Nitroimidazole antimycobacterial (MDR-TB)
Delamanid
Brand names: Deltyba
Adult dose
Dose: 100mg BD for 24 weeks (with optimised background regimen)
Route: Oral
Frequency: BD with food
Clinical pearls
- WHO MDR-TB consolidated guideline: Group C agent
- BTS/SIGN; UKHSA TB strategy
- Specialist TB centre prescribing; ECG and electrolyte monitoring throughout
Contraindications
- Albumin <2.8 g/dL
- Severe QT prolongation / risk factors
- Hypersensitivity
Side effects
- QT prolongation (significant)
- Nausea
- Vomiting
- Headache
- Insomnia
- Hyperuricaemia
- Hepatotoxicity
Interactions
- QT-prolonging drugs (avoid)
- Strong CYP3A4 inducers
- Bedaquiline (additive QT)
Monitoring
- ECG (QT) at baseline, monthly
- Electrolytes (K, Mg)
- LFTs
- Albumin
- Treatment response (smear, culture)
Reference: BNF; WHO MDR-TB; BTS/SIGN; UKHSA; SmPC; https://bnf.nice.org.uk/drugs/delamanid/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Pathways
- Infective Endocarditis · ESC 2023 Infective Endocarditis Guidelines; NICE NG41
- Eczema Herpeticum · BAD; NICE CKS
- Suspected Bacterial Meningitis (Adult) · NICE NG240 (2024); NICE NG143 (paeds)
- Clostridioides difficile Colitis · NICE NG199 (2021); IDSA/SHEA 2021
- Returning Traveller — Fever · NaTHNaC; PHE; ESCMID 2018
- Malaria — Diagnosis & Management · PHE 2016; WHO 2023