Ethambutol Uses, Dosage, Side Effects, and Treatment Guidelines

Key Points About Ethambutol

Ethambutol is an antibiotic primarily used to treat bacterial infections, including tuberculosis and other mycobacterial infections. It works by slowing or stopping the growth of bacteria in the body. Ethambutol is often prescribed alongside other medications to ensure a more effective treatment. It’s important to follow your healthcare provider’s instructions carefully and report any side effects you may experience. If you have concerns about your treatment, consider consulting one of our telemedicine providers for guidance.

Names of Ethambutol Medication

US Brand Name: Myambutol

Generic Name: Ethambutol

The generic name, Ethambutol, refers to the active ingredient, while the brand name, Myambutol, is the name given by the manufacturer.

Pharmacologic Category of Ethambutol

Ethambutol belongs to the following pharmacologic categories:

1. Antitubercular Agent
2. Antimycobacterial Agent

Ethambutol Dosage Guidelines

Ethambutol is used to treat various infections, including tuberculosis and other mycobacterial infections. The dosage will depend on the specific condition being treated. Always consult your doctor before making any changes to your dose. If you have questions, you can schedule a telemedicine appointment with one of our providers.

Ethambutol Dosage for Tuberculosis (Pulmonary and Extrapulmonary)

Initial Dose: 15-25 mg/kg orally once daily

Duration: Typically 6-12 months, depending on the severity of the infection and response to treatment

Ethambutol Dosage for Nontuberculous Mycobacterial Infections

Initial Dose: 15-25 mg/kg orally once daily

Duration: Treatment can last several months to over a year, depending on the infection

Ethambutol Dosage for Leprosy

Initial Dose: 15-25 mg/kg orally once daily, often in combination with other medications

Duration: Treatment typically lasts 6-12 months

Ethambutol Dosage for Chronic Granulomatous Disease

Initial Dose: 15-25 mg/kg orally once daily

Duration: Treatment duration varies depending on the severity of the condition

Ethambutol Dosage for Osteomyelitis

Initial Dose: 15-25 mg/kg orally once daily

Duration: Typically 6-12 months, depending on the response to treatment

Ethambutol Dosage for Meningitis

Initial Dose: 15-25 mg/kg orally once daily

Duration: Treatment duration varies based on the severity of the infection

Ethambutol Dosage for Pneumonia

Initial Dose: 15-25 mg/kg orally once daily

Duration: Treatment typically lasts several weeks to months, depending on the infection

Ethambutol Dosage for Lung Infections

Initial Dose: 15-25 mg/kg orally once daily

Duration: Treatment duration varies based on the type and severity of the infection

Ethambutol Dosage for Bacterial Infections

Initial Dose: 15-25 mg/kg orally once daily

Duration: Treatment duration varies depending on the infection

Ethambutol Dosage Forms and Strengths

Tablet: 100 mg, 400 mg

How to Take Ethambutol: Administration Instructions

Ethambutol should be taken by mouth, usually once daily, with or without food. It is essential to take this medication exactly as prescribed by your healthcare provider. Do not skip doses or stop taking the medication early, even if you start feeling better, as this can lead to the infection returning or becoming resistant to treatment. If you miss a dose, take it as soon as you remember. However, if it is close to the time of your next dose, skip the missed dose and continue with your regular schedule. Do not double the dose to make up for a missed one.

Ethambutol Contraindications

A contraindication is a specific situation or condition where a particular medication should not be used because it may cause harm. If you have any of the following conditions, Ethambutol may not be the right medication for you. Always discuss your medical history with your healthcare provider before starting a new medication.

1. Optic Neuritis: Ethambutol can damage the optic nerve, potentially worsening vision problems. If you already have optic neuritis, taking Ethambutol could lead to further vision loss.
2. Severe Kidney Disease: Ethambutol is processed by the kidneys. If your kidneys are not functioning properly, the medication may accumulate in your body, increasing the risk of side effects.
3. Allergic Reaction: If you have had an allergic reaction to Ethambutol in the past, you should not take it again. Symptoms of an allergic reaction can include rash, itching, swelling, and difficulty breathing.
4. Children under 13 years old: Ethambutol is generally not recommended for children under 13 because it can affect their vision, and they may not be able to report vision changes accurately.

