Details
| Stereochemistry | RACEMIC |
| Molecular Formula | C10H24N2O2.2ClH |
| Molecular Weight | 277.232 |
| Optical Activity | ( + / - ) |
| Defined Stereocenters | 2 / 2 |
| E/Z Centers | 0 |
| Charge | 0 |
SHOW SMILES / InChI
SMILES
Cl.Cl.CC[C@@H](CO)NCCN[C@@H](CC)CO
InChI
InChIKey=AUAHHJJRFHRVPV-BZDVOYDHSA-N
InChI=1S/C10H24N2O2.2ClH/c1-3-9(7-13)11-5-6-12-10(4-2)8-14;;/h9-14H,3-8H2,1-2H3;2*1H/t9-,10-;;/m0../s1
| Molecular Formula | C10H24N2O2 |
| Molecular Weight | 204.3098 |
| Charge | 0 |
| Count |
|
| Stereochemistry | ABSOLUTE |
| Additional Stereochemistry | No |
| Defined Stereocenters | 2 / 2 |
| E/Z Centers | 0 |
| Optical Activity | UNSPECIFIED |
| Molecular Formula | ClH |
| Molecular Weight | 36.461 |
| Charge | 0 |
| Count |
|
| Stereochemistry | ACHIRAL |
| Additional Stereochemistry | No |
| Defined Stereocenters | 0 / 0 |
| E/Z Centers | 0 |
| Optical Activity | NONE |
DescriptionCurator's Comment: Description was created based on several sources, including http://www.drugbank.ca/drugs/DB00330
Curator's Comment: Description was created based on several sources, including http://www.drugbank.ca/drugs/DB00330
ETHAMBUTOL HYDROCHLORIDE is an oral chemotherapeutic agent which is specifically effective against actively growing microorganisms of the genus Mycobacterium, including M. tuberculosis. Ethambutol inhibits RNA synthesis and decreases tubercle bacilli replication. Nearly all strains of M. tuberculosis and M. kansasii as well as a number of strains of MAC are sensitive to ethambutol. Ethambutol inhibits arabinosyl transferases which is involved in cell wall biosynthesis. By inhibiting this enzyme, the bacterial cell wall complex production is inhibited. This leads to an increase in cell wall permeability. ETHAMBUTOL HCl is indicated for the treatment of pulmonary tuberculosis. It should not be used as the sole antituberculous drug, but should be used in conjunction with at least one other antituberculous drug.
Approval Year
Targets
| Primary Target | Pharmacology | Condition | Potency |
|---|---|---|---|
Target ID: Probable arabinosyltransferase C Sources: http://www.drugbank.ca/drugs/DB00330 |
|||
Target ID: Probable arabinosyltransferase B Sources: http://www.drugbank.ca/drugs/DB00330 |
|||
Target ID: CHEMBL1877 Sources: http://www.drugbank.ca/drugs/DB00330 |
Conditions
| Condition | Modality | Targets | Highest Phase | Product |
|---|---|---|---|---|
| Primary | MYAMBUTOL Approved Usepulmonary tuberculosis Launch Date1967 |
Cmax
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
4.5 μg/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/10049268/ |
25 mg/kg single, oral dose: 25 mg/kg route of administration: Oral experiment type: SINGLE co-administered: |
ETHAMBUTOL serum | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
|
3.3 μg/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/10049268/ |
25 mg/kg single, oral dose: 25 mg/kg route of administration: Oral experiment type: SINGLE co-administered: aluminum-magnesium antacid |
ETHAMBUTOL serum | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
|
3.8 μg/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/10049268/ |
25 mg/kg single, oral dose: 25 mg/kg route of administration: Oral experiment type: SINGLE co-administered: |
ETHAMBUTOL serum | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: HIGH-FAT |
AUC
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
28 μg × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/10049268/ |
25 mg/kg single, oral dose: 25 mg/kg route of administration: Oral experiment type: SINGLE co-administered: |
