Formulary
Ethambutol hydrochloride: Indications, Dosing, Side Effects and Interactions
Ethambutol hydrochloride clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 3 min read
Ethambutol hydrochloride: Indications, Dosing, Side Effects and Interactions
Ethambutol hydrochloride clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Tuberculosis, in combination with other drugs (standard unsupervised 6-month treatment)**
- **Child** (By Mouth): 20 mg/kg once daily for 2 months (initial phase).
- **Adult** (By Mouth): 15 mg/kg once daily for 2 months (initial phase).
**Tuberculosis, in combination with other drugs (intermittent supervised 6-month treatment) (under expert supervision)**
- **Child** (By Mouth): 30 mg/kg 3 times a week for 2 months (initial phase).
- **Adult** (By Mouth): 30 mg/kg 3 times a week for 2 months (initial phase).
**Tuberculosis, in combination with other drugs (standard unsupervised 6-month treatment) for ethambutol hydrochloride**
- **Child** (By mouth): 20 mg/kg once daily for 2 months (initial phase).
**Tuberculosis, in combination with other drugs (intermittent supervised 6-month treatment) (under expert supervision) for ethambutol hydrochloride**
- **Child** (By mouth): 30 mg/kg 3 times a week for 2 months (initial phase).
**Congenital tuberculosis, in combination with other drugs for ethambutol hydrochloride**
- **Neonate** (By mouth): 20 mg/kg once daily for 2 months (initial phase).
Cautions
Elderly (in adults); young children (in children) Cautions, further information Understanding warnings Patients who cannot understand warnings about visual side-effects should, if possible, be given an alternative drug. In particular, ethambutol should be used with caution in children until they are at least 5 years old and capable of reporting symptomatic visual changes accurately.
Contraindications
Optic neuritis; poor vision
Side effects
Common or very common Hyperuricaemia; nerve disorders; visual impairment Rare or very rare Nephritis tubulointerstitial Frequency not known Alveolitis allergic; appetite decreased; asthenia; confusion; dizziness; eosinophilia; fever; flatulence; gastrointestinal discomfort; gout; hallucination; headache; jaundice; leucopenia; nausea; nephrotoxicity; neutropenia; photosensitive lichenoid eruption; sensation abnormal; severe cutaneous adverse reactions (SCARs); skin reactions; taste metallic; thrombocytopenia; tremor; vomiting Side-effects, further information Ocular toxicity is more common where excessive dosage is used or if the patient's renal function is impaired. Early discontinuation of the drug is almost always followed by recovery of eyesight.
Interactions
**Other interactions (2):**
- Aluminium hydroxide may impair the absorption of Ethambutol.
- Therefore antacids containing this ingredient should be avoided during treatment with Ethambutol.
Pregnancy
Not known to be harmful.
Breast feeding
Amount too small to be harmful.
Renal impairment
Risk of optic nerve damage. Should preferably be avoided in patients with renal impairment. M Dose adjustments If creatinine clearance less than 30 mL/minute, use 15-25 mg/kg (max. 2.5 g) 3 times a week-monitor plasma-ethambutol concentration. M See Prescribing in renal impairment .
Medicinal forms
Solution
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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