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Ethionamide is an antibiotic used to treat tuberculosis.
Ethionamide has a high rate of side effects.
Ethionamide was discovered in 1956 and approved for medical use in the United States in 1965.
1 Medical uses
2 Adverse effects
3 Mechanism of action
4 Society and culture
6 External links
Ethionamide is used in combination with other antituberculosis agents as part of a second-line regimen for active tuberculosis.
Ethionamide is well absorbed orally with or without food, but is often administered with food to improve tolerance.
The antimicrobial spectrum of ethionamide includes M. tuberculosis, M. bovis and M. segmatis.
The FDA has placed it in pregnancy category C, because it has caused birth defects in animal studies.
Ethionamide frequently causes gastrointestinal distress with nausea and vomiting which can lead patients to stop taking it.
Ethionamide can cause hepatocellular toxicity and is contraindicated in patients with severe liver impairment. Patients on ethionamide should have regular monitoring of their liver function tests.
Both central neurological side effects such as psychiatric disturbances and encephalopathy, along with peripheral neuropathy have been reported.
Ethionamide is structurally similar to methimazole, which is used to inhibit thyroid hormone synthesis, and has been linked to hypothyroidism in several TB patients.
Ethionamide may worsen the adverse effects of other antituberculous drugs being taken at the same time. It boosts levels of isoniazid when taken together and can lead to increased rates of peripheral neuropathy and hepatotoxicity.
Mechanism of action
Ethionamide is a prodrug
Expression of the ethA gene is controlled by ethR, a transcriptional repressor. It is thought that improving ethA expression will increase the efficacy of ethionamide and prompting interest by drug developers in EthR inhibitors as a co-drug.
Society and culture
It is sold under the brand name Trecator by Wyeth Pharmaceuticals which was purchased by Pfizer in 2009.
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