Sural
Form: Tablet
Strength: 400mg
Generic Name: Ethambutol
Company: Ambee Pharmaceuticals Ltd.
MRP:৳ 1.66 (Tablet)
Is Antibiotic: Yes
Indications
Sural is used to treat pulmonary tuberculosis. Sural should not be used alone, but in combination with at least one other tuberculosis drug. The choice of the second drug depends on clinical experience, safety considerations, and lab tests. In patients who haven’t had previous treatment, commonly used combinations are:
– Sural plus isoniazid
– Sural plus isoniazid plus streptomycin.
In patients who have had previous treatment, drug resistance is common, so Sural should be combined with another second-line drug that the bacteria are sensitive to based on lab tests. Some drugs that can be used with Sural are cycloserine, ethionamide, pyrazinamide, viomycin, and others. Other combinations can also be used, including isoniazid, aminosalicylic acid, and streptomycin.
Pharmacology
Sural works by stopping bacteria from making certain substances they need, which affects their metabolism and prevents them from multiplying and growing. Sural only works against bacteria that are dividing.
Dosage & Administration
Adult & Elderly: Sural should never be used alone for treatment. Sural is given once a day. Sural can be taken with or without food. Treatment should continue until lab tests show the bacteria are gone and the patient is feeling better.
Pediatric: Sural is not recommended for children under 13 years old because Sural hasn’t been proven safe for them.
Initial Treatment: For those who haven’t had tuberculosis treatment before, give 15 mg/kg body weight once a day. In newer studies, isoniazid is usually given at the same time in a single dose.
Retreatment: For those who have had treatment before, give 25 mg/kg body weight once a day. At least one other drug the bacteria are sensitive to must be used at the same time. After 60 days, lower the dose to 15 mg/kg body weight and continue giving Sural once a day.
During the 25 mg/kg dose period, regular eye exams are recommended.
Renal Impairment: The dose may need to be adjusted based on blood levels of the drug.
Interaction
Absorption may be reduced when taken with aluminium hydroxide.
Contraindications
Sural should not be used by people who are allergic to Sural or have optic neuritis (inflammation of the eye nerve), unless a doctor decides Sural’s necessary. Sural is also not recommended for people who can’t notice or report any vision problems or changes.
Side Effects
Common side effects include eye problems like blurry vision, trouble seeing colors, and reduced vision. Sural may also cause kidney issues leading to gout. Other effects can include confusion, dizziness, headache, nausea, loss of appetite, liver problems, nerve damage, low blood platelets, lung issues, allergic reactions (like rashes), fever, and joint pain. Rarely, Sural can cause eye bleeding.
Pregnancy & Lactation
Sural is classified as Category C. Animal studies have shown Sural may harm the fetus, and there are no controlled studies in pregnant women. Sural should only be used if the doctor thinks the benefits outweigh the risks to the baby.
Precautions & Warnings
Sural should be used cautiously in patients with eye problems (like cataracts), kidney problems, and during pregnancy and breastfeeding.
Overdose Effects
No specific overdose effects have been provided in the available information.
Therapeutic Class
Sural belongs to the Anti-Tubercular Chemotherapeutics class.
Storage Conditions
Store between 20-25°C. Keep Sural away from light, moisture, and excessive heat.
Similar Brands of Ethambutol (Tablet – 400mg)
| Brand Name | Form | Strength | Company | MRP (৳) |
|---|---|---|---|---|
| Fiambutol L | Tablet | 400mg | Sanofi Bangladesh Ltd. | 3.41 |
| Servambutol | Tablet | 400mg | Novartis (Bangladesh) Ltd. | 3.44 |