Question

The anti-tubercular drug safe in liver disease is

• A. INH
• B. Rifampicin
• C. Ethambutol
• D. Pyrazinamide

Hint:

Think about which first-line ATT drug's toxicity is ocular rather than hepatic.

Answer 1

The Correct Option is C

This question tests which anti-TB drug spares the liver.

1. INH: causes hepatocellular injury; unsafe in liver disease.
2. Rifampicin: causes cholestatic hepatotoxicity; unsafe.
3. Ethambutol: cleared renally, main toxicity is ocular (optic neuritis), not hepatic; safe to continue.
4. Pyrazinamide: most hepatotoxic first-line drug; unsafe.

A quick way to remember it: of the four first-line drugs, only Ethambutol's toxicity is in the eye, not the liver. Correct answer: Ethambutol.