Kombutol - instructions for use, reviews, analogs and formulations (tablets 100 mg, 200 mg, 400 mg, 600 mg, 800 mg, 1 g) of the drug for the treatment of all forms of tuberculosis and MAS infection in adults, children and pregnancy. Adverse effects, composition

In this article, you can read the instructions for using the drug Kombutol. There are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors of specialists on the use of Kombutol in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues Kombutol with available structural analogues. Use to treat all forms of pulmonary and extrapulmonary tuberculosis and nontuberculous mycobacteriosis in adults, children, as well as during pregnancy and lactation.Composition of the drug and side effects when it is taken.

Kombutol second-line anti-tuberculosis drug. It has a bacteriostatic effect only on Mycobacterium tuberculosis (mycobacterium tuberculosis), including strains resistant to streptomycin, kanamycin, isoniazid, paraaminosalicylic acid (PASC) and ethionamide. The mechanism of action is not exactly fixed. It seems that ethambutol (the active ingredient of Combutol) penetrates into mycobacteria and breaks the synthesis of ribonucleic acid (RNA). It is active only for intensively dividing bacteria. The resistance of Mycobacterium tuberculosis to ethambutol develops relatively slowly.

Composition

Ethambutol hydrochloride + excipients.

Pharmacokinetics

After intake, absorption from the gastrointestinal tract (GIT) is 80%, the rest of the dose is excreted with feces unchanged. Food intake has little effect on absorption. At a single dose of 25 mg per 1 kg of body weight, the maximum concentration of ethambutol in blood plasma is reached after 4 hours and is 5 μg per ml, after 24 hours the concentration is less than 1 μg per ml. Ethambutol is distributed in most tissues, including the lungs, kidneys, red blood cells. It penetrates into the cerebrospinal fluid with inflammation of the meninges.Ethambutol is excreted mainly with urine in unchanged form, 8-15% in the form of inactive metabolites, aldehyde and dicarboxylic derivatives.

Indications

• tuberculosis of respiratory organs, confirmed bacteriologically and histologically;
• tuberculous meningitis;
• tuberculosis of bones and joints;
• tuberculosis of the urogenital system;
• tuberculosis of the central nervous system;
• tuberculosis of the spine;
• tuberculosis of the eye;
• lupus;
• tuberculosis of other organs;
• non-tuberculous mycobacteriosis, including MAS infection - a disease caused by Mycobacterium avium-intracellulare (also called Mycobacterium avium complex, MAS).

Forms of release

Tablets 100 mg, 200 mg, 400 mg, 600 mg, 800 mg and 1 g.

Instructions for use and dosing regimen

Take inside at a dose of 15-25 mg per 1 kg of body weight 1 time per day, or 50 mg per 1 kg of body weight 2 times a week, or 25-30 mg per kilogram 3 times a week.

The maximum daily dose for adults is 2.5 mg.

Side effect

• dizziness;
• depression;
• peripheral neuritis (inflammation of the peripheral nerves);
• retrobulbar neuritis (inflammation of the optic nerve);
• violation of color perception (mostly green and red);
• reduction of central and peripheral fields of vision;
• the emergence of cattle (blind areas in sight);
• nausea, vomiting, loss of appetite;
• arthritis (inflammation of the joint);
• skin rash.

Contraindications

• neuritis (inflammation) of the optic nerve;
• cataract;
• diabetic retinopathy (retinal lesion);
• inflammatory diseases of the eyes;
• pregnancy;
• impaired renal function;
• children's age till 13 years;
• hypersensitivity to ethambutol.

Application in pregnancy and lactation

The use of Kombutol during pregnancy is contraindicated.

Etambutol penetrates the placental barrier, excreted in breast milk.

In experimental studies, the teratogenic effect of ethambutol was established.

Use in children

Contraindicated in childhood to 13 years.

special instructions

At the beginning of treatment, it is possible to increase cough, increase the amount of sputum.

Combobutol is used only in combination with other antituberculosis drugs. In combination with Isoniazid and rifampicin is highly effective in the treatment of tuberculosis.

When performing long-term therapy, it is necessary to regularly monitor the functions of vision, the picture of peripheral blood, as well as the functional state of the liver and kidneys.

Drug Interactions

With the simultaneous use of aluminum hydroxide, a decrease in the absorption of ethambutol from the gastrointestinal tract occurs.

There is evidence of a possible increase in optical neuropathy due to ethambutol, when it is used in combination with isoniazid.

Under the influence of ethambutol, a change in the metabolism of zinc is possible.

Analogues of the drug Combutol

Structural analogs for the active substance:

• Apputol;
• EMB-Fatol;
• Eckox;
• Li-butol;
• Etambusin;
• Ethambutol;
• Ethambutol hydrochloride.

Analogues on the curative effect (funds for the treatment of tuberculosis):

• Aloe syrup with iron;
• Ascoril eksponorant;
• Benemycin;
• Bromhexine-Ferein;
• Vitamin D3 aqueous solution;
• Heptavit;
• Hydrocortisone;
• Glutoxim;
• Eckox;
• Zanotsin;
• Zukoks;
• Isoniazid;
• Kanamycin sulfate;
• Kapastat;
• Coxerin Plus;
• Combine;
• Mairin;
• Maksakvin;
• Metazide;
• The mukonist;
• Sodium nucleate;
• Sodium para-aminosalicylate;
• Ofloxacin;
• Pisina;
• Pyrazinamide;
• Polybacterin;
• Prednisolone;
• Prothionamide-Acry;
• P-zinc;
• Retinol palmitate;
• Rimactan;
• Rimpacine;
• Rimpin IPZ;
• Rifadine;
• Rifakomb;
• Rifamor;
• Rifampicin;
• Rifaren;
• Reefater;
• Rifinag;
• Rifogal;
• Streptomycin;
• Tizamide;
• Tubelon;
• Fenazide;
• Phthisopyrum;
• Phthisopyrum;
• Phthisoetham;
• Cycloserin;
• Ciprobrin;
• Cigapan;
• Ergocalciferol (Vitamin D2);
• Eremfat;
• Etambusin;
• Ethambutol;
• Ethionamide.

Phthisiatric doctor's opinion

I want to share my observations related to the use of Kombutol. I appoint him as part of a comprehensive therapy for adults with different forms of tuberculosis, both pulmonary and extrapulmonary. I noticed that the smaller the frequency of taking Kombutol, the less often there are side reactions from the nervous system and digestive organs. And this despite the fact that the total dose that the patient receives is approximately the same. Patients taking pills twice a week rarely complain about vision problems, dizziness, nausea and vomiting.

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