Ethionamide review

Ethionamide is a drug introduced in tablet forms used in the treatment of tuberculosis. Ethionamide’s complete chemical name is 2-ethylthioisonicotinamide. It is a yellow crystalline, nonhygroscopic compound having faint to moderate odor. It is insoluble in water, but has been found to be soluble in methanol and ethanol.

Ethionamide is considered a prodrug, a substance that is initially administered in inactive form and is then metabolized in vivo. Prodrugs in general, are designed to improve the overall bioavailability of the body.

Ethionamide is to be used alongside other medications that treat active infections of tuberculosis. Ethionamide is marketed under the brand name Trecator. It is used to treat tuberculosis patients already resistant to isoniazid or rifampin.

Each trecator tablet contains 250 mg of ethionamide. The dosage of the drug is dependent on the patient’s body weight. The usual dosage for adults is at 15 to 20 mg per kilogram of body weight per day. As the patient tolerates and reacts to the drug, the dose may be lowered or raised, with a maximum dosage of 1 gram daily. The administration of the drug is done orally.

Clinical tests have reported various side effects experienced by patients taking ethionamide in various body areas. Majority of side effects reported in the gastrointestinal tract include nausea, diarrhea, abdominal pains, vomiting, increased salivation, metallic taste in the mouth, weight and appetite loss, and mouth and lip sores.

The use of ethionamide may also result in side effects concerning the nervous system such as psychotic disturbances that may include mental depression, drowsiness, restlessness, headaches, and dizziness. Unlikely side effects experienced upon ethionamide use include blurred vision, neuritis and pellagra-like syndrome.

Serious side effects like increase in bilirubin and serum levels in the liver may occur, as well as hepatitis.

Ethionamide is contraindicated in patients with severe liver impairment and known hypersensitivity to the drug and its known components.

Ethionamide has been reported to temporarily increase concentrations of serums in ioniazid. Concomitant use of ethionamide with the drug cycloserine has reported to potentiate adverse effects as well side effects such as convulsions.

When taking ethionamide, alcohol ingestion should be monitored as reports of psychotic reactions have been reported. The use ethionamide alone may result in rapid development of drug resistance. Ethionamide should be administered concurrently with at least two other companion drugs, such as rifampin, ethambutol, kanamycin, pyrazinamide, and isoniazid.

An essential caution in the use of ethionamide is that patients should strictly comply with the drug therapy to prevent complications and drug resistance. The patients should take in only prescribed doses and the therapy must continue until the physician orders otherwise.

Pregnant women are advised to seek counsel from physicians prior to the administration of the drug ethionamide. Though no known studies have been made on pregnant women, the potential benefits of the drug must be weighed against the risks it poses to the unborn child. Pregnant women must only take Ethionamide if clearly needed, and if deemed by the physician that it is essential with the anti-tuberculosis treatment.

It is not known whether the drug is excreted in breast milk, hence nursing mothers or mothers planning to breastfeed must consult with their doctors prior to the usage of the drug.

Ethionamide has the following structural formula:

Chemical structure of ethionamide

• Molecular formula of ethionamide is C8H10N2S
• Chemical IUPAC Name is 2-ethylpyridine-4-carbothioamide
• Molecular weight is 166.244 g/mol
Ethionamide available : 250mg tablets

Brand name(s): Aethionamidum, Aetina, Aetiva, Amidazin, Amidazine, Atina, Ethimide, Ethina, Ethinamide, Ethionamidum, Ethioniamide, Ethylisothiamide, Ethyonomide, Etimid, Etiocidan, Etionamid, Etionamida, Etionamide, Etioniamid, Etionid, Etionizin, Etionizina, Etionizine, Fatoliamid, Iridocin, Iridozin, Isothin, Isotiamida, Itiocide, Nicotion, Nisotin, Nizotin, Rigenicid, Sertinon, Teberus, Thianid, Thianide, Thioamide, Thiomid, Thioniden, Tianid, Tio-Mid, Tiomid, Trecator, Trecator SC, Trekator, Trescatyl, Trescazide, Tubenamide, Tubermin, Tuberoid, Tuberoson

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