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^ a b Lewis SM, Dirksen SR, Heitkemper MM, Bucher L, Harding M (5 December 2013). Annals of the Academy of Medicine, Singapore. "Ethambutol-associated optic neuropathy" (PDF). Branch, Michel Eichelbaum, Bernard Testa, Andrew Somogyi. ^ Stereochemical aspects of drug action and disposition. Chirotechnology : industrial synthesis of optically active compounds. ^ World Health Organization model list of essential medicines: 21st list 2019. Pharmaceutical Innovation: Revolutionizing Human Health. ^ Landau R, Achilladelis B, Scriabine A (1999). Archived from the original on 8 April 2014. Therapeutic Goods Administration, Department of Health, Australia. ^ "Prescribing medicines in pregnancy database". ^ a b c Stuart MC, Kouimtzi M, Hill SR, eds. Archived from the original on 5 June 2016. The American Society of Health-System Pharmacists. ^ a b c d e f g h "Ethambutol Hydrochloride". Archived from the original on 19 July 2014. Chemical Entities of Biological Interest. Tarascon Pocket Pharmacopoeia (Deluxe Lab-Coat ed.). It is well absorbed from the gastrointestinal tract and well distributed in body tissues and fluids. Disruption of the arabinogalactan synthesis inhibits the formation of this complex and leads to increased permeability of the cell wall. It disrupts arabinogalactan synthesis by inhibiting the enzyme arabinosyl transferase. Mycolic acids attach to the 5'-hydroxyl groups of D-arabinose residues of arabinogalactan and form mycolyl-arabinogalactan-peptidoglycan complex in the cell wall. It works by obstructing the formation of cell wall. Įthambutol is bacteriostatic against actively growing TB bacilli. Red-green color blindness People taking ethambutol should be monitored for changes in visual acuity and color discrimination. Optic neuritis (hence contraindicated in children below six years of age). Medical uses Įthambutol is used along with other medications to treat a number of infections including: tuberculosis, Mycobacterium avium complex, and Mycobacterium kansasii. Hence the use of (S,S)-enantiomer greatly improved the risk/benefit balance. Toxicity is associated to both dose and duration of treatment. On the other hand, all the three isomers are equipotent in terms of the major side-effect of the drug, optic neuritis. This enantiomer is 500 and 12 fold more potent than the (R,R)-ethmabutol and the meso-form respectively. The (S,S)-(+)-enantiomer harbors the antitubercular activity. An enantiomeric pair (S,S)- and (R,R)-ethmabutol, along with the achiral stereoisomer called meso-form. Ethambutol contains two constitutionally symmetrical chiral centers in its structure and exists in three stereoisomeric forms. It is a typical example of an old drug that was introduced for clinical use in its unichiral form. (S,S)-(+)-Ethambutol is powerful and selective antitubercular drug. It is on the World Health Organization's List of Essential Medicines and is available as a generic medication. 
Ethambutol is believed to work by interfering with the bacteria's metabolism. In the United States the FDA has raised concerns about eye issues in the baby if used during pregnancy. Use during pregnancy or breastfeeding has not been found to cause harm. It is not recommended in people with optic neuritis, significant kidney problems, or under the age of five. Other side effects include liver problems and allergic reactions. Ĭommon side effects include problems with vision, joint pain, nausea, headaches, and feeling tired. It may also be used to treat Mycobacterium avium complex, and Mycobacterium kansasii. It is usually given in combination with other tuberculosis medications, such as isoniazid, rifampicin and pyrazinamide.
Ethambutol ( EMB, E) is a medication primarily used to treat tuberculosis.
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