ETHAMBUTOL

Drugs in Pregnancy and Lactation.

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Name: ETHAMBUTOL
Class: Antituberculosis Agent
Risk Factor:    B

Fetal Risk Summary

No reports linking the use of ethambutol with congenital defects have been located. The drug crosses the placenta to the fetus (1,2). In a woman who delivered at 38 weeks' gestation, ethambutol concentrations in the cord and maternal blood 30 hours after an 800-mg (15 mg/kg) dose were 4.1 and 5.5 ng/mL, respectively, a cord:maternal serum ratio of 0.75 (1). The amniotic fluid ethambutol level was 9.5 ng/mL (1). These levels were within the range (1–5 ng/mL) required to inhibit the growth of Mycobacterium tuberculosis (1).

The literature supports the safety of ethambutol in combination with isoniazid and rifampin during pregnancy (3,4,5,6 and 7). One investigator studied 38 patients (42 pregnancies) receiving antitubercular therapy (3). The minor abnormalities noted were within the expected frequency of occurrence. Another researcher observed six aborted fetuses at 5–12 weeks of age (4). Embryonic optic systems were specifically examined and were found to be normal. Most reviewers consider ethambutol, along with isoniazid and rifampin, to be the safest antituberculosis therapy (8,9). However, long-term follow-up examinations for ocular damage have not been reported, causing concern among some clinicians (10).

Breast Feeding Summary

Ethambutol is excreted into human milk. Milk concentrations in two women (unpublished data) were 1.4 µg/mL (after an oral dose of 15 mg/kg) and 4.60 µg/mL (dosage not given) (11). Corresponding maternal serum levels were 1.5 µg/mL and 4.62 µg/mL, respectively, indicating milk:serum ratios of approximately 1:1. The American Academy of Pediatrics considers ethambutol to be compatible with breast feeding (12).

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World’s leading meds delivered to your door – and you don’t even need a prescription! Only certified, first class drugs on offer! Buy more and spend less with our great discount system.

References

  1. Shneerson JM, Francis RS. Ethambutol in pregnancy-foetal exposure. Tubercle 1979;60:167–9.
  2. Holdiness MR. Transplacental pharmacokinetics of the antituberculosis drugs. Clin Pharmacokinet 1987;13:125–9.
  3. Bobrowitz ID. Ethambutol in pregnancy. Chest 1974;66:20–4.
  4. Lewit T, Nebel L, Terracina S, Karman S. Ethambutol in pregnancy: observations on embryogenesis. Chest 1974;66:25–6.
  5. Snider DE, Layde PM, Johnson MW, Lyle MA. Treatment of tuberculosis during pregnancy. Am Rev Respir Dis 1980;122:65–79.
  6. Brock PG, Roach M. Antituberculous drugs in pregnancy. Lancet 1981;1:43.
  7. Kingdom JCP, Kennedy DH. Tuberculous meningitis in pregnancy. Br J Obstet Gynaecol 1989;96:233–5.
  8. American Thoracic Society. Treatment of tuberculosis and tuberculosis infection in adults and children. Am Rev Respir Dis 1986;134:355–63.
  9. Medchill MT, Gillum M. Diagnosis and management of tuberculosis during pregnancy. Obstet Gynecol Surv 1989;44:81–4.
  10. Wall MA. Treatment of tuberculosis during pregnancy. Am Rev Respir Dis 1980;122:989.
  11. Snider DE Jr, Powell KE. Should women taking antituberculosis drugs breast-feed? Arch Intern Med 1984;144:589–90.
  12. Committee on Drugs, American Academy of Pediatrics. The transfer of drugs and other chemicals into human milk. Pediatrics 1994;93:137–50.

Index

Q&A about Ethambutol

Harris
Is there any liquid medicine avaliable for Akurit-4 for TB(Isoniazid + Rifampin + Pyridazine + Ethambutol)?
bookahol...
Some of the TB drugs are available in syrup form. You really have to check your doctor and insist. Also pay a visit to a good pharmacist; they often know more details about drugs than doctors.
raads r
Iam on medication for TB can i use centrum vitamins along with it?
Right now iam using Ethambutol,Rifampicin and INH tablets. Is it ok to take 'One-a-Day vitamins for women' , or will there be any side affects
Haliman S
Of course it is no harm at all to take Centrum except for your pocket.

