Myambutol (Ethambutol)
Class and Category of Drug
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Chemical class: Diisopropylethylene diamide derivative
Therapeutic class: Antitubercular
Pregnancy category: C
Drug Indications and Dosages
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As adjunct to treat tuberculosis and atypical mycobacterial infections caused by Mycobacterium tuberculosis
Tablets
Adults and adolescents who haven't received previous antituberculotic therapy. 15 mg/kg daily.
Adults and adolescents who have received antituberculotic therapy. 25 mg/kg daily; after 60 days, decreased to 15 mg/kg daily.
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Contraindications of Drug
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Hypersensitivity to ethambutol or its components, inability to report changes in vision, optic neuritis
Generic Drug Interactions
Drugs
antacids that contain aluminum hydroxide: Decreased absorption of ethambutol
other neurotoxic drugs: Increased risk of neurotoxicity, such as optic and peripheral neuritis
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Drugs Adverse Reactions
Central Nervous System: Burning sensation or weakness in arms and legs, confusion, disorientation, dizziness, fever, headache, malaise, paresthesia, peripheral neuritis
Eyes, Ears, Nose, And Throat: Blurred vision, decreased visual acuity, eye pain, optic neuritis, red-green color blindness
Gastrointestinal: Abdominal pain, anorexia, hepatic dysfunction, nausea, vomiting
Hematologic: Leukopenia, neutropenia, thrombocytopenia
Musculoskeletal: Arthralgia, gouty arthritis, joint pain
Respiratory: Pulmonary infiltrates
Skin: Dermatitis, erythema multiforme, pruritus, rash
Other: Anaphylaxis, hypersensitivity syndrome (rash or exfoliative dermatitis, eosinophilia, and one of the following: hepatitis, pneumonitis, nephritis, myocarditis, pericarditis), lymphadenopathy
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Nursing Considerations for Generic Drugs
• Expect prescriber to refer patient for an ophthalmologic examination that includes tests for visual fields, acuity, and red-green color blindness before taking ethambutol and monthly thereafter. This is especially likely if therapy is prolonged or dosage exceeds 15 mg/kg daily.
WARNING Notify prescriber immediately if patient develops vision changes, and expect ethambutol to be stopped if they occur.
• Expect to give the patient at least one other antituberculotic with ethambutol, as prescribed, because bacteria may become resistant quickly to a single drug.
• Monitor laboratory test results for changes in liver function or for increased serum uric acid level if patient has gouty arthritis or impaired renal function. Notify prescriber of any abnormalities.
• Obtain a monthly sputum specimen, as ordered, to check bacteriologic response in sputum-positive patient.
• Know that successful ethambutol therapy typically takes 6 to 12 months but may take years.
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Ethambutol
Preparations
International Brand Drug Names
The information about drugs (tablets, pills, capsules, creams, solution, nasal spray, inhaler) around the world.
British Pharmacopoeia, 2008 edition: Ethambutol Tablets;
The United States Pharmacopeia 31, 2008: Ethambutol Hydrochloride Tablets; Rifampin, Isoniazid, Pyrazinamide, and Ethambutol Hydrochloride Tablets.
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