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Ethambutol (Myambutol)
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Ethambutol

Ethambutol is an antibacterial agent. It works by stopping the growth of TB cells, which results in cell death. Ethambutol is used for treating tuberculosis (TB) infections of the lung along with other medicines. It may also be used to treat other conditions as determined by your doctor.

Other names for this medication:
Combutol, Etambutol, Myambutol, Rifafour, Rimstar

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Also known as:  Myambutol.

Description

Ethambutol (EMB, E) is a medication primarily used to treat tuberculosis. It is usually given in combination with other tuberculosis medications, such as isoniazid, rifampicin and pyrazinamide. It may also be used to treat Mycobacterium avium complex, and Mycobacterium kansasii. It is taken by mouth.

Common side effects include problems with vision, joint pain, nausea, headaches, and feeling tired. Other side effects include liver problems and allergic reactions. It is not recommended in people with optic neuritis, significant kidney problems, or under the age of five. Use during pregnancy or breastfeeding has not been found to cause harm. In the United States the FDA has raised concerns about eye issues in the baby if used during pregnancy. Ethambutol is believed to work by interfering with the bacteria's metabolism.

Dosage

Ethambutol should not be used alone, in initial treatment or in retreatment. Ethambutol should be administered on a once every 24-hour basis only. Absorption is not significantly altered by administration with food. Therapy, in general, should be continued until bacteriological conversion has become permanent and maximal clinical improvement has occurred.

Ethambutol is not recommended for use in pediatric patients under thirteen years of age since safe conditions for use have not been established.

Overdose

If you take too much Ethambutol, call your local Poison Control Center or seek emergency medical attention right away.

Storage

Store at room temperature between 20 and 25 degrees C (68 and 77 degrees F) away from moisture and heat. Throw away any unused medicine after the expiration date. Keep out of the reach of children.

Side effects

The most common side effects associated with Ethambutol are:

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Side effect occurrence does not only depend on medication you are taking, but also on your overall health and other factors.

Contraindications

Do not take Ethambutol if you are allergic to any of its ingredients.

Because this medication may have adverse effects on vision, talk to your doctor if you have eye problems such as optic neuritis, cataracts, or diabetic retinopathy.

Tell your doctor if you have kidney disease as your doctor may need to decrease the dose you take.

thuoc ethambutol 400 mg

This prospective study included 150 newly diagnosed pulmonary and extrapulmonary tuberculous children. The organism was isolated and identified after decontamination. Antimicrobial susceptibility testing was performed by proportion method using Lowenstein-Jensen medium (PMLJ) and Etest. Minimal inhibitory concentration for both first and second line anti tuberculous drugs was determined by Etest. Comparison between the two methods was done.

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Resistance-associated hot mutations could be determined within 2 h after PCR amplification using pyrosequencing. About 45 fg DNA per reaction was required to obtain sufficient PCR products to produce a clear, accurate pyrosequencing pattern. No mutations were found in all 20 drug-susceptible clinical isolates, while all isolates with mutations showed corresponding drug resistances.

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Altered pharmacokinetics of antituberculosis drugs may contribute to an increased risk of tuberculosis treatment failure for diabetic patients. We previously found that rifampin exposure was 2-fold lower in diabetic than in nondiabetic tuberculosis patients during the continuation phase of treatment. We now examined the influence of diabetes on the pharmacokinetics of antituberculosis drugs in the intensive phase of tuberculosis treatment, and we evaluated the effect of glycemic control. For this purpose, 18 diabetic and 18 gender- and body weight-matched nondiabetic tuberculosis patients were included in an Indonesian setting. Intensive pharmacokinetic sampling was performed for rifampin, pyrazinamide, and ethambutol at steady state. The bioavailability of rifampin was determined by comparing rifampin exposure after oral versus intravenous administration. Pharmacokinetic assessments were repeated for 10 diabetic tuberculosis patients after glycemic control. No differences in the areas under the concentration-time curves of the drugs in plasma from 0 to 24 h postdose (AUC(0-24)), the maximum concentrations of the drugs in plasma (C(max)), the times to C(max) (T(max)), and the half-lives of rifampin, pyrazinamide, and ethambutol were found between diabetic and nondiabetic tuberculosis patients in the intensive phase of tuberculosis treatment. For rifampin, oral bioavailability and metabolism were similar in diabetic and nondiabetic patients. The pharmacokinetic parameters of antituberculosis drugs were not correlated with blood glucose levels or glucose control. We conclude that diabetes does not alter the pharmacokinetics of antituberculosis drugs during the intensive phase of tuberculosis treatment. The reduced exposure to rifampin of diabetic patients in the continuation phase may be due to increased body weight and possible differences in hepatic induction. Further research is needed to determine the cause of increased tuberculosis treatment failure among diabetic patients.

ethambutol drug classification

National Tuberculosis Programme, the Philippines.

