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Ethambutol information from DrugsUpdate  

See Available Brands of Ethambutol in India

P - Contraindicated in pregnancy

Ethambutol (commonly abbreviated EMB or simply E) is a bacteriostatic antimycobacterial drug prescribed to treat tuberculosis.  It is usually given in combination with other tuberculosis drugs, such as isoniazid, rifampicin and pyrazinamide.

It is sold under the trade names Myambutol and Servambutol.

Pharmacodynamics

Pharmacokinetics

Ethambutol interferes with RNA synthesis, causing suppression of Mycobacteria multiplication. It also has bacteriostatic action against M tuberculosis by acting on rapidly growing pathogens in cavity walls and is also effective in slow-growing pathogens. Has some action against atypical opportunistic Mycobacteria e.g. M kansasii, M avium complex (MAC).

Absorption
80% is absorbed from the GI tract (oral).

Distribution
Lungs, kidneys, erythrocytes, CSF (in meningitis); crosses the placenta and enters breast milk.

Metabolism

Hepatic: Converted to the aldehyde and dicarboxylic acid derivatives (inactive).

Excretion
Via urine (as unchanged, 8-15% as metabolites), via faeces (20% as unchanged); 3-4 hr (elimination half-life).

Ethambutol Indications / Ethambutol Uses

Information Not Available

Ethambutol Adverse Reactions / Ethambutol Side Effects

Retrobulbar neuritis with a reduction in visual acuity, constriction of visual field, central or peripheral scotoma and green-red colour blindness. Retinal haemorrhage (rare); reduced renal clearance of urates (acute gout); GI disturbances eg, nausea, vomiting, abdominal pain, anorexia; rash, headache, dizziness, confusion, hallucinations, malaise, jaundice; thrombocytopenia; pulmonary infiltrates.

Precautions

Information Not Available

Special Precautions

Impaired pre-treatment visual acuity, elderly, children. Perform liver, kidney and visual acuity tests regularly. Caution when assessing visual acuity in patients with cataracts, DM, recurrent eye inflammation to make sure that changes are not due to the underlying causes.

Other Drug Interactions

Absorption delayed or reduced by aluminum hydroxide. Synergistic effect with other antitubercular agents.

Other Interactions

Information Not Available

Dosage

Oral
Primary treatment of pulmonary and extrapulmonary tuberculosis
Adult: As hydrochloride: Initial 8 wk: 15 mg/kg/day or 30 mg/kg thrice wkly given with isoniazid, rifampicin and pyrazinamide. For patients with history of antimycobacterial therapy: Initial doses: 25 mg/kg/day for 60 days, thereafter reduce to 15 mg/kg/day.
Child: For treatment of drug-resistant tuberculosis: 15-25 mg/kg daily or 50 mg/kg twice wkly. For congenitally acquired tuberculosis: Neonates: 15 mg/kg once daily and ≥1 mth: 15 mg/kg once daily or 30 mg/kg 3 times wkly for 2 mth initial treatment phase.

Elderly
Renal impairment: Dose reduction may be required.

Food(before/after)

Should be taken with food

List of Contraindications

Ethambutol and Pregnancy

Category B: Either animal-reproduction studies have not demonstrated a foetal risk but there are no controlled studies in pregnant women or animal-reproduction studies have shown an adverse effect (other than a decrease in fertility) that was not confirmed in controlled studies in women in the 1st trimester (and there is no evidence of a risk in later trimesters).

Ethambutol and Lactation

Contraindicated in lactation

Ethambutol and Children

Information Not Available

Ethambutol and Geriatic

Information Not Available

Ethambutol and Other Contraindications

Hypersensitivity; optic neuritis. Lactation

Storage

Oral
Store at 15-25°C.

Lab interference

Oral
Store at 15-25°C.

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