nonreplicating bacilli. | Used only in combination with bedaquiline and linezolid, with or without moxifloxacin. FDA approved in 2019 for highly drug-resistant pulmonary TB. | Hepatotoxicity, QT prolongation, neuropathy and myelosuppression largely require monitoring within the combination regimen. |
Current important regimens
- BPaLM: Bedaquiline + Pretomanid + Linezolid + Moxifloxacin for 6 months, for eligible MDR/RR-TB.
- BPaL: Bedaquiline + pretomanid + linezolid, used when fluoroquinolone resistance means moxifloxacin should be omitted.
WHO continues to prioritize BPaLM/BPaL for eligible drug-resistant TB patients, as summarized in its 2024 TB treatment update. WHO also lists pretomanid to support implementation of these shorter regimens in its essential medicines update.
Exam point: The three “new drugs” commonly named are bedaquiline, delamanid, and pretomanid. They should never be used alone, because resistance can emerge quickly.
Sources: Goodman & Gilman’s The Pharmacological Basis of Therapeutics, section “Newer Drugs” and “Bicyclic Nitroimidazoles: Delamanid and Pretomanid”; Katzung’s Basic and Clinical Pharmacology, 16th ed., sections “Bedaquiline” and “Pretomanid.”
Write the name of two recently approved drugs for MDR Tuberculosis.
Reading File
Finding Sources
Searching PubMed
tuberculosis AND (bedaquiline OR delamanid)
Searching the Web
WHO new medicines MDR TB bedaquiline delamanid
- Bedaquiline
- Delamanid
Both are newer drugs used in multidrug-resistant tuberculosis (MDR-TB).
This is a shared conversation. Sign in to Orris to start your own chat.