Ethionamide Dosage

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Usual Adult Dose for:

Usual Pediatric Dose for:

Additional dosage information:

Usual Adult Dose for Tuberculosis - Active

500 mg to 1 g orally (15 to 20 mg/kg) in 1 or more divided doses per day

Maximum dose: 1 g orally per day

Duration: Treatment should continue until permanent bacteriological conversion and maximal clinical improvement have occurred, generally, 18 to 24 months.

Usual Pediatric Dose for Tuberculosis - Active

10 to 20 mg/kg orally in 2 or 3 divided doses per day or 15 mg/kg orally once per day after meals.

Maximum dose: 1 g orally per day

Duration: Treatment should continue until permanent bacteriological conversion and maximal clinical improvement have occurred, generally, 18 to 24 months.

Renal Dose Adjustments

Adults:
CrCl less than 30 mL/min: 250 to 500 mg/day.

Liver Dose Adjustments

Ethionamide is contraindicated in patients with severe hepatic impairment.

Precautions

Ethionamide is contraindicated in patients with severe hepatic impairment.

Due to rapid development 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 is susceptible.

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 have been reported with excessive alcohol ingestion during ethionamide therapy.

Baseline and periodic ophthalmologic examinations are recommended. 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.

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. Ethionamide and the other medications should then be restarted sequentially to determine which one(s) is/are responsible for the hepatotoxicity.

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 and systemic dissemination of the disease, or other life-threatening complications of tuberculosis, is judged to be imminent.

Dialysis

Adults: 250 to 500 mg/day.

Other Comments

Ethionamide should be taken with meals or at bedtime to minimize gastrointestinal intolerance.

Concomitant pyridoxine is recommended.

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