Ethambutol Intravenous for Adults

Who can administer

May be administered by registered competent doctor or nurse/midwife

Important information

• Unlicensed preparation
• Must be diluted before administration via IV infusion. High peak levels increase risk of damage to eyesight so DO NOT GIVE undiluted

Available preparations

EMB-Fatol 1g in 10ml vial

Reconstitution

Already in solution

Dilute further prior to administration

Infusion fluids

Sodium chloride 0.9% or Glucose 5%

Methods of intravenous administration

Slow intravenous infusion

• Add required dose to 500ml infusion solution and administer over at least 2 hours ^{(ref 1)}
• Slow infusion required, as high peak levels increase risk of damage to eyesight

Dose in adults

Usual dose

• Use the same dose by intravenous infusion as would be given orally
• Switch to oral therapy as soon as possible

Renal impairment ^{(ref 2)}

GFR (mL/min/1.73m2)	Dose	Alternative dose
Greater than 20	Usual dose
10 to 20	15 mg/kg every 24 to 36 hours	7.5 to 15 mg/kg/day
less than 10	15 mg/kg every 48 hours	5 to 7.5 mg/kg/day

Monitoring

• Hypersensitivity syndrome has been reported (skin reaction, eosinophilia plus one or more of the following: hepatitis, pneumonitis, nephritis, myocarditis, pericarditis). Fever and lymphadenopathy may be present.
• Anaphylactoid reactions have been reported
• Ethambutol can cause optic neuritis and must be discontinued in patients who report changes in their eyesight, as it can cause irreversible visual damage (blindness) if treatment is not discontinued in a timely manner.
• Monitor renal and hepatic function

Storage

Store below 25⁰C

References

1: Medusa UK Injectable Medicines guide downloaded 17th Jan 2023

2: Renaldrugdatabase.com, downloaded 17th Jan 2023

Therapeutic classification

Anti-tuberculosis agent