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| Interactions: | Cycloserine
Adverse Effect: neurologic adverse effects, including seizures Clinical Management: If possible, avoid concurrent administration of cycloserine and ethionamide in patients with a history of or predisposed to seizure disorders. Caution should be used and patients closely monitored for CNS toxicity if this combination of agents is to be given.
Ethambutol
Adverse Effect: excessive adverse effect (GI distress, headache, confusion, neuritis, and hepatotoxicity) Clinical Management: Monitor patients receiving combined ethambutol and ethionamide for excessive side effects, especially hepatotoxicity and CNS effects. This combination of agents should only be administered to patients found to have normal baseline liver function. Regular liver function tests should be performed .
INH
Adverse Effect: peripheral neuritis, hepatotoxicity, and encephalopathy Clinical Management: If possible, avoid concurrent administration of isoniazid and ethionamide in patients with a history of or predisposed to peripheral neuropathy or liver disorders. Patients should be found to have normal baseline liver function before combined isoniazid-ethionamide therapy is initiated. Regular liver function tests should be performed.
Pyrazinamide
Adverse Effect: hepatotoxicity Clinical Management: Combined pyrazinamide-ethionamide therapy should only be administered to patients found to have normal baseline liver function. Regular liver function tests should be performed during use of this combination of agents. Patients with diabetes mellitus are more likely to experience hepatotoxicity and have more difficulty with diabetic management; these patients need close monitoring. Ethionamide should be withdrawn if significant alterations in liver tests are observed.
Rifampicin
Adverse Effect: hepatotoxicity Clinical Management: Combined rifampin and ethionamide therapy should only be administered to patients found to have normal baseline liver function. Regular liver function tests should be performed in patients receiving this combination of agents. Patients with diabetes mellitus are more likely to experience hepatitis and have more difficulty with diabetic management; these patients need close monitoring. Ethionamide should be withdrawn if significant alterations in liver tests are observed. |
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