Ethionamide
Indications
Ethionamide is used for:
Tuberculosis; Leprosy
Adult Dose
Oral
Tuberculosis; Leprosy
Adult: 15-20 mg/kg/day. Max: 1 g/day.
Not to exceed 1000 mg/day in 3-4 divided doses
Child Dose
Oral
Tuberculosis; Leprosy
Child: Tuberculosis: 15-20 mg/kg/day, given in 2-3 divided doses. Max: 1 g/day.
Renal Dose
End-stage renal disease on hemodialysis: 250-500 mg/day
CrCl <30 mL/min: 250-500 mg/day
CrCl > 30 mL/min: No dose adjustment necessary
Administration
Should be taken with food. Take at mealtimes.
Contra Indications
Hypersensitivity to ethionamide
Severe hepatic dysfunction
Precautions
Difficulty in managing DM. Monitor blood glucose, thyroid and visual function. Perform LFT before and during treatment. Caution in patients with psychiatric illness or depression. Pregnancy, lactation.
Lactation: excretion in milk unknown; use with caution
Pregnancy-Lactation
Interactions
May increase serum levels of isoniazid and potentiate the adverse effects of other antituberculous drugs when used concurrently. May cause psychotic reaction when taken with excessive ethanol.
Potentially Fatal: Increased incidence of hepatotoxicity with rifampicin. Increase CNS toxicity with cycloserine.
Adverse Effects
Side effects of Ethionamide :
>10%
Disorder of gastrointestinal tract (50%)
Frequency Not Defined
Anorexia, excessive salivation, metallic taste, nausea, vomiting, abdominal pain, diarrhoea. Peripheral and/or optic neuritis, psychiatric disturbances eg, depression, anxiety, psychosis, postural hypotension. Jaundice, hepatitis. Thrombocytopenia, skin rashes, stomatitis, gynaecomastia.
Mechanism of Action
Ethionamide inhibits peptide synthesis. It is active against mycobacteria species. Bacteriostatic against M.tuberculosis. Also active against atypical mycobacteria eg, M. kansasii, and some strains of M. avium complex, and M. leprae.