Tibinyl E400

Tibinyl E400 is an anti-tuberculosis drug with a bacteriostatic type of activity. It inhibits the reproduction of mycobacterium tuberculosis, which are resistant to isoniazid, ethionamide, PASK with streptomycin and kanamycin.

At the initial stage of therapy, there may be an increase in sputum volume and an increase in coughing. The medicine can be used only in combination with other anti-tuberculosis drugs. During prolonged treatment, it is necessary to constantly monitor the parameters of peripheral blood and the work of the kidneys with the liver. [1]

Indications Tibinyl E400

It is used for different types of tuberculosis (both pulmonary and affecting other organs).

Release form

The release of the medication is in the form of tablets.

Pharmacokinetics

After oral administration, it is absorbed inside the gastrointestinal tract (approximately 75-80% of ethambutol).

The medication is distributed within many fluids and tissues. High drug values are noted inside the lungs with urine, saliva and kidneys. [2]

Metabolic processes take place mostly inside the liver: about 15% of the drug during metabolism is transformed into inactive metabolic components. [3]

The half-life is 3-4 hours. Excretion is carried out through the kidneys; about 80% of the drug is excreted over a period of 24 hours. In this case, 20% of the substance is excreted in the feces in the form of metabolic elements that do not have activity.

Dosing and administration

In the case of performing primary therapy for persons over 15 years of age and adults, use portions of 15 mg / kg, once a day.

When passing through a repeated treatment cycle, the medication is used at a dosage of 25 mg / kg, once a day for a period of 2 months. After that, a switch is made to a portion of 15 mg / kg, 1 time per day.

• Application for children

You can not appoint Tibinil E400 to persons under the age of 15.

Use Tibinyl E400 during pregnancy

It is forbidden to use the medication in pregnant women and with hepatitis B.

Contraindications

The main contraindications:

• strong personal sensitivity to the medication;
• cataract or neuritis that affects the optic nerve;
• inflammation in the eye area and retinopathy of the diabetic type.

Side effects Tibinyl E400

Among the side signs:

• neuritis affecting the optic nerve (1- or 2-sided; with it, there is a disorder in the perception of certain colors (green and red), narrowing of the visual fields and a weakening of visual acuity almost to complete blindness) or hemorrhage in the retinal region;
• headaches, disorientation, confusion and dizziness, as well as hallucinations, polyneuropathy, paresthesias and malaise;
• occasionally, symptoms of intolerance are noted (fever, itching, epidermal rash, tachycardia, leukopenia, vasculitis and arthralgia; anaphylaxis, SJS or TEN are occasionally observed);
• heartburn, abdominal pain, diarrhea, anorexia, metal taste and vomiting, and in addition, jaundice and an increase in transaminase activity;
• the appearance of thrombocytopenia or tubulointerstitial nephritis is possible, as well as the development of an acute gouty attack and a decrease in uric acid clearance rates.

Negative manifestations are mainly observed in diabetics, the elderly, people with liver failure or chronic alcoholism.

Overdose

In the case of poisoning, neurological disorders (in particular damage to the optic nerve (resulting in blindness)) are most likely to be expected. In addition, diarrhea, loss of appetite, fever, vomiting, confusion, headaches, hallucinations, dizziness, asystole, and respiratory depression may occur.

The medicine has no antidote; symptomatic procedures are performed. Due to the rapid absorption of drugs, it is necessary to immediately induce vomiting or perform gastric lavage. The use of activated carbon is advisable only immediately after the introduction of Tibinil E400.

It is necessary to control and maintain the work of important organs and systems; if necessary, perform resuscitation procedures. Peritoneal dialysis, forced diuresis, or hemodialysis can be performed. If the patient's condition is life-threatening, exchange blood transfusion is performed (due to the fact that this allows you to remove erythrocytes, inside which ethambutol accumulates in large volumes).

Interactions with other drugs

Al hydroxide and similar antacids interfere with the absorption of ethambutol from the gastrointestinal tract, which is why they cannot be used together with the medicine.

Pyrazinamide with ethambutol have a synergistic effect on the excretion of uric acid.

Exposure to ethambutol can weaken the activity of digitoxin.

The combination of Tibinil E400 and isoniazid with the use of cyclosporin A causes a potentiation of the disintegration of the latter with an increase in the risk of graft rejection.

Combination with disulfiram can increase serum ethambutol values and potentiate its toxicity.

Ethanol potentiates the toxic activity of ethambutol in relation to the visual organ, which is why it is necessary to stop drinking alcohol for the period of therapy.

Storage conditions

Tibinyl E400 should be stored in a place protected from sunlight and children. Temperature is standard for medicines.

Shelf life

Tibinyl E400 can be used within a 36-month term from the date of release of the pharmaceutical product.

Analogs

The analogues of the drug are the substances Teriz and Paizin with Inbutol, as well as Phenazid and Pira.