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Tetrandrine is a natural chemical product purified from fourstamen stephania root which recently has been shown to act similarly as synthesized drug efflux pump inhibitor verapamil. The aim of the study is to examine whether tetrandrine could potentiate anti-tubercular drugs to which Mycobacterium tuberculosis (MTB) has turned resistant via efflux mechanisms.

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These pulmonary MAC cavities were significantly frequently located in segments S2, S3, S9, and S10, and their distribution was different from that of pulmonary tuberculosis at the patients' initial visit. Examination of the external diameters of these cavities after chemotherapy showed that 42.1% of cavities expanded, 0.2% were unchanged, and 56.1% shrank. The mean diameter of the cavities decreased significantly (by 3.1 mm) after chemotherapy. The mean size of the cavities in the upper lobe did not differ from the mean size of the cavities in the lower lobe before chemotherapy; however, the reduction in cavity size was significantly higher in the lower lobe cavities. In 14 cases, the cavities disappeared under the standard chemotherapy regimen in an average of 971 days, and there was a tendency for lower lobe cavities to disappear more rapidly.

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Ethambutol (EMB) is a first-line drug used for antitubercular therapy in combination with other drugs as recommended by World Health Organization DOTS/DOTS-Plus regimens. EMB is also effective in the treatment of opportunistic mycobacterial infections in patients with human immunodeficiency virus. The emb locus has been considered as a drug target for EMB, and substitutions of codon 306 in Mycobacterium tuberculosis gene embB have been shown to be the most frequent and predictive mutations for EMB resistance. The aim of the present study was to detect embB and embC gene mutations in EMB-resistant clinical isolates. A total of 23 isolates of M. tuberculosis from patients with pulmonary tuberculosis were included in the study. Drug sensitivity was tested by proportion method and E-test. All 23 isolates were EMB resistant. Primers to amplify the embB and embC gene were designed, and polymerase chain reaction products were subjected for sequence analysis. H37Rv standard laboratory strain was used as control. Nucleotide sequencing showed that 16 strains had a mutation in the embB gene. The most common mutation observed in the embB gene was at codon 306, followed by mutations at codons 299 and 378 in 4 and 2 isolates, respectively. Novel mutations have been reported at codons 239, 240, 247, 282, 311, 368, 397, 446, 469, and 471. Sequence analysis of the embC gene showed mutation in 8 isolates at codon 270. Novel mutations in embC have been reported at codons 251 and 254. The most common nucleotide polymorphism in our isolates was at codons 306 and 299 in the embB gene and at codon 270 in the embC gene. A mutation at codon 306 was usually associated with high-level ethambutol resistance.

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The MICs of isoniazid and ethambutol were equal or slightly above the critical concentration in most of the strains (92% and 84%, respectively), defined as "low-level resistance". Rifampicin and streptomycin exhibited very high MICs in most of the strains (100% and 77%, respectively), indicating a "high-level resistance".

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The specific management of drug-resistant patients is only possible where facilities exist for both mycobacterial culture and for drug-susceptibility testing. Treatment guidelines in the United Kingdom and elsewhere are predicated on the drug-resistance data prevailing in the circumstances of their use. In developed countries, the inclusion of the fourth drug (ethambutol but occasionally streptomycin) depends on the level of isoniazid resistance expected or known in a given patient group. Most parts of the world do not have the capabilities to perform mycobacterial culture and drug-susceptibility testing. In these countries, therefore, the "standard" advised regimen has to cover the possibility of the commoner drug resistances. The view taken in the United Kingdom is that where drug-susceptibility tests are available, they should be followed, and treatment modified. The drug treatment of multidrug-resistant tuberculosis (MDR TB), defined as combined resistance to rifampicin and isoniazid, plus or minus other antituberculosis drugs, is complex, time consuming, and demanding on both patient and physician. In the United Kingdom the advice is that treatment should only be carried out by physicians with substantial experience in managing complex resistant cases, only in hospitals with appropriate isolation facilities, and in very close liaison with Mycobacteriology Reference Centres. Treatment should start with five or more drugs to which the organism is, or is likely to be, susceptible and continued until sputum cultures become negative. Treatment with three drugs should continue for at least an additional nine months.