ETHAMBUTOL serum | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
|
27.5 μg × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/10049268/ |
25 mg/kg single, oral dose: 25 mg/kg route of administration: Oral experiment type: SINGLE co-administered: aluminum-magnesium antacid |
ETHAMBUTOL serum | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
|
29.6 μg × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/10049268/ |
25 mg/kg single, oral dose: 25 mg/kg route of administration: Oral experiment type: SINGLE co-administered: |
ETHAMBUTOL serum | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: HIGH-FAT |
Doses
| Dose | Population | Adverse events |
|---|---|---|
25 mg/kg 1 times / day multiple, oral Recommended Dose: 25 mg/kg, 1 times / day Route: oral Route: multiple Dose: 25 mg/kg, 1 times / day Sources: |
unhealthy, 79 years |
Disc. AE: Agranulocytosis... AEs leading to discontinuation/dose reduction: Agranulocytosis (1 patient) Sources: |
AEs
| AE | Significance | Dose | Population |
|---|---|---|---|
| Agranulocytosis | 1 patient Disc. AE |
25 mg/kg 1 times / day multiple, oral Recommended Dose: 25 mg/kg, 1 times / day Route: oral Route: multiple Dose: 25 mg/kg, 1 times / day Sources: |
unhealthy, 79 years |
Overview
| CYP3A4 | CYP2C9 | CYP2D6 | hERG |
|---|---|---|---|
OverviewOther
| Other Inhibitor | Other Substrate | Other Inducer |
|---|---|---|
Drug as perpetrator
| Target | Modality | Activity | Metabolite | Clinical evidence |
|---|---|---|---|---|
Page: 1.0 |
moderate [IC50 53.9 uM] | likely Comment: Drug-drug interaction index prediction Page: 1.0 |
||
Page: 1.0 |
moderate [IC50 57.6 uM] | likely Comment: Drug-drug interaction index prediction Page: 1.0 |
||
Sources: https://pubmed.ncbi.nlm.nih.gov/24910189/ Page: 1.0 |
moderate [IC50 8.4 uM] | |||
Sources: https://pubmed.ncbi.nlm.nih.gov/24910189/ Page: 1.0 |
moderate [IC50 9.4 uM] | |||
| no | ||||
Sources: https://pubmed.ncbi.nlm.nih.gov/24910189/ Page: 1.0 |
no | |||
Sources: https://pubmed.ncbi.nlm.nih.gov/24910189/ Page: 1.0 |
no | |||
Page: 4.0 |
no | |||
| no | ||||
| no | ||||
Page: 4.0 |
no | |||
Page: 4.0 |
no | |||
Page: 4.0 |
no | |||
Page: 1.0 |
no | unlikely Comment: Drug-drug interaction index prediction Page: 1.0 |
||
Page: 1.0 |
strong [IC50 253.8 uM] | likely Comment: Drug-drug interaction index prediction Page: 1.0 |
||
Page: 1.0 |
strong [IC50 92.6 uM] | likely Comment: Drug-drug interaction index prediction Page: 1.0 |
||
Sources: https://pubmed.ncbi.nlm.nih.gov/24910189/ Page: 1.0 |
strong [Ki 1.4 uM] | |||
Sources: https://pubmed.ncbi.nlm.nih.gov/24910189/ Page: 1.0 |
strong [Ki 2.9 uM] | |||
Page: 1.0 |
weak [IC50 4100 uM] | likely Comment: Drug-drug interaction index prediction Page: 1.0 |
||
Sources: https://pubmed.ncbi.nlm.nih.gov/24910189/ Page: 1.0 |
weak | |||
Sources: https://pubmed.ncbi.nlm.nih.gov/24910189/ Page: 1.0 |
weak | |||
Sources: https://pubmed.ncbi.nlm.nih.gov/24910189/ Page: 1.0 |
weak | |||
Page: 4.0 |
weak | |||
Page: 4.0 |
weak | |||
Page: 4.0 |
weak | |||
| yes [IC50 88.2 uM] |
Drug as victim
| Target | Modality | Activity | Metabolite | Clinical evidence |
|---|---|---|---|---|
Page: 1.0 |
major | |||
Page: 1.0 |
major | |||
Page: 4.0 |
no | |||
Page: 1.0 |
yes | |||
Page: 1.0 |
yes | |||
Page: 1.0 |
yes | |||
Sources: https://pubmed.ncbi.nlm.nih.gov/17258938/ Page: 1.0 |
yes | |||
Page: 1.0 |
yes | likely Comment: DDI index of >0.1 Page: 1.0 |
||
Page: 1.0 |
yes | likely Comment: Drug-drug interaction index prediction Page: 1.0 |
PubMed
| Title | Date | PubMed |
