Ethambutol (E)

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    Update: January 2022

     

    Forms and strengths

    • 100 mg and 400 mg tablets
    • 100 mg dispersible tablet, to be dispersed in 10 ml water

    Dosage

    • Child and adult: 15 to 25 mg/kg once daily
    • Maximum dose: 1200 mg daily
    • Renal insufficiency: 15 to 25 mg/kg 3 times a week

     

    Weight
    (kg)

    Daily dose
    (mg)

    400 mg
    tablet

    100 mg
    tablet

    5

    75-125

    1 tab

    6

    90-150

    1 tab

    7

    105-175

    1 tab

    8

    120-200

    2 tab

    9

    135-225

    2 tab

    10

    150-250

    2 tab

    11

    165-275

    2 tab

    12

    180-300

    2 tab

    13

    195-325

    2 tab

    14

    210-350

    3 tab

    15

    225-375

    3 tab

    16

    240-400

    3 tab

    17

    255-425

    3 tab

    18

    270-450

    1 tab

    19

    285-475

    1 tab

    20

    300-500

    1 tab

    21

    315-525

    1 tab

    22

    330-550

    1 tab

    23

    345-575

    1 tab

    24

    360-600

    1 tab

    25

    375-625

    1 tab

    26

    390-650

    1 tab

    27

    405-675

    1½ tab

    28

    420-700

    1½ tab

    29

    435-725

    1½ tab

     

    30-35

    800

    2 tab

    36-45

    800

    2 tab

    46-55

    1200

    3 tab

    56-70

    1200

    3 tab

    > 70

    1200

    3 tab

     

    Contra-indications, adverse effects, precautions

    • Do not administer to patients with severe renal impairment or pre-existing optic neuritis (e.g. diabetic retinopathy).
    • May cause: dose-related retrobulbar optic neuritis, exarcerbated in renal impairment.
    • The dosage must be carefully adjusted to the weight, especially for children under 5 years, as it is more difficult to detect visual changes at this age.
    • For the management of adverse effects, see Appendix 17.
    • Pregnancy: no contra-indication
    • Breastfeeding: no contra-indication

    Monitoring

    • Symptomatic monitoring. 

    Patient instructions

    • Take with or without food.
    • 100 mg dispersible tablets should be dispersed in 10 ml water.

    Remarks

    • For adults on drug-susceptible TB treatment, ethambutol is given as part of a fixed-dose combination.
    • Ethambutol is also used in the treatment of drug-resistant TB treatment for longer duration. For treatment > 2 months, daily doses should be closer to 15 mg/kg and visual acuity and colour discrimination should be monitored.

    Storage

     
    – 
     
    –  Below 25 °C