Objective: Adverse drug reactions are the most common cause of drug withdrawal in chronic treatment settings. Tuberculosis (TB) has been considered a recurrent and relapsing disease that needs long-term therapy. Most patients suffer from the adverse effects of TB therapy. Hence, various remedies were used to tackle these adverse effects including antioxidant vitamins, herbal remedies, and others. Aims: The present intervention study aims to investigate the role of propolis in protecting the animal model against oxidant/antioxidant induced by TB therapy together with the propolis role in modulation of metabolic profile as part of lipid peroxidation context. Methods: Serum was collected from rats exposed to rifampicin/isoniazid with or without propolis therapy alongside the control placebo group for comparison. Results: The results have shown a significant (p<0.05) reduction of malondialdehyde and significant (p<0.05) elevation of total antioxidant status. Lipid profile positively improved indicated by significantly reduced total cholesterol, triglyceride, and elevated high-density lipoprotein. Conclusion:  our study confirmed that propolis provides protection against redox and metabolic derangement induced by rifampicin/isoniazid medications which are in current TB therapy, therefore, we do advise the use of propolis as an adjunct therapy for patients on such medications.

The elimination of most drugs based on liver/renal excretion; making liver and kidneys the commonest target organ for exposure to toxic materials. Long-term use of drugs surpassed the effect and aggravate the toxicity. Tuberculosis (TB) is chronic disease with long-term therapy and the deleterious impact of antitubelculosis is certain. Various pharmacokinetic manoveuors were proposed to avoid the potential harmful effect of TB therapy. The present study aimed at mitigating the destructive effects of TB therapy using propolis. To do so, rats were exposed to isoniazid or rifampicin or a combination of them in groups of 8 rats each for a period of 8-weeks these groups were matched with similar group with a propolis ad-on therapy. These results were compared to propolis-free negative control group and positive propolis-treated group. The histological and laboratory findings confirmed that isoniazid or rifampicin or a combination of them jeopardized hepatorenal function and induced deleterious damage. However, isoniazid has shown more intensive deleterious effect compared to rifampicin. Nonetheless, propolis restore the quasi-equilibrium status for kidney and liver via restoring its normal architecture and functionality. To sum up, the potential defect of anti-TB was restored via using propolis as add-on therapy, we do advise using propolis as an adjuvant TB therapy in critically-ill and clinical cases required long-term TB therapy.