Ethambutol Drug Interactions

Ethambutol may interact with other medications, which can affect how well it works or increase the risk of side effects. Be sure to inform your healthcare provider about all the medications you are taking, including over-the-counter drugs and supplements. Some medications that may interact with Ethambutol include:

1. Antacids containing aluminum hydroxide (e.g., Maalox, Mylanta): These can reduce the absorption of Ethambutol, making it less effective. It is recommended to take Ethambutol at least 4 hours before or after taking antacids.
2. Other antibiotics (e.g., Rifampin, Isoniazid): Ethambutol is often used in combination with other antibiotics to treat tuberculosis. However, combining these medications can increase the risk of liver damage. Your healthcare provider will monitor your liver function closely.
3. Gout medications (e.g., Probenecid): Ethambutol can increase uric acid levels in the blood, which may worsen gout symptoms. If you are taking medication for gout, your doctor may need to adjust your treatment plan.

Ethambutol in Pregnancy

Is it safe to take Ethambutol when pregnant?

Ethambutol is classified as a Category C medication for pregnancy by the FDA. This means there is not enough research to definitively determine its safety during pregnancy. While animal studies have shown some risk, there are no well-controlled studies in pregnant women. If you are pregnant or planning to become pregnant, it’s important to discuss the potential risks and benefits of Ethambutol with your healthcare provider. In some cases, the benefits of treating serious infections like tuberculosis may outweigh the potential risks to your baby.

Ethambutol while Breastfeeding

Is it safe to take Ethambutol while breastfeeding?

Ethambutol does pass into breast milk, but the amounts are generally low. However, since Ethambutol can cause vision problems, it’s crucial to monitor your baby for any signs of side effects, such as changes in vision or behavior. Always consult your healthcare provider before breastfeeding while taking Ethambutol to ensure it’s safe for both you and your baby.

Estimated Cost of Ethambutol Medication

The estimated cost of a 30-day supply of Ethambutol (400 mg tablets) without insurance ranges from $20 to $40 with a GoodRx coupon. Prices may vary depending on the pharmacy and location. It’s always a good idea to check for discounts or coupons that can help reduce the cost of your prescription.

Possible Alternatives to Ethambutol

If Ethambutol isn’t the right medication for you, other treatment options are available depending on your condition. Always consult your healthcare provider before making any changes to your treatment plan. Our telemedicine providers are available to discuss these alternatives with you.

Tuberculosis Treatment Alternatives

Other antibiotics, such as Rifampin, Isoniazid, and Pyrazinamide, are commonly used in combination therapy for tuberculosis. In addition to medication, lifestyle changes, such as improving nutrition and avoiding exposure to others with active TB, can also help manage the condition.

Mycobacterial Infections

Alternatives may include Clarithromycin or Azithromycin, depending on the specific type of mycobacterial infection. Your provider may also recommend supportive treatments like bronchodilators or corticosteroids to help manage symptoms.

Leprosy Treatment

Dapsone and Rifampin are commonly used to treat leprosy. In some cases, Clofazimine may also be added to the treatment regimen to enhance effectiveness.

Nontuberculous Mycobacterial Infections

Macrolide antibiotics like Azithromycin or Clarithromycin are often used as alternatives. In some cases, surgery may be necessary to remove infected tissue if the infection is severe or unresponsive to medication.

Chronic Granulomatous Disease

Prophylactic antibiotics like Trimethoprim-Sulfamethoxazole and antifungal medications may be used to prevent infections. Gene therapy is also being explored as a potential treatment option for this condition.

Osteomyelitis Treatment

Treatment may include other antibiotics such as Vancomycin or Ceftriaxone. In some cases, surgery may be required to remove infected bone tissue, especially if the infection is persistent or severe.

Meningitis Treatment

Depending on the cause, alternatives may include antibiotics like Ceftriaxone or antiviral medications. Supportive care, such as corticosteroids, may also be recommended to reduce inflammation and improve outcomes.

Pneumonia Treatment

Alternatives include antibiotics like Amoxicillin or Azithromycin. Lifestyle changes, such as quitting smoking and improving air quality in your home, can also help prevent future infections and support lung health.

Lung Infections

Depending on the type of infection, alternatives may include antibiotics like Levofloxacin or antifungal medications. Pulmonary rehabilitation and breathing exercises may also be beneficial in managing symptoms and improving lung function.

Bacterial Infections

Depending on the type of bacteria, alternatives may include antibiotics like Amoxicillin, Doxycycline, or Ciprofloxacin. Your healthcare provider will choose the most appropriate treatment based on the specific infection and your overall health.

Recent Updates on Ethambutol Research

Recent research on Ethambutol has focused on its use in combination therapies for drug-resistant tuberculosis. Studies indicate that Ethambutol remains effective in treating multi-drug resistant TB when used as part of a carefully monitored treatment plan. Researchers are also exploring the potential for Ethambutol in shorter treatment regimens, which could improve patient adherence and reduce side effects. Ongoing studies are investigating the long-term effects of Ethambutol on vision, particularly in vulnerable populations such as children and the elderly.

James Kingsley

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