For a patient on the 4R regimen, what is the primary concern?

The primary concern for a patient on the 4R regimen, which typically consists of Rifampin, Rifabutin, and other supportive medications, is peripheral neuropathy. This side effect is particularly important because it can result from the use of certain medications, such as isoniazid (if included in the regimen), which is known to potentially cause nerve damage if not supplemented with vitamin B6 (pyridoxine). Monitoring for signs of peripheral neuropathy is crucial, as early detection can facilitate timely management and prevention of further complications.

In the context of this regimen, flu-like syndrome may occur due to hypersensitivity to rifamycins, but it is usually not as serious a concern as neuropathy. Renal toxicity is a consideration with some antitubercular agents, but this is less commonly associated with the 4R regimen itself. Finally, while interactions with HIV medications can be a relevant issue, the focus on direct side effects leads to peripheral neuropathy being the more pressing concern to monitor in patients undergoing this treatment for tuberculosis.