Indications
Sural Tablet is used for:
Tuberculosis
Adult Dose
Oral
Primary treatment of pulmonary and extrapulmonary tuberculosis
Adult: Initial 8 wk: 15 mg/kg/day or 30 mg/kg thrice wkly given with isoniazid, rifampicin and pyrazinamide.
For patients with history of antimycobacterial therapy: Initial doses: 25 mg/kg/day for 60 days, thereafter reduce to 15 mg/kg/day.
Child Dose
Tuberculosis
Child: PO 15–25 mg/kg, max 2.5 g q24h
For treatment of drug-resistant tuberculosis: 15-25 mg/kg daily or 50 mg/kg twice wkly.
For congenitally acquired tuberculosis:
Neonates: 15 mg/kg once daily and >1 mth: 15 mg/kg once daily or 30 mg/kg 3 times wkly for 2 mth initial treatment phase.
Renal Dose
Renal impairment: Dose adjustment may be needed as determined by blood levels of ethambutol.
Administration
Should be taken with food.
Contra Indications
Hypersensitivity; optic neuritis. Lactation.
Precautions
Impaired pre-treatment visual acuity, elderly, children. Perform liver, kidney and visual acuity tests regularly. Caution when assessing visual acuity in patients with cataracts, DM, recurrent eye inflammation to make sure that changes are not due to the underlying causes.
Lactation: enters breast milk; use with caution (AAP Committee states "compatible with nursing")
Pregnancy-Lactation
Pregnancy Category: B
Lactation: enters breast milk; use with caution (AAP Committee states "compatible with nursing")
Interactions
Delayed or reduced absorption w/ Al hydroxide.
Side Effects
Side effects of Ethambutol :
Acute gout or hyperuricemia, Abdominal pain, Anaphylaxis, Anorexia, Confusion, disorientation, Fever, Headache, LFT abnormalities, Malaise, Nausea
Optic neuritis; symptoms may include decreased acuity, color blindness or visual defects (usually revrsible with discontinuation, though irreversible blindness has been reported)
Peripheral neuritis, Pruritis, Rash, Vomiting
Mode of Action
Ethambutol interferes with RNA synthesis, causing suppression of Mycobacteria multiplication. It also has bacteriostatic action against M tuberculosis by acting on rapidly growing pathogens in cavity walls and is also effective in slow-growing pathogens. Has some action against atypical opportunistic Mycobacteria e.g. M kansasii, M avium complex (MAC).
Note
Sural 400mg Tablet generic name is Ethambutol. Sural 400mg Tablet is manufactured by Ambee Pharmaceuticals Ltd.Sural is availble in all over Bangladesh.
Mes BD drug index information on Sural Tablet is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.