|---|---|---|
| Decreased retinal nerve fibre layer thickness detected by optical coherence tomography in patients with ethambutol-induced optic neuropathy. | 2007-07 |
|
| Rapid phenotypic assay of antimycobacterial susceptibility pattern by direct mycobacteria growth indicator tube and phage amplified biological assay compared to BACTEC 460 TB. | 2007-03 |
|
| Abnormal multifocal electroretinogram (mfERG) in ethambutol toxicity. | 2006-12-22 |
|
| [Case of SIADH caused by ethionamide in a patient with pulmonary tuberculosis]. | 2006-12 |
|
| Activity of 7-methyljuglone in combination with antituberculous drugs against Mycobacterium tuberculosis. | 2006-11 |
|
| [Ocular toxicity by the use of ethambutol]. | 2006-10-07 |
|
| Antituberculous therapy-induced fulminant hepatic failure: successful treatment with liver transplantation and nonstandard antituberculous therapy. | 2006-09 |
|
| Enhanced susceptibility of multidrug resistant strains of Mycobacterium tuberculosis to granulysin peptides correlates with a reduced fitness phenotype. | 2006-07 |
|
| Ethambutol-associated optic neuropathy. | 2006-04 |
|
| Ocular toxicity of ethambutol. | 2006-02 |
|
| Menstrual disorders in nongenital tuberculosis. | 2006 |
|
| [Vision impairment in the course of lung tuberculosis treatment]. | 2006 |
|
| [Meningoencephalitis tuberculosis--primary isolation of resistant M. tuberculosis]. | 2006 |
|
| Fluoroquinolones: an important class of antibiotics against tuberculosis. | 2006 |
|
| Differential antibiotic susceptibilities of starved Mycobacterium tuberculosis isolates. | 2005-11 |
|
| Is liver transplantation advisable for isoniazid fulminant hepatitis in active extrapulmonary tuberculosis? | 2005-11 |
|
| [Mycobacterium bovis tuberculosis in a female patient with AIDS]. | 2005-09-24 |
|
| Diversity in domain architectures of Ser/Thr kinases and their homologues in prokaryotes. | 2005-09-19 |
|
| Multifocal ERG in ethambutol associated visual loss. | 2005-08 |
|
| Rapidly developing optic neuritis secondary to ethambutol: possible mechanism of injury. | 2005-07 |
|
| Multifocal electroretinogram demonstrated macular toxicity associated with ethambutol related optic neuropathy. | 2005-06 |
|
| Antimycobacterial agents differ with respect to their bacteriostatic versus bactericidal activities in relation to time of exposure, mycobacterial growth phase, and their use in combination. | 2005-06 |
|
| Phenotypic and molecular characterization of Mycobacterium tuberculosis isolates resistant to both isoniazid and ethambutol. | 2005-06 |
|
| In vitro activity of linezolid, clarithromycin and moxifloxacin against clinical isolates of Mycobacterium kansasii. | 2005-06 |
|
| Optical coherence tomography can measure axonal loss in patients with ethambutol-induced optic neuropathy. | 2005-05 |
|
| The role of ultrasound and echo-color Doppler in the diagnosis and follow-up of tuberculosis of the transplanted kidney. | 2005-03 |
|
| Synthesis, antimicrobial activity and molecular modeling studies of halogenated 4-[1H-imidazol-1-yl(phenyl)methyl]-1,5-diphenyl-1H-pyrazoles. | 2004-10-15 |
|
| [Septic shock following intracavitary Bacillus Calmette-Guerin therapy for postcystectomy ureteral cancer]. | 2004-09 |
|
| The activity of grepafloxacin in two murine models of Mycobacterium avium infection. | 2004-06 |
|
| Ethambutol-induced acute renal failure. | 2004-05 |
|
| Ethambutol-induced optic neuropathy in a patient with pituitary macroadenoma: case report. | 2004-04-03 |
|
