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Brand name: ethambutol
Generic name: Servambutol, myambutol, Sural, Tibitol, EMB, Etibi, Ethambutol, Mycobutol

ethambutol information:
Ethambutol appears to inhibit the synthesis of one or more metabolites, thus causing impairment of cell metabolism, arrest of multiplication, and cell death{16}. Patients developing visual abnormality during Ethambutol hydrochloride tablets treatment may show subjective visual symptoms before, or simultaneously with, the demonstration of decreases in visual acuity, and all patients receiving Ethambutol hydrochloride tablets should be questioned periodically about blurred vision and other subjective eye symptoms. Because cooperation is essential for performance of these tests, use of ethambutol in young children whose visual acuity cannot be monitored requires careful consideration of risks and benefits{01}. Testing of visual acuity should be performed before beginning Ethambutol hydrochloride tablet therapy and periodically during drug administration, except that it should be done monthly when a patient is on a dosage of more than 15 mg/kg/day. For patients weighing less than 50 kg, the doses of rifampin (450 mg), pyrazinamide (1500 mg) and ethambutol (800 mg) were reduced. In the initial 2 month phase of treatment (60 days), 361 patients received rifapentine 600 mg twice a week in combination with daily isoniazid, pyrazinamide, and ethambutol and 361 subjects received rifampin in combination with isoniazid, pyrazinamide and ethambutol all administered daily. The doses of the companion drugs were the same in both treatment arms during the initial phase: isoniazid 300 mg, pyrazinamide 2000 mg, and ethambutol 1200 mg. The patient was subsequently given isoniazid, pyrazinamide, ethambutol, ciprofloxacin, and recovered from tuberculosis. If signs and symptoms of hepatotoxicity occur, rifampin, isoniazid, pyrazinamide, and ethambutol combination should be discontinued promptly{08}{09}. It is suggested that ethambutol not be used in children whose visual acuity cannot be monitored. Ethambutol should be included unless primary isoniazid resistance is unlikely (isoniazid resistance rate documented to be less than 4%). The 8-month regimen includes administration of isoniazid, rifampin, and pyrazinamide, together with streptomycin or ethambutol {55} for the first two months, after which isoniazid and thiacetazone combination is administered daily for the remaining 6 months. 1% of TB patients were infected with TB strains that were resistant to at least one drug used as first-line treatment for TB (isoniazid, rifampin, pyrazinamide, ethambutol, and streptomycin) and 2. After being admitted to the hospital with multiple symptoms of tuberculosis, the patient was prescribed rifampin, isoniazid, pyrazinamide, and ethambutol. In addition, studies in rats given high doses of ethambutol have shown that ethambutol causes minor abnormalities of the cervical vertebrae. Optic neuropathy including optic neuritis or retrobulbar neuritis occurring in association with Ethambutol hydrochloride tablet therapy may be characterized by one or more of the following events: decreased visual acuity, scotoma, color blindness, and/or visual defect. Progressive decreases in visual acuity during therapy must be considered to be due to Ethambutol hydrochloride tablets. Studies have shown that there are definite fluctuations of one or two lines of the Snellen chart in the visual acuity of many tuberculous patients not receiving Ethambutol hydrochloride tablets. Ethambutol was discontinued when isoniazid and rifampin susceptibility testing results were confirmed. Priftin has been studied as part of the initial regimen with isoniazid, pyrazinamide and ethambutol [see Clinical Studies (14)]. Ethambutol or streptomycin should be added to the initial regimen until sensitivity to isoniazid and rifampin is demonstrated. In the initial 2 month phase of treatment (60 days), 361 patients received rifapentine 600 mg twice a week in combination with daily isoniazid, pyrazinamide, and ethambutol and 361 subjects received rifampin 600 mg in combination with isoniazid, pyrazinamide and ethambutol all administered daily. During this phase, which should last 2 to 3 months, rifampin, isoniazid, pyrazinamide, and ethambutol combination should be administered on a daily, continuous basis{02}. Ethambutol does not penetrate intact meninges, but 10 to 50% may penetrate the meninges of patients with tuberculous meningitis{16}. Up to 15% of ethambutol is metabolized to inactive metabolites{16}. Patients with culture-positive, drug-susceptible pulmonary tuberculosis who had completed the initial 2 month phase of treatment with 4 drugs (rifampin, isoniazid, pyrazinamide, and either ethambutol or streptomycin) under direct observation were randomly assigned to receive either rifapentine 600 mg and isoniazid 15 mg/kg (max 900 mg) once weekly or rifampin 10 mg/kg (max 600 mg) and isoniazid 15 mg/kg (max 900 mg) twice weekly for the 4 month continuation phase. Studies in rabbits given high doses of ethambutol have shown that ethambutol may cause monophthalmia, limb reduction defects, hare lip and cleft palate{16}. If careful evaluation confims the magnitude of visual change and fails to reveal another cause, Ethambutol hydrochloride tablets should be discontinued and the patient reevaluated at frequent intervals.

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