Ethionamide

Ethionamide Brand Name

Ethionamide is the name of the active ingredient of the drug under the brand name Trecator, which is produced by the American pharmaceutical company Pfizer. Under the Trecator brand, ethionamide is available to consumers in 250 mg dosage.

The excipients that make up the tablet – croscarmellose sodium, dye, magnesium stearate, microcrystalline cellulose, polyethylene glycol, polyvinyl alcohol, povidone, silicon dioxide, talc, titanium dioxide – don’t have any significant effect on the patient and are intended, in fact, in order for the tablet to have the necessary properties in terms of solubility, density, weight, color and size.

What Is Ethionamide?

Ethionamide is a second-line anti-tuberculosis drug, that is, second line of therapy. The mechanism of its action is not precisely known, however, apparently, ethionamide suppresses the synthesis of mycobacterial proteins, exerting a bacteriostatic effect on the causative agent of tuberculosis. In addition, ethionamide enhances phagocytosis at the site of tuberculous inflammation, which promotes its resorption. However, during treatment, the tuberculostatic activity of ethionamide decreases quite strongly and quickly.

Ethionamide, a derivative of isonicotinic acid. In its pure form it is a yellow crystalline powder with a weak to moderate sulfur odor, not hygroscopic. Ethionamide is practically insoluble in water and ether, sparingly soluble in ethyl and methyl alcohol, propylene glycol; soluble in acetone, dichloroethane; freely soluble in pyridine.

It is noteworthy that ethionamide is more active in an acidic environment. It acts on extra- and intracellularly located Mycobacterium tuberculosis (including strains resistant to isoniazid and streptomycin). In high concentrations, the drug acts on Mycobacterium leprae and some atypical mycobacteria (for example, Mycobacterium avium). The use of ethionamide inhibits the development of resistance of tuberculosis bacilli to other anti-tuberculosis drugs.

When ethionamide is taken concomitantly with cycloserine, the risk of developing neurotoxic side effects, in particular seizures, increases (especially in patients with a history of neurological diseases). When combining the drug with isoniazid, rifampicin and pyrazinamide, the risk of hepatotoxicity increases. Ethionamide enhances the toxic effects of alcohol, so alcohol and ethionamide are incompatible, especially during a treatment regimen that requires large doses of medication. Alcohol increases the likelihood and risk of developing epileptic seizures.

Ethionamide dosage form

When taken orally, the initial dose of ethionamide for adults is 250 mg/day, after 5 days the dose is increased to 500 mg/day,after another 5 days – to 0.75-1 g/day. A gradual increase in dosage is necessary to minimize the development of side effects, especially from the nervous and digestive systems.

The maximum daily dose of the drug for adults is 1 g.

For children, ethionamide is prescribed in doses of 10-20 mg/kg body weight per day, depending on the severity of the disease, the general condition of the body, and the presence of concomitant diseases. The duration of treatment is 1-2 years.

Ethionamide is produced by a large number of pharmaceutical companies. In addition to the original drug under the trade name Trecator, ethionamide is present in the product range of almost every major drug manufacturer. Thus, if desired, a US resident can order ethionamide from any other manufacturer, be it Indian, Canadian, Hungarian, and so on. Moreover, in almost all cases, patients have access to only one dosage option, namely 250 mg, since it is recognized as the most convenient in terms of varying the dosage in accordance with the individual needs of the patient and the doctor’s recommendations.

The medicine must be taken orally about half an hour after a meal, preferably with milk or orange juice, which improves its absorption into the blood. Ethionamide is prescribed routinely at 250 mg 3-4 times a day. For patients over the age of 60 years, if their body weight is less than 50 kg, it is recommended to take 250 mg twice a day. For children, the daily dosage should not exceed 750 mg per day.

Buy Ethionamide without Prescription

Ethionamide, as recommended by the FDA, the World Health Organization, and local regulatory authorities in most countries around the world, is available only by prescription. This makes sense, since before treatment it is necessary to test the pathogen for sensitivity to the drug, as well as examine the gastrointestinal tract and liver function. During treatment, it is necessary to monitor the level of liver transaminase activity every 2-4 weeks, conduct an ophthalmological examination, and for patients suffering from diabetes, regularly determine blood sugar levels. When ethionamide is used together with pyrazinamide, even more frequent monitoring of liver function is necessary to avoid liver damage due to the hepatotoxic effect of the drug. To prevent side effects, body on MID should be combined with nicotinamide and vitamin B6. This helps reduce the load on the liver.

Despite the fact that, legally, ethionamide is deservedly a prescription drug, there are situations when the patient needs to replenish the supply of this medicine, but the treasured prescription is not at hand. This can happen if the paper is lost during a move or on a business trip, or the pharmacy requires a more recent prescription than the patient already has, even if he follows all the doctor’s recommendations and regularly undergoes all necessary examinations. Finally, not all people with tuberculosis are willing to simply go to the local pharmacy, where they may know their neighbors, family and co-workers, and present a prescription for a drug against such a stigmatized disease as tuberculosis. In this case, buying ethionamide without a doctor’s prescription in online pharmacies becomes a real lifesaver.

Of course, not all pharmacies provide such a service, but most large international, as well as Indian national online pharmacies are very formal about the requirement to provide a prescription. As a rule, in order to buy even such a serious drug as ethionamide, you just need to check the box that asks you if you know that the drug is a prescription drug.