Supriya Ghosh (Editor)

Ethambutol

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AHFS/Drugs.com
  
Monograph

ATC code
  
J04AK02 (WHO)

Molar mass
  
204.31 g/mol

Routes of administration
  
by mouth

Protein binding
  
20–30%

CAS ID
  
74-55-5

Ethambutol

Trade names
  
Myambutol, Etibi, Servambutol, others

Pregnancy category
  
US: C (Risk not ruled out)

Ethambutol treats tuberculosis overview


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.

Contents

Common side effect 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.

Ethambutol was discovered in 1961. It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system. Ethambutol is available as a generic medication. The wholesale cost in the developing world is about 2.58 to 4.73 USD per month. In the United States it costs 100 to 200 USD per month.

Ethambutol toxic optic neuropathy


Medical uses

Ethambutol is used along with other medications to treat a number of infections including: tuberculosis, Mycobacterium avium complex, and Mycobacterium kansasii.

Adverse effects

  • Optic neuritis (hence contraindicated in children below six years of age)
  • Red-green color blindness
  • Peripheral neuropathy
  • Arthralgia
  • Hepatotoxicity
  • Hyperuricaemia
  • Vertical nystagmus
  • Milk skin reaction
  • Mechanism of action

    Ethambutol is bacteriostatic against actively growing TB bacilli. It works by obstructing the formation of cell wall. Mycolic acids attach to the 5'-hydroxyl groups of D-arabinose residues of arabinogalactan and form mycolyl-arabinogalactan-peptidoglycan complex in the cell wall. It disrupts arabinogalactan synthesis by inhibiting the enzyme arabinosyl transferase. Disruption of the arabinogalactan synthesis inhibits the formation of this complex and leads to increased permeability of the cell wall.

    Pharmacokinetics

    It is well absorbed from the gastrointestinal tract and well distributed in body tissues and fluids. 50% is excreted unchanged in urine.

    References

    Ethambutol Wikipedia