During bedaquiline treatment, nausea, joint pain, and headache are relatively common adverse reactions. Most symptoms are mild to moderate and can be effectively relieved through reasonable adjustment and symptomatic management, but severe conditions should be watched for.

I. Management of Nausea

1. Adjustment of administration method

Bedaquiline should be taken with food to reduce gastric irritation. Avoid taking it on an empty stomach, and do not lie down immediately after taking it.

2. Dietary adjustment

Eat small, frequent meals and avoid greasy, spicy, and strongly scented foods. Choose light, easily digestible foods such as rice, noodles, and soda crackers.

3. Fluid supplementation

Drink water in small amounts multiple times to prevent dehydration. Ginger tea, peppermint tea, and similar beverages may be tried to relieve nausea.

4. Pharmacologic intervention

If nausea persistently affects eating, antiemetic drugs may be used under medical guidance. Do not use drugs arbitrarily on your own to avoid interactions with bedaquiline.

5. Watch for severe conditions

If frequent vomiting, inability to eat, obvious dehydration, or worsening abdominal pain occurs, seek medical attention immediately, and suspend bedaquiline and evaluate if necessary.

II. Management of Joint Pain

1. Assess the cause

Joint pain may be related to bedaquiline, or may be caused by tuberculosis itself, concomitant medications, or other diseases, and needs to be judged by a doctor.

2. Rest and activity

Reduce weight-bearing activity during the acute phase and rest appropriately. After symptoms improve, gentle joint movement can be performed to avoid stiffness caused by long-term immobility.

3. Physical measures

Local hot or cold compresses can relieve pain. Gentle massage and moderate stretching help reduce discomfort.

4. Analgesic drugs

Acetaminophen or nonsteroidal anti-inflammatory drugs may be used under medical guidance. Avoid drugs that interact with bedaquiline, and pay attention to liver function.

5. Watch for severe conditions

If joint redness, swelling, heat, and pain are obvious, movement is limited, or fever is present, seek medical attention as soon as possible to rule out infectious arthritis or other serious problems.

III. Management of Headache

1. Lifestyle adjustment

Maintain a regular routine and ensure adequate sleep. Avoid staying up late, overwork, and emotional stress.

2. Environmental adjustment

Keep the environment quiet and the light soft. Reduce screen time and avoid strong light and noise stimulation.

3. Fluid supplementation

Dehydration can trigger or worsen headache, so drink an appropriate amount of water. Avoid excessive caffeine and alcohol.

4. Analgesic management

For mild to moderate headache, analgesics such as acetaminophen may be used under medical guidance. Avoid long-term or excessive self-medication.

5. Watch for severe conditions

If headache is severe, sudden in onset, accompanied by vomiting, blurred vision, altered consciousness, or neck stiffness, seek medical attention immediately to rule out serious neurological problems.