ETHIONAMIDE

Ethionamide should be given with at least one, sometimes two, other drugs to which the organism is known to be susceptible to be killed. Drugs used as companion agents are rifampin, ethambutol, pyrazinamide, cycloserine, kanamycin, streptomycin, and isoniazid. The usual warnings, precautions, and dosage regimens for these companion drugs should be observed.

Patient compliance is essential to the success of the antituberculosis therapy and to prevent the emergence of drug-resistant organisms. It is recommended that directly observed therapy be practiced when patients are taking anti-tuberculosis drugs.

You should check with your doctor immediately if any of these side effects occur when taking ethionamide:

Less common

• Clumsiness or unsteadiness
• confusion
• mental depression
• mood or other mental changes
• numbness, tingling, burning, or pain in hands and feet
• yellow eyes or skin

Some of the side effects that can occur with ethionamide may not need medical attention:

More common

• Dizziness (especially when getting up from a lying or sitting position)
• loss of appetite
• metallic taste
• nausea or vomiting
• sore mouth

Precautions

• Resistance: Ethionamide is contraindicated in patients with severe hepatic impairment because of resistance, ethionamide should not be used alone for the treatment of tuberculosis. It should be given with at least 1 or 2 other drugs to which the organism can be killed.
• Compliance: Patient compliance is essential to the success of the antituberculosis regimen and to prevent development of resistant organisms. Patients should closely adhere to the drug regimen for the full duration of treatment. Directly-observed treatment (DOT) is recommended for all antituberculosis therapy.
• Psychotic reactions:  This have been reported with excessive alcohol ingestion during ethionamide therapy.
• Eye problem: Patients should be advised to consult with their physician if they experience blurry vision, or loss of vision with or without eye pain during treatment.
• Liver profile: Serum transaminases (SGOT, SGPT) should be measure before starting therapy and monthly thereafter. If transaminases increased, ethionamide and the other antimycobacterial(s) may be temporarily discontinued until they normalize
• 
Blood glucose should be monitored before and during therapy. Diabetic patients may experience episodes of hypoglycemia.
• Hypothyroidism has been reported. Thyroid function tests should be monitored periodically.
• Antimycobacterial agents have been associated with vitamin B12 deficiency, folic acid deficiency, megaloblastic anemia, and sideroblastic anemia.
• Ethionamide should not be administered in pediatric patients less than 12 years of age except when the organisms are definitely resistant to primary therapy.

Pregnancy Risk: Category C. Risk cannot be ruled out.

Breastfeeding: Ethionamide tablets should be administered to nursing mothers only if the benefits outweigh the risks. Newborns who are breast-fed by mothers who are taking ethionamide tablets should be monitored for adverse effects.

Interactions

Ethionamide tablets has been found to increase concentrations of isoniazid.

Convulsions have been reported when ethionamide is administered with cycloserine and special care should be taken when the treatment regimen includes both of these drugs.

Excessive ethanol ingestion should be avoided because a psychotic reaction has been reported.

Overdose

If overdose is suspected, contact a poison control center or emergency room immediately.

Notes

Do not share this medication with others.

Laboratory and/or medical tests (such as sputum test, eye/vision exams, liver/thyroid function, blood glucose, complete blood count) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.

Missed Dose

For the best possible benefit, it is important to take each scheduled dose of this medication as directed. If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

Storage

Store at room temperature between 68-77 degrees F (20-25 degrees C) away from light and moisture. Do not store in the bathroom. Keep all medicines away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

Brands

There are no brands containing this molecule.