Ethambutol (drug interactions)
Ethambutol is an antibiotic commonly used in conjunction with isoniazid for the treatment of tuberculosis. It is crucial to be aware of potential drug interactions when taking ethambutol, as it may affect the absorption of essential minerals like copper and zinc. To mitigate this, it is recommended to take mineral supplements at least two hours apart from ethambutol. Additionally, interactions with herbal supplements such as St. John's wort and high doses of vitamin B6 have been noted, though research on these interactions is limited. Patients should also avoid antacids containing aluminum hydroxide for four hours after taking the medication, as they can impede absorption.
Caution is advised for individuals with renal dysfunction, hyperuricemia, hepatic impairments, or optic neuritis, as they should avoid ethambutol. There is a heightened risk of neurological side effects when ethambutol is taken alongside disulfiram, a medication for alcohol dependence. Patients should also be mindful of other medications affecting the nervous system, liver, or kidney function. Due to the possibility of over one hundred other drug interactions, it is essential for individuals to consult with their healthcare provider regarding any other medications they are taking before starting ethambutol.
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Subject Terms
Ethambutol (drug interactions)
DEFINITION: A drug used with isoniazid in the treatment of tuberculosis.
INTERACTIONS: Copper, zinc, aluminum hydroxide, St. John's wort, vitamin B6, various prescription medications
TRADE NAME: Myambutol
Copper and Zinc
Effect: Take at a Different Time of Day
Ethambutol may interfere with the absorption of copper and zinc by binding to them. To avoid deficiency, one should take supplements of these essential minerals. The doses of ethambutol and mineral supplements should be separated by at least two hours.
Other Interactions
Research remains limited on all the interactions between ethambutol and herbs and supplements. Other known interactions include St. John’s wort and high doses of vitamin B6. Patients are advised to avoid antacids containing aluminum hydroxide four hours after taking ethambutol as they may affect absorption. Patients with renal dysfunction, hyperuricemia, hepatic impairments, and optic neuritis should avoid ethambutol. Disulfiram, a drug used for alcohol dependence, may increase the risk of neurological side effects when taken with ethambutol. Caution should also be taken with drugs that affect the nervous system, are processed by the liver, or affect kidney function. Individuals taking ethambutol are also cautioned to avoid live vaccines. Over one hundred other drugs and medications that doctors believe could potentially interact with ethambutol, and because those interactions range from major to minor, patients should discuss all medications with their doctor before consuming ethambutol.
Bibliography
"Ethambutol Interactions." Drugs.com, www.drugs.com/drug-interactions/ethambutol.html. Accessed 10 Sept. 2024.
"Ethambutol (Myambutol)." Everyday Health, www.everydayhealth.com/drugs/ethambutol. Accessed 10 Sept. 2024.
Lee, Nick. "Ethambutol - StatPearls." NCBI, 2 May 2024, www.ncbi.nlm.nih.gov/books/NBK559050. Accessed 10 Sept. 2024.
Mandell, G. L., and W. A. Petri. "Antimicrobial Agents: Drugs Used in the Chemotherapy of Tuberculosis, Mycobacterium avium Complex Disease, and Leprosy." Goodman and Gilman’s The Pharmacological Basis of Therapeutics, edited by Laurence L. Brunton et al. 11th ed., New York: McGraw-Hill Medical, 2011.
Solecki, T. J., et al. "Effect of a Chelating Drug on Balance and Tissue Distribution of Four Essential Metals." Toxicology, vol. 31, no. 3-4, 1984, pp. 207-216.