Ethambutol hydrochloride

CLINICAL USE

Antibacterial agent:Tuberculosis

DOSE IN NORMAL RENAL FUNCTION

15 mg/kg/day or 30 mg/kg 3 times a week (supervised dosing)

PHARMACOKINETICS

Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :277.2

%Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :20–30

%Excreted unchanged in urine &nbsp &nbsp : 50

Volume of distribution (L/kg) &nbsp &nbsp &nbsp :1.6–3.2

half-life – normal/ESRD (hrs)&nbsp &nbsp &nbsp :3–4/5–15

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 &nbsp &nbsp : Dose as in normal renal function

10 to 20 &nbsp &nbsp : 15 mg/kg every 24–36 hours, or 7.5–15 mg/kg/day

<10 &nbsp &nbsp &nbsp &nbsp &nbsp : 15 mg/kg every 48 hours, or 5–7.5 mg/kg/day

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:Not dialysed. Dose as in GFR <10 mL/min

HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Dialysed. Dose as in GFR

<10 &nbsp &nbsp &nbsp &nbsp &nbsp : mL/min, or on dialysis days only give 25 mg/kg post-dialysis

HDF/high flux &nbsp :Dialysed. Dose as in GFR

<10 &nbsp &nbsp &nbsp &nbsp &nbsp : mL/min, or on dialysis days only give 25 mg/kg post-dialysis

CAV/VVHD &nbsp &nbsp &nbsp:Dialysed. Dose as in GFR=10–20 mL/min

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugs

None known

ADMINISTRATION

Reconstition

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Route

Oral

Rate of Administration

–

Comments

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OTHER INFORMATION

Monitor plasma levels. Dosages should be individually determined and adjusted according to measured levels and renal replacement therapyPeak levels are taken 2–2.5 hours post dose (2–6 mg/L or 7–22 micromol/L); trough is taken pre dose (<1 mg/L or <4 micromol/L)Baseline visual acuity tests should be performed prior to initiating ethambutolDaily dosing is preferred by some specialists to aid compliance and ensure maximum therapeutic effect

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