TPT can be associated with a wide variety of adverse events (common adverse effects for each regimen are noted in Table). In general, mild to moderate adverse events (i.e., those not interfering with, or only modestly interfering with, instrumental activities of daily living, also known as Grade-1 and Grade-2 adverse events) should result in greater monitoring but do not necessarily require stopping therapy. However, severe adverse events that interfere with normal daily activity, including the ability to go to work (Grade 3) or any life-threatening or disabling adverse event (Grade 4) should lead to a pause in treatment until recovery or permanent discontinuation. A change to an alternative regimen should be considered once the patient has recovered. Detailed approaches to the management of specific adverse events have been published elsewhere.2,21
Evidence is lacking regarding the best approach to manage interruptions in TPT. However, the WHO has provided recommendations based on expert opinion.2,84
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