Delamanid is an important drug for the treatment of multidrug-resistant tuberculosis. To ensure efficacy and reduce adverse reactions, patients must strictly master its administration method, principles for handling missed doses, and dose adjustment rules.

I. Administration with Meals and Key Points

1. Must be taken with meals

The absorption of Delamanid is significantly affected by food. Patients should take the drug with a meal. Taking it with food can effectively improve the bioavailability of the drug and ensure sufficient therapeutic concentration in the blood.

2. Swallow whole

The tablet should be swallowed whole with water. Do not chew, crush, or split the tablet, so as not to affect the drug's release and absorption characteristics.

3. Principle of combination therapy

Delamanid cannot be used alone to treat tuberculosis. It must be used as part of a combination therapy regimen together with other anti-tuberculosis drugs to prevent the development of drug resistance.

II. Handling of Missed Doses

1. Principle of timely make-up dosing

If a patient forgets to take the drug and more than 12 hours remain before the next scheduled dose, the missed dose should be taken as soon as possible.

2. Close to the next dose time

If, when the missed dose is discovered, less than 12 hours remain before the next dose, the missed dose should be skipped, and the next dose should be taken at the scheduled time as usual.

3. Never double the dose

Under no circumstances should a patient take double the dose at the next administration to make up for a missed dose, as this may increase the risk of drug toxicity and side effects.

III. Dose Adjustment and Special Precautions

1. Standard dose and course of treatment

The recommended adult dose is usually 100 mg twice daily (i.e., 200 mg/day), taken with meals, and the course of treatment is usually 24 weeks. The specific course of treatment should be determined by the physician according to the patient's condition.

2. Dose adjustment related to adverse reactions

If a patient develops serious cardiac adverse reactions such as QT interval prolongation during medication, the physician should assess the risk. If necessary, the drug should be suspended or the concomitant medication regimen adjusted, rather than arbitrarily reducing the dose on one's own.

3. Patients with hepatic or renal impairment

For patients with severe hepatic or renal impairment, there is currently a lack of sufficient pharmacokinetic data. The drug should be used cautiously under strict medical monitoring, with close attention to changes in liver function indicators.

4. Avoid discontinuing the drug on one's own

Patients must not discontinue the drug or change the dose on their own because symptoms improve or because of mild discomfort. They must strictly follow the physician's instructions to complete the full course of treatment to prevent treatment failure or relapse.