| Ethambutol-induced optic neuritis in patients with end stage renal disease on hemodialysis: two case reports and literature review. | 2004-03 |
|
| Pancytopenia due to extensive hemophagocytosis following anti-tubercular treatment. | 2004-02 |
|
| New agents active against Mycobacterium avium complex selected by molecular topology: a virtual screening method. | 2004-01 |
|
| [Unusual therapeutic approach in treatment of pulmonary tuberculosis in six year old girl]. | 2004 |
|
| Evaluation of visual functions in patients on ethambutol therapy for tuberculosis: a prospective study. | 2003-12 |
|
| Familial clustering of rifampin-induced acute renal failure. | 2003-12 |
|
| Ocular ethambutol toxicity. | 2003-11 |
|
| Ethambutol and optic neuropathy. | 2003-07 |
|
| Mefloquine, moxifloxacin, and ethambutol are a triple-drug alternative to macrolide-containing regimens for treatment of Mycobacterium avium disease. | 2003-06-15 |
|
| Leber's hereditary optic neuropathy precipitated by ethambutol. | 2003-05-04 |
|
| Ten years of extrapulmonary tuberculosis in a Danish university clinic. | 2003 |
|
| Spectrum of drugs against atypical mycobacteria: how valid is the current practice of drug susceptibility testing and the choice of drugs? | 1992-12 |
|
| The Garrod Lecture. Understanding the chemotherapy of tuberculosis--current problems. | 1992-05 |
|
| CI-960 (PD127391 or AM-1091), sparfloxacin, WIN 57273, and isepamicin activity against clinical isolates of Mycobacterium avium-intracellularae complex, M. chelonae, and M. fortuitum. | 1992-02 |
|
| Bacteriostatic and bactericidal activity of antituberculosis drugs against Mycobacterium tuberculosis, Mycobacterium avium-Mycobacterium intracellulare complex and Mycobacterium kansasii in different growth phases. | 1992 |
|
| Chlorpromazine: a drug potentially useful for treating mycobacterial infections. | 1992 |
|
| Antimycobacterial spectrum of sparfloxacin and its activities alone and in association with other drugs against Mycobacterium avium complex growing extracellularly and intracellularly in murine and human macrophages. | 1991-12 |
|
| In vivo activities of newer rifamycin analogs against Mycobacterium avium infection. | 1991-10 |
|
| Mode of action of ethambutol on Mycobacterium tuberculosis, strain H37R V. | 1963-06 |
Sample Use Guides
In Vivo Use Guide
Sources: http://www.drugs.com/dosage/ethambutol.html
Usual Adult Dose for Tuberculosis - Active
Initial treatment: 15 mg/kg orally once a day for 6 to 8 weeks with concurrent isoniazid therapy.
Retreatment: 25 mg/kg orally once a day for 60 days concurrently with at least one other anti-TB drug. After 60 days, decrease dose to 15 mg/kg orally once a day.
As an alternative to single daily dose, a dose of 40 mg/kg orally twice a week or 30 mg/kg orally 3 times a week can be administered. This generally follows 2 weeks of daily therapy.
Route of Administration:
Oral
In Vitro Use Guide
Curator's Comment: In vitro antimycobacterial activity against Mycobacterium tuberculosis H37Rv was evaluated.
The antimycobacterial activity of ethambutol was assessed against Mycobacterium tuberculosis (H37Rv) strain using micro plate Alamar Blue assay (MABA). Compound showed inhibitory activity with MIC value 3.125 ug/mL
| Substance Class |
Chemical
Created
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Edited
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| Record UNII |
JNG307DJ5X
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| Record Status |
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| Record Version |
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