Interacting drugs- summary

Ethionamide +

Zalcitabine                                                                                                                                      these drugs are associated with peripheral neuropathy
     Avoid concomittant use when possible      
                  

 

Active tuberculosis where first line treatment drugs(isoniazid, rifampicin) has failed.

 

Anorexia,nausa, vomiting are more common.
 Diarrhoea, metallic  taste,

Hepatitis, jaundice, stomatitis
Depression, drowsiness and asthenia,

Convulsions, peripheral neuritis, neuropathy,
Olfactory disturbances, blurred vision, diplopia, optic neuritis.

Postoral hypotension,
Skin rash, acne, alopecia,

Thrombocytopenia,
Gynaecomastia, impotence, menorrhagia.

 

Severe hypersensitivity to ethionamide, severe hepatic damage.

Special precautions:
Monitor transaminase(AST,ALT) prior to and every 2 to 4 weeks during therapy.
Management of diabetes may be more difficult and hepatitis occurs more frequently.

 

Indications:
Active tuberculosis where first line treatment drugs(isoniazid, rifampicin) has failed.

Dosage:
Administer at least one other effective antitubercular drug.
Adult- 0.5 to 1g/day in divided doses.
Children- a dose of 15 to 20mg/kg/day(maximum 1g)  is recommended.
 Concomittant admin of pyridoxine is recommended.


 

Alopecia - ( 1650 )

Dermal papules often with follicular accentuation and usually with hair loss in affected areas are the typical findings.



Drugs causing adverse reactions-  ( 385 )

1. Cytotoxics
2. Ethionamide
3. Heparin
4. Oral contraceptives - withdrawal

 

1. May cause stomach upset, loss of appetite, metallic taste, or salivation. Notify physician, if   these become severe.
2. Take with food to reduce gastric GI upsets.

3. Allergies- Tell your doctor if you have ever had any unusual or allergic reactions to ethionamide,isoniazid   or niacin. Also tell your doctor  if your are allergic to any other substances such as foods,  preservatives or dyes.

4. Pregnancy-  women with tuberculosis should be treated with medicines to treat TB . If you have any concerns   talk to your doctor  
   
5. Breast feeding-  mothers who are taking this medicine and who wish to breast feed should discuss this   with their doctor.    
       
6. Elderly- there is no specific information comparing the use of this medicine in older people with use in   other age groups.
    
7. Other medicines- tell your doctor if you are taking any of the following-
    
     Cyclosporine- use of ethionamide with cyclosporine may increase the chance of nervous side effects such
     as convulsions- seizure  
      
7.  Other medical problems- presence of other medical problems may affect the use of this medicine-

     Diabetes mellitus- diabetes may be harder to control in patients taking ethionamide

     Liver disease- patients with severe liver disease have an increased chance of side effects   
          
8. Missed dose-
    If you miss a dose of this medicine take it as soon as possible. However if it is almost time for your next dose
    go back to your regular dosing schedule.
    Do not double doses.

 

Pharmacology:
Bacteriostatic against Mycobacterium tuberculosis

Pharmacokinetics:
Oral administration of ethionamide yields peak plasma concentrations in 3 hours. The drug is
metabolised in the liver and less than 1% is excreted in the urine

 

Can be taken with food

Pregnancy
Use during pregnancy only when clearly needed.

Children:
Optimum dosage for children has not been established.