ethionamide (Rx)

Brand and Other Names:Trecator
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

tablet

  • 250mg
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Tuberculosis, Active

15-20 mg/kg/day PO 

Initiate dose at 250 mg/day for 1-2 days; THEN increase to 250 mg twice daily for 1-2 days with gradual increases to highest tolerated dose; 750 mg/day average dose

Not to exceed 1000 mg/day in 3-4 divided doses

Renal Impairment

End-stage renal disease on hemodialysis: 250-500 mg/day

CrCl <30 mL/min: 250-500 mg/day

CrCl ≥ 30 mL/min: No dose adjustment necessary

Administration

Part of multi-drug regimen; not first-line treatment

Take with food

Dosing Considerations

If susceptibility tests indicate that the patient's organism is resistant to one of first-line antituberculosis drugs (i.e., isoniazid or rifampin) yet susceptible to ethionamide, ethionamide should be accompanied by at least one drug to which M. tuberculosis isolate is known to be susceptible;3 if tuberculosis is resistant to both isoniazid and rifampin, yet susceptible to ethionamide, ethionamide should be accompanied by at least two other drugs to which the M. tuberculosis isolate is known to be susceptible

Directly observed therapy is recommended for all patients receiving treatment for tuberculosis

Monitor: baseline & periodic LFTs, TFTs, glucose

Dosage Forms & Strengths

tablet

  • 250mg
more...

Tuberculosis, Active

M. tuberculosis resistant to isoniazid or rifampin, or patient intolerant to drugs

10-20 mg/kg/day divided BID/TID PO OR 

15 mg/kg PO qDay

No more than 1000 mg/day in 3-4 divided doses

Administration

Part of multi-drug regimen; not first-line treatment

Take after meals

Dosing Considerations

If susceptibility tests indicate that the patient's organism is resistant to one of first-line antituberculosis drugs (i.e., isoniazid or rifampin) yet susceptible to ethionamide, ethionamide should be accompanied by at least one drug to which M. tuberculosis isolate is known to be susceptible; if tuberculosis is resistant to both isoniazid and rifampin, yet susceptible to ethionamide, ethionamide should be accompanied by at least two other drugs to which the M. tuberculosis isolate is known to be susceptible

Directly observed therapy is recommended for all patients receiving treatment for tuberculosis

Monitor: baseline & periodic LFTs, TFTs, glucose

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Interactions

Interaction Checker

and ethionamide

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            >10%

            Disorder of gastrointestinal tract (50%)

            Frequency Not Defined

            Postural hypotension

            Depression

            Dizziness

            Drowsiness

            Headache

            Peripheral neuropathy

            Psychosis

            Photosensitivity

            Rash

            Excessive salivation

            Gynecomastia

            Hypoglycemia

            Impotence

            Anorexia

            Dyspepsia

            Diarrhea

            Nausea

            Metallic taste

            Vomiting

            Thrombocytopenia

            Elevated liver transaminases

            Hepatitis

            Optic neuritis

            Visual changes

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            Warnings

            Contraindications

            Hypersensitivity to ethionamide

            Severe hepatic dysfunction

            Cautions

            Use caution in diabetes mellitus, thyroid disease, hepatic impairment

            HIV patients may have malabsorption syndrome

            Used as monotherapy in the treatment of tuberculosis results in rapid development of resistance; give suitable companion drug or drugs; base the choice on results of susceptibility testing; therapy may be initiated prior to receiving results of susceptibility tests as deemed appropriate by physician; administer with at least one, sometimes two, other drugs to which organism is known to be susceptible

            Prescribing drug in the absence of a proven or strongly suspected bacterial infection indication is unlikely to provide benefit to patient and increases risk of development of drug-resistant bacteria

            Ethionamide may potentiate adverse effects of other antituberculous drugs administered concomitantly

            Perform ophthalmologic examinations (including ophthalmoscopy) before and periodically during therapy

            Excessive ethanol ingestion should be avoided; psychotic reaction reported

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            Pregnancy & Lactation

            Pregnancy Category: C

            Lactation: excretion in milk unknown; use with caution

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

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            Pharmacology

            Metabolism: liver

            Excretion: kidney

            Mechanism of Action

            Bacteriostatic or bactericidal

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            Formulary

            FormularyPatient Discounts

            Adding plans allows you to compare formulary status to other drugs in the same class.

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            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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