Adult Dosing

Active pulmonary tuberculosis

• Initial treatment: 15-20 mg/kg PO daily
• Max: 1600 mg/day

Note:

• Part of multi-drug regimen

Pediatric Dosing

Pulmonary tuberculosis

<5 yrs

• Dose: 15 mg/kg PO daily
• Max: 1000 mg/day

>5 yrs

• Dose: 15-20 mg/kg PO daily
• Max: 1000 mg/day

Note:

• Part of multi-drug regimen

[Outline]

• Adult Dosing
• Pediatric Dosing

• Treatment of pulmonary tuberculosis in conjunction with at least one other antituberculous drug

• Hypersensitivity to any of the ingredients of the product
• Optic neuritis

• N/A

Renal Dose Adjustment (Based on CrCl)

• >50 mL/min: Normal dose
• 10-50 mL/min: Give dose q24-36 hrs
• <10mL/min: Give dose q48 hrs

Hepatic Dose Adjustment

• Hepatic impairment: Dose adjustments not defined

• Visual acuity due to optic neuritis has been reported with ethambutol. This effect is reversible and related to dose and duration, however irreversible blindness is also been reported. Monitor vision impairment periodically by physical examination including ophthalmoscopy, finger perimetry and testing of color discrimination during the therapy
• It is difficult to evaluate visual acuity in patients with visual defects such as cataracts, recurrent inflammatory conditions of the eye, optic neuritis, and diabetic retinopathy, hence use cautiously and consideration should be given to relationship between benefits expected and possible visual deterioration
• Etambutol can cause liver toxicities including fatalities, monitor liver function test at baseline and periodically thereafter
• Main path of excretion of ethambutol is kidney, hence reduce the dose as determined by serum levels in patients with decreased renal function
• Perform baseline and periodic assessment of organ system functions, including renal, hepatic, and hematopoietic

Cautions: Use cautiously in

• Renal impairment
• Hepatic impairment
• Eye diseases
• Gout

Pregnancy Category:C

Breastfeeding: Limited data indicates low levels of ethambutol is produced in milk following the maternal doses of 15 mg/kg daily and would not be expected to cause any adverse effects in breastfed infants, especially older than 2 months. The amount of ethambutol in milk is insufficient to treat tuberculosis in the breastfed infant. The Centers for Disease Control and Prevention and other professional organizations states not to discourage breastfeeding in women taking ethambutol. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 9 March 2011). As ethambutol is excreted in human milk, manufacturer advises to use ethambutol in nursing mothers only if the expected benefit to the mother outweighs the potential risk to the infant.

• CNS: Headache, dizziness, mental confusion, disorientation, hallucinations
• NEURO: Numbness, tingling sensation
• CV: Myocarditis, pericarditis
• GI: Anorexia, nausea, vomiting, gastrointestinal upset, abdominal pain, livertoxicity, hepatitis
• EENT: Optic neuritis, irreversible blindness, color blindness
• RESP: Pneumonitis
• DERM: Dermatitis, erythema multiforme, pruritus, rash, exfoliative dermatitis
• MUSC: Joint pain, precipitation of acute gout
• HEMA: Thrombocytopenia, leucopenia, neutropenia, eosinophilia, lymphadenopathy
• GU: Elevation of uric acid, nephritis
• MISC: Hypersensitivity, anaphylactic/anaphylactoid reaction, fever, malaise

• Antitubercular agent; inhibits arabinosyl transferases an enzyme involved in cell wall biosynthesis, thereby inhibiting bacterial cell wall complex production leading to an increase in cell wall permeability
• Metabolized by liver
• Renally excreted (50% unchanged); feces (20-22% unchanged)
• Half-life: 3-4 hrs; renal impairment: 8 hrs

US Trade Name(s)

• Myambutol

US Availability

ethambutol

• TABS: 100, 400 mg

Myambutol

• TABS: 100, 400 mg

Canadian Trade Name(s)

• Etibi

Canadian Availability

Etibi

• TABS: 100, 400 mg

UK Trade Name(s)

• N/A

UK Availability

• N/A

Australian Trade Name(s)

• Myambutol

Australian Availability

Myambutol

• TABS: 100, 400 mg

[Outline]

Antimicrobials

Antituberculosis Agents

Miscellaneous Agents

Infectious Disease

Antituberculosis Agents

Miscellaneous Agents

Pricing data from www.DrugStore.com in U.S.A.

• Ethambutol HCl 400 MG TABS [Bottle] (LUPIN PHARMACEUTICALS)
  30 mg = $52.99
  90 mg = $149.95

Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.

• Ethambutol Hydrochloride 100 MG Oral Tablet (Versa Pharmaceutical)
• Ethambutol Hydrochloride 400 MG Oral Tablet (American Health Packaging)
• Ethambutol Hydrochloride 400 MG Oral Tablet (BARR LABORATORIES, INC.)
• Ethambutol Hydrochloride 400 MG Oral Tablet (State of Florida DOH Central Pharmacy)
• Ethambutol Hydrochloride 400 MG Oral Tablet (Versa Pharmaceutical)