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Ethambutol Dosage

Medically reviewed by Drugs.com. Last updated on Apr 12, 2024.

Applies to the following strengths: 100 mg; 400 mg

Usual Adult Dose for Tuberculosis - Active

Patients without previous antituberculous treatment (Initial treatment): 15 mg/kg orally once a day

Patients with previous antituberculous treatment (Retreatment):
Initial dose: 25 mg/kg orally once a day for 60 days
Maintenance dose: 15 mg/kg orally once a day

Comments:


Use: Treatment of pulmonary tuberculosis

US Department of Health and Human Services (US HHS), National Institutes of Health (NIH), Health Resources and Services Administration (HRSA), and US Centers for Disease Control and Prevention (US CDC) Recommendations:
DRUG-SUSCEPTIBLE TUBERCULOSIS:
Initial Phase: 15 to 25 mg/kg orally once a day PLUS isoniazid, rifampin/rifabutin, and pyrazinamide

DRUG-RESISTANT TUBERCULOSIS:
Initial phase: 15 to 25 mg/kg orally once a day PLUS moxifloxacin/levofloxacin, rifampin/rifabutin, and pyrazinamide

Continuation phase: 15 to 25 mg/kg orally once a day PLUS moxifloxacin/levofloxacin, and rifampin/rifabutin

Weight-based dosing recommendations:
Patients 40 to 55 kg: 800 mg orally once a day

Use: First-line drug for the treatment of Mycobacterium tuberculosis

Infectious Diseases Society of America (IDSA), US CDC, and American Thoracic Society (ATS) Recommendations:
Daily dosing:
Infectious Diseases Society of America (IDSA), US CDC, and American Thoracic Society (ATS) Recommendations:
Daily dosing:

2 times a week dosing recommendations:

3 times a week dosing recommendations:

Use: First-line drug for the treatment of drug-susceptible tuberculosis

Usual Adult Dose for Mycobacterium avium-intracellulare - Treatment

US HHS, NIH, HRSA, and US CDC Recommendations:
15 mg/kg orally once a day PLUS clarithromycin


Comments:

Uses:

IDSA, US CDC, and ATS Recommendations:
Initial Therapy for Nodular/Bronchiectatic Disease (Intermittent Therapy): 25 mg/kg orally 3 times a week PLUS rifampin and clarithromycin/azithromycin

Initial Therapy for Cavitary Disease, Advanced/Severe OR Previously Treated Disease: 15 mg/kg orally once a day PLUS rifampin/rifabutin and clarithromycin/azithromycin

Comments:

Uses:

Usual Adult Dose for Mycobacterium avium-intracellulare - Prophylaxis

US HHS, NIH, HRSA, and US CDC Recommendations:
15 mg/kg orally once a day PLUS clarithromycin


Comments:

Uses:

IDSA, US CDC, and ATS Recommendations:
Initial Therapy for Nodular/Bronchiectatic Disease (Intermittent Therapy): 25 mg/kg orally 3 times a week PLUS rifampin and clarithromycin/azithromycin

Initial Therapy for Cavitary Disease, Advanced/Severe OR Previously Treated Disease: 15 mg/kg orally once a day PLUS rifampin/rifabutin and clarithromycin/azithromycin

Comments:

Uses:

Usual Adult Dose for Mycobacterium kansasii

IDSA, US CDC, and ATS Recommendations:
15 mg/kg orally once a day
Duration of therapy: 18 months

Comment: Patients should have at least 12 months of negative sputum cultures.

Use: Treatment of nontuberculous mycobacterial pulmonary disease caused by Mycobacterium kansasii

Usual Pediatric Dose for Tuberculosis - Active

13 years and older:
Patients without previous antituberculous treatment (Initial treatment): 15 mg/kg orally once a day

Patients with previous antituberculous treatment (Retreatment):
Initial dose: 25 mg/kg orally once a day for 60 days
Maintenance dose: 15 mg/kg orally once a day

Comments:


Use: Treatment of pulmonary tuberculosis

US HHS, NIH, HRSA, and US CDC Recommendations:
DRUG-SUSCEPTIBLE TUBERCULOSIS:
Intensive phase: 15 to 25 mg/kg orally once a day PLUS isoniazid, rifampin, and pyrazinamide
Maximum dose: 2.5 grams/day
Duration of therapy: 2 months

DRUG-RESISTANT TUBERCULOSIS:
Initial phase: 15 to 25 mg/kg orally once a day PLUS moxifloxacin/levofloxacin, rifampin/rifabutin, and pyrazinamide

Continuation phase: 15 to 25 mg/kg orally once a day PLUS moxifloxacin/levofloxacin, and rifampin/rifabutin

Weight-based dosing recommendations:
Patients 40 to 55 kg: 800 mg orally once a day

Comment: Lymph node tuberculosis may be treated as minimal intrathoracic disease.

Uses:

American Academy of Pediatrics (AAP), IDSA, US CDC, and ATS Recommendations:
Infants, Children, and Adolescents: 15 to 25 mg/kg orally once a day OR 50 mg/kg orally 2 times a week
Maximum dose: 2.5 grams/dose
Duration of therapy: 2 months

Uses:

Usual Pediatric Dose for Mycobacterium avium-intracellulare - Treatment

US HHS, NIH, HRSA, and US CDC Recommendations:
15 to 25 mg/kg orally once a day PLUS clarithromycin
Maximum dose: 2.5 grams/day
Duration of therapy: At least 12 months

Comments:


Use: Initial treatment of MAC disease

Usual Pediatric Dose for Mycobacterium avium-intracellulare - Prophylaxis

US HHS, NIH, HRSA, and US CDC Recommendations:
Secondary Prophylaxis (Chronic Suppressive Therapy):
15 to 25 mg/kg orally once a day PLUS clarithromycin and/or rifabutin
Maximum dose: 2.5 grams
Secondary prophylaxis may be discontinued if the following are met:


Comments:

Uses:

Renal Dose Adjustments

Dose adjustment(s) may be required; however, no specific guidelines have been suggested. Caution recommended.

US HHS, NIH, HRSA, and US CDC Recommendations:
CrCl 10 to 50 mL/min: 15 to 25 mg/kg orally every 24 to 36 hours
CrCl less than 10 mL/min: 15 to 25 mg/kg orally every 48 hours

ATS, US CDC, and IDSA Recommendations:
Drug-susceptible Tuberculosis:
CrCl less than 30 mL/min: 15 to 25 mg/kg orally 3 times a week

Comment: Therapeutic drug monitoring should be considered to guide dosing.

Liver Dose Adjustments

Data not available

ATS, US CDC, and IDSA Recommendations:
Patients with liver disease:
Treatment without pyrazinamide: 15 to 25 mg/kg orally once a day PLUS isoniazid and rifampin


Treatment without isoniazid: 15 to 25 mg/kg orally once a day PLUS rifampin, pyrazinamide, with/without a fluoroquinolone

Patients with severe, unstable liver disease:
15 to 25 mg/kg orally once a day PLUS moxifloxacin/levofloxacin, cycloserine, and a second-line injectable

Weight-based dosing recommendations:
Patients 40 to 55 kg: 800 mg orally once a day

Precautions

CONTRAINDICATIONS:


Safety and efficacy have not been established in patients younger than 13 years; this drug is not recommended for use in these patients.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

US HHS, NIH, HRSA, and US CDC Recommendations:
Hemodialysis: 15 to 25 mg/kg orally 3 times a week after hemodialysis

Comment: Therapeutic drug monitoring should be considered to guide dosing.

Other Comments

Administration advice:


Storage requirements:

General:

Monitoring:

Patient advice:

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.