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side effects of ethambutol hcl 400 mg 2015-10-03

Mycobacterium szulgai is a rare human pathogen that mainly causes pulmonary diseases. We report the first case of M. szulgai causing septic arthritis in a patient with human immunodeficiency virus. A culture from Ofloxacin Price Mercury Drug the joint aspiration was needed to isolate and identify this organism. The patient was treated successfully with ciprofloxacin, clarithromycin, and ethambutol.

ethambutol dosage in renal failure 2016-08-09

There were 29 patients (19 males) with a median age of 37 (range 26-65) years. Site of TB were: lung (70%), lymph node (27.6%), and gastrointestinal tract (3.4%). At the time of TB diagnosis, median (range) CD4 cell count and HIV RNA were 74 (23-178) cells/microl and 229,000 (26,100-750,000) copies/ml, respectively. All patients received isoniazid, rifampin, ethambutol, and pyrazinamide in the first 2 months of TB therapy but the continuation phase was different depending on whether efavirenz (EFV) or nevirapine (NVP) was used. ART was initiated at a median of 8 weeks of TB treatment. All patients received NNRTI-based regimens (EFV 62.1%, NVP 37.9%). Percentage of patients with HIV RNA<50 copies/ml at 24 and 48 weeks of ART was 65.5 and 75.9%. Median Levofloxacin Tablets 500 Mg Side Effects CD4 cell count at 24, 48, and 72 weeks were 156, 186, and 227 cells/microl, respectively. Eighteen patients were cure; eight were treatment completed; two were treatment interrupted; and one died from CMV encephalitis. There was neither occurrence of new OI or relapse of TB in 26 patients who completed 72-week follow-up.

ethambutol dose in renal failure 2016-08-27

We report clinical and radiographic findings in a patient with disseminated tuberculosis (TB) of the brain. A Burmese man developed a left hemiparesis and mild cognitive difficulty 1 month into therapy for miliary TB. A head MRI showed numerous (> 100) contrast-enhancing supratentorial and infratentorial lesions. Following 9 months of treatment with isoniazid, ethambutol, rifampin, and pyrazinamide, most lesions resolved; however, one cortical tuberculoma enlarged significantly. The patient was continued on isoniazid and rifampin, with radiographic resolution of the tuberculoma 4 months Cefpodoxima 200 Mg Para Que Sirve later.

ethambutol antibiotic 2017-01-06

Sequence analysis of known antibiotic resistance genes of the Loxof 500 Mg Tab Mycobacterium tuberculosis complex (MTBC) is increasingly being used to infer phenotypic resistance to a variety of antibiotics. However, a clear understanding of the genotype-phenotype relationship is required to interpret genotypic susceptibility results accurately. In this context, it is particularly important to distinguish phylogenetically informative neutral polymorphisms from true resistance-conferring mutations.

maximum daily dose of ethambutol 2015-04-27

Drug resistance was evaluated in 258 randomly selected sputa smear TB positive cases between the periods of November 2011 to February 2012 at the CPGH-Mombasa. Basic demographic data was obtained using administered questionnaires, and clinical history extracted from the files. For laboratory analyses, 2mls of sputum was obtained, decontaminated and subjected to mycobacteria DNA analyses. Detection of first line drug resistance genes was done using MDRTDR plus kit. This was followed with random selection of 83 cases for second line drug resistance genes Zeclar Clarithromycine 50 Mg testing using Genotype MDRTBsl probe assay kit (HAINS Lifesciences, GmbH, Germany), in which ethambutol mutation probes were included. The data was then analyzed using SPSS statistical package version 19.0.

ethambutol drug 2016-07-18

The total number of strains isolated was 77 and the global rate of resistance was 14.1%. Rate of primary drug resistance Azitromicina 500 Mg Para Que Sirve was 12.1%, and acquired 27%. No multidrug resistant case was detected. Primary drug resistance was 3% to isoniazid, 3% to rifampin, 3% to pyrazinamid, 4.5% to ethambutol and 3% to streptomycin. Acquired drug resistance was 9.1% against isoniazid and 27% against streptomicin, no resistance against the other drugs tested being found.

ethambutol dose tb 2015-09-11

Under the Revised National Tuberculosis Control Programme of India, patients with new smear-positive pulmonary tuberculosis are treated with a thrice-weekly regimen of antitubercular drugs (2H(3)R(3)Z(3)E(3)/4H(3)R(3) [H isoniazid, R rifampicin, Z pyrazinamide and E ethambutol]) for 6 months. We conducted Combutol 200 Mg a retrospective analysis of the efficacy andtolerability of this regimen under clinical trial conditions in HIV-negative patients with newly diagnosed smear-positive pulmonary tuberculosis.

thuoc ethambutol 400 mg 2015-10-30

No progression of Nor Metrogyl Syrup Uses ocular lesions could be seen after a 6 months therapy with rifampicin, isoniazide and ethambutol.

is ethambutol a drug 2016-05-13

177 patients with MDR-TB were assigned to a study group (88 cases Novidat 500mg Tablets ), treated with LVFX, CPM, pyrazinamide (PZA), rifapentine (RFT) and pasiniazid (PSZ); or a control group, treated with streptomycin (SM), ethambutol (EMB), PZA, RFT and PSZ. The course of treatment was 21 months.