Ethambutol side effects and mechanism of action |
Brand Name :- Myambutol, Embutol, Etibi, and Combutol
Chemical structure of ethambutol:-
The chemical structure of ethambutol, also known as 2,2'-(ethylenediamine)bis(2-methyl propanol), can be represented by the following molecular formula and structural formula:
Molecular formula: C10H24N2O2
The structure of ethambutol consists of a central ethylenediamine molecule with two branches of methyl propanol groups. The two hydroxyl groups in the molecule make it a polar compound, and this property plays a vital role in its mechanism of action as an antimycobacterial agent.
Background and indication:-
Ethambutol is a drug of choice for tuberculosis along with other anti-TB drugs such as isoniazid, rifampin, and pyrazinamide.FDA approve ethambutol on 6 November 1967.
Ethambutol is used for the treatment of pulmonary tuberculosis as a first-line treatment in combination with rifampin, isoniazid, and pyrazinamide.
Mechanism of action of ethambutol:-
The exact mechanism of action of ethambutol is not fully known, but it is believed to work by inhibiting the biosynthesis of the mycobacterial cell wall, which leads to the disruption of cell wall synthesis and ultimately results in cell death.
Ethambutol specifically targets the arabinosyltransferase enzyme, which is involved in the synthesis of the arabinogalactan component of the mycobacterial cell wall. By inhibiting this enzyme, ethambutol interferes with the incorporation of arabinogalactan into the cell wall, resulting in the formation of defective cell walls that are more susceptible to damage by other antimycobacterial drugs.
Drug-Drug interactions of ethambutol:
|
Drug Class |
Examples |
Potential Interaction |
|
Antacids |
Aluminum hydroxide, magnesium hydroxide |
Reduced absorption of ethambutol |
|
Antimalarials |
Chloroquine, quinine |
Increased risk of retinopathy |
|
Antipsychotics |
Chlorpromazine, thioridazine |
Increased risk of optic neuritis |
|
Antiretrovirals |
Zidovudine, didanosine |
Increased risk of peripheral neuropathy |
|
Cytotoxic agents |
Doxorubicin, cyclophosphamide |
Increased risk of bone marrow suppression |
|
Diuretics |
Furosemide, hydrochlorothiazide |
Increased risk of hypokalemia |
|
Neuromuscular blockers |
Vecuronium, atracurium |
Increased risk of neuromuscular blockade |
|
Proton pump inhibitors |
Omeprazole, pantoprazole |
Reduced absorption of ethambutol |
- Nausea and vomiting
- Upset stomach or abdominal pain
- Loss of appetite
- Headache
- Dizziness
- Confusion
- Blurred vision or other vision changes
- Fever or chills
- Joint pain
- Rash
Read in detail about isoniazid here ⇗⇗
Commonly asking questions about ethambutol
Here are some commonly asked questions about ethambutol:
What is ethambutol used for?
Ethambutol is used to treat tuberculosis, a bacterial infection that primarily affects the lungs.
How does ethambutol work?
Ethambutol works by inhibiting the synthesis of the cell wall of the tuberculosis bacteria, thereby preventing the bacteria from multiplying.
What are the side effects of ethambutol?
The common side effects of ethambutol include gastrointestinal upset, rash, itching, dizziness, and blurred vision. Long-term use of ethambutol can cause optic neuritis, a condition that can lead to vision loss.
How is ethambutol taken?
Ethambutol is usually taken orally as a tablet or syrup, with or without food. The dosage and duration of treatment depend on the severity of the tuberculosis infection and other factors such as the patient's age and weight.
Can ethambutol be used during pregnancy or breastfeeding?
Ethambutol should be used during pregnancy or breastfeeding only if the benefits outweigh the potential risks. if you are pregnant or breastfeeding you should consult a doctor before taking ethambutol.
What should I do if I miss a dose of ethambutol?
If you miss a dose of ethambutol, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule.
Can ethambutol interact with other medications?
Ethambutol can interact with certain medications, such as antacids containing aluminum, which can reduce the absorption of ethambutol. It is should be better to inform your doctor of all medications you are taking before starting treatment with ethambutol.
How long does ethambutol take to work?
Ethambutol can start to work within a few days of starting treatment, but it usually takes several months of continuous use to completely eliminate the tuberculosis bacteria from the body.
Is it safe to drink alcohol while taking ethambutol?
It is not recommended to drink alcohol while taking ethambutol, as alcohol can increase the risk of liver damage and other side effects.
Can ethambutol be used to treat other infections?
Ethambutol is primarily used to treat tuberculosis, but it may also be used in combination with other medications to treat different infections caused by certain types of bacteria.
How is ethambutol supplied?
Ethambutol is available in tablet and syrup form, and it is usually supplied in strengths of 100mg, 200mg, 400mg, or 800mg. It is important to take the medication exactly as prescribed by a healthcare provider.
How often do I need to have my vision checked while taking ethambutol?
Because ethambutol can cause vision changes, it is important to have your vision checked before starting treatment and periodically throughout the course of treatment. Your healthcare provider will determine the frequency of vision checks based on your individual situation.
What should I do if I experience vision changes while taking ethambutol?
If you experience any changes in your vision while taking ethambutol, such as blurred vision or difficulty distinguishing colors, you should contact your healthcare provider immediately. They may recommend adjusting the dosage of ethambutol or discontinuing the medication altogether.
Can ethambutol be used in children?
Ethambutol can be used in children, but the dosage and duration of treatment may be different than for adults. It is important to consult a healthcare provider for guidance on the appropriate use of ethambutol in children.
What should I do if I develop an allergic reaction to ethambutol?
If you develop symptoms of an allergic reaction to ethambutol, such as difficulty breathing, hives, or swelling of the face, lips, tongue, or throat, seek immediate medical attention.
How should ethambutol be stored?
Ethambutol should be stored at room temperature, away from heat and moisture. It should be kept out of the reach of children and pets.
Can ethambutol cause interactions with certain foods?
There are no known food interactions with ethambutol. However, it is important to follow a healthy and balanced diet while taking this medication to support your body's ability to fight off the infection.
What precautions should I take while taking ethambutol?
While taking ethambutol, avoiding exposure to people with tuberculosis or other contagious diseases is important. You should also practice good hygiene, such as washing your hands regularly, to reduce the risk of infection.
What should I do if I miss multiple doses of ethambutol?
If you miss multiple doses of ethambutol, contact your healthcare provider for guidance. They may recommend adjusting the dosage or restarting treatment altogether.
Can ethambutol be used in combination with other medications?
Ethambutol is often used in combination with other medications to treat tuberculosis like isoniazid, rifampin, and pyrazinamide.
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