Most people do not need any vitamin supplements if they eat various kinds of food.
lav007us
Is there an increased chance of a person getting TB again who was infected in past but treated completely?
I have had TB in the past and completed my 9 month course without missing a single dose. I want to know my chances of getting infected again over a normal person who was never infected in the past. More/Equal/less

My dose included : Rifampicin, isoniazid, and Ethambutol.

I fell very worried now days when ever I have cough even if it is because of cold. Is there need to be over cautious?
umesh
Equal.Be cautious/not necessarily overcautious.
jah
what herbal medicine that can cure my ptb?
i feel headache,dizziness,uncomfortable feelings when i take rifampicin,ethambutol and isoniazid so i decided to quit taking my medicine..i tried to find herbal medine for the alternatives drugs to cure my PTB
psa1002
Do you have Pulmonary Tuberculosis?

I hope you didn't just stop taking the medications. How long have you been taking the meds?

The goal of treatment is to cure the infection with drugs that fight the tuberculosis bacteria. The intial treatment may involve a combination of many drugs. It is continued until lab tests show which medicine works best.

Treatment usually lasts for 6 months, but longer courses may be needed for persons with AIDS or whose disease responds slowly.

You may need to be admitted to a hospital to prevent the spread of the disease to others until you are no longer contagious.

Incomplete treatment of TB infections (such as failure to take medications for the prescribed length of time) can contribute to the emergence of drug-resistant strains of bacteria.
curiousp...
Alcohol consumption while on tuberculosis treatment?
Hello, I am in the 4th month of tuberculosis treatment. It isn't pulmonary tuberculosis, it has affected my bones. Pyrazinamide has been stopped last month but I'm still on rifampicin, isoniazid & ethambutol. Is it reasonably safe (I know that it isn't recommended) to have a couple of drinks once in a week?
lpachal
Hope this helps. It's about all I found. This is about daily alcohol consumption though. So I think to be on the safe side I'd recommend you lay off any type of alcohol while you are being treated with these medications. Read the following.

http://www.critpath.org/aric/gloss/body/...
Harris
Harm in dissolving tablets and takin them?
I am taking 2 tablets of AKuriT 4(Rifampicin + Isoniazid + Ethambutol + Pyrazinamide - 150mg + 75mg + 275mg + 400mg) for the past 1 month for TB treatment. However, as I am unable to swallow, I take it in powdered form. I have informed my doctor about this. Kindly let me know if there is any harm in taking it this way. Also, is there any harm if I keep the medicines exposed to the air for a few minutes.
The Foosaaaah
No harm.
subwoofe...
A patient was taking anti TB drugs for two weeks now but he still coughing.Does his drugs are working in him?
He is taking rifampicin, isoniazid, pyrazinamide and ethambutol HCL
Bacteria Boy
As people have said, TB requires antibioitcs for at least 6 months, so there is nothing to worry about. I assume they carried out tests to determine whether or not he had a resistant TB strain or not....
aian_yna
m taking anti-tb drug & developed rashes, what anti-allergy drug should i take?
i'm taking myrin-p forte for 1 week (ethambutol, rifampicin, isoniazid, pyrazinamide) and developed rashes on my thighs which are really very itchy! what should i take to alleviate the itch? is chlorpheniramine okay to take?
telsacoi...
You can try it and see if it works or take some benadryl. You will have to contact your doctor and see what they want to do.They may have to switch you and remove a drug or they may keep you on it.
sk
what will happen if ethambutolis used with alcohol?
what will happen if alcohol is consumed while under medication with ethambutol
boggle10
It doesn't appear that the consumption of alcohol has any adverse side effects with this medication.

However, I wouldn't go overboard. A drink or two at the most and all should be well.

Then again, if I were you, I would consult the prescribing physician just to be absolutely positive.

Cheers!
Stevie B
Pharmacy Case Study?
A 42 year old man with HIV/AIDS is diagnosed with tuberculosis.

Treatment is started with Klaricid (500mg twice daily), Ethambutol (400mg daily) and Mycobutin (3 capsules daily).

Does anyone have any info on this that might help. Im not qualified yet but i thought the Mycobutin was a bit dodgy?
Lea
Mycobutin is the preferred rifampin because it doesn't have the P450 effect as regular rifampin. Clarithromycin is not a preferred drug for TB. Fluroquinolones are used more, they are the preferred second line medication. Also, where is the isoniazid or pyrazinamide? Look up the WHO recommended TB treatment.