Ethionamide


Concise Prescribing Info
Indications/Uses
TB.
Dosage/Direction for Use
Adult : PO In combination w/ 1 or 2 anti-TB agents: 15-20 mg/kg/day. Usual: Initial: 250 mg/daily for 1-2 days, increased to 250 mg bid for 1-2 days, then gradually increased to highest tolerated dose. Max: 1 g/day.
Dosage Details
Oral
Tuberculosis
Adult: In combination w/ 1 or 2 anti-TB agents: 15-20 mg/kg daily as single dose or in divided doses. Usually given at an initial dose of 250 mg daily for 1-2 days, increased to 250 mg bid for 1-2 days, then gradually increased to highest tolerated dose. Max: 1 g daily in 3-4 divided doses.
Child: 10-20 mg/kg daily in 2-3 divided doses, or alternatively, 15 mg/kg daily as a single dose. Max: 1 g daily.
Hepatic Impairment
Severe: Contraindicated.
Administration
Should be taken with food. Take at mealtimes.
Contraindications
Hypersensitivity to ethionamide. Severe hepatic impairment.
Special Precautions
Patient w/ depression or other psychiatric illness, DM, porphyria, thyroid dysfunction. Hepatic or renal impairment. Pregnancy and lactation.
Adverse Reactions
Nervous: Psychotic disturbances, mental depression, anxiety, drowsiness, dizziness, restlessness, headache, peripheral neuritis, paraesthesia, seizures, tremors, pellagra-like syndrome, hallucination, asthenia.
CV: Orthostatic hypotension.
GI: Nausea, vomiting, diarrhoea, abdominal pain, excessive salivation, metallic taste, stomatitis, anorexia, wt loss.
Resp: Olfactory disturbances.
Hepatic: Hepatitis, transient increase in serum bilirubin, AST, ALT.
Endocrine: Hypothyroidism, hypoglycaemia, gynaecomastia, impotence, menorrhagia.
Haematologic: Thrombocytopenia.
Musculoskeletal: Joint pain, acute rheumatic symptoms.
Ophthalmologic: Diplopia, optic neuritis, blurred vision.
Dermatologic: Rash, photosensitivity, purpura, acne, dermatitis, alopecia.
MonitoringParameters
Monitor serum ALT and AST at baseline and mthly; blood glucose and TSH periodically. Perform ophthalmologic exams prior to and during therapy. Evaluate CNS changes, ocular changes, and neuritis during therapy.
Drug Interactions
May potentiate AR of other anti-TB drugs. Additive CNS effect w/ isoniazid and cycloserine. May cause seizures w/ cycloserine.
Food Interaction
May cause psychotic reaction w/ excessive alcohol ingestion.
Action
Description: Ethionamide’s exact mechanism of action has not been fully elucidated, however, the drug appears to inhibit peptide synthesis. It may be bacteriostatic or bactericidal in action, depending on the concentration of drug attained at the site of infection and susceptibility of organism.
Pharmacokinetics:
Absorption: Readily absorbed from the GI tract. Time to peak serum concentration: Approx 1 hr.
Distribution: Widely distributed throughout body tissues and fluids. Crosses placenta and CSF. Volume of distribution: 93.5 L. Plasma protein binding: 30%.
Metabolism: Extensively metabolised in the liver to the active metabolite sulfoxide and some inactive metabolites.
Excretion: Via urine (<1% as unchanged drug). Elimination half-life: Approx 2 hr.
Chemical Structure

Click on icon to see table/diagram/image
Storage
Store between 20-25°C.
ATC Classification
J04AD03 - ethionamide ; Belongs to the class of thiocarbamide derivatives. Used in the systemic treatment of tuberculosis.
Disclaimer: This information is independently developed by MIMS based on Ethionamide from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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