ETHIONAMIDE

Antibiotic with activity against Mycobacterium tuberculosis. It is bacteriostatic or bactericidal depending on concentration of the medicine at the site of infection

Dosage Forms

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Tablet

125 mg
250 mg

Uses

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  • Multi-drug-resistant tuberculosis (MDR-TB)

Dose and Duration

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MDR-TB (in combination with other medicines)
Adult: 15–20 mg/kg up to a usual dose of 500–1000 mg daily depending on bodyweight and tolerance. Give in 1–2 doses daily
Child: 10–20 mg/kg in 1–2 divided doses

Contraindications

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  • Hypersensitivity to ethionamide
  • Severe hepatic impairment

Side Effects

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  • Headache, dizziness, drowsiness
  • Asthenia, paresthesia
  • Epigastric discomfort, abdominal pain, anorexia
  • Nausea, vomiting, diarrhoea
  • Elevated serum transaminases, hepatitis, jaundice

Interactions

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  • Rifampicin (increased risk of hepatitis with jaundice-avoid concomitant use)
  • Isoniazid (increased serum concentration of isoniazid)

Patient Instructions

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  • Swallow with food to minimise gastrointestinal side effects

Pregnancy

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  • Do not use

Breast-feeding

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  • Can be used

⚠️ Caution

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  • Obtain baseline liver function tests prior to therapy and monitor serum transaminases every 2–4 weeks during therapy. Discontinue all medicines temporarily if jaundice develops and transaminase levels exceed three times the Upper Limit of Normal (ULN), or if transaminase levels exceed five times the ULN with or without symptoms. Re-introduce the medicines sequentially after resolution of laboratory abnormalities
  • Give with pyridoxine (Vitamin B₆) and nicotinamide (Vitamin B₃) to prevent neurotoxic effects of ethionamide
  • Monitor blood glucose and thyroid function periodically throughout therapy
  • Carry out periodic opthalmoscopy during therapy
  • Monitor breast-feeding child if used in the mother