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 :277.2

%Protein binding :20–30

%Excreted unchanged in urine : 50

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

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

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : Dose as in normal renal function

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

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

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

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

HD :Dialysed. Dose as in GFR

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

HDF/high flux :Dialysed. Dose as in GFR

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

CAV/VVHD :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

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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

See how to identify renal failure stages according to GFR calculation

See how to diagnose irreversible renal disease

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