Trecator SC: Targeted Tuberculosis Treatment for Resistant Strains
| Product dosage: 250 mg | |||
|---|---|---|---|
| Package (num) | Per pill | Price | Buy |
| 20 | $2.24 | $44.72 (0%) | 🛒 Add to cart |
| 30 | $2.09 | $67.08 $62.78 (6%) | 🛒 Add to cart |
| 40 | $2.00 | $89.44 $79.98 (11%) | 🛒 Add to cart |
| 60 | $1.92 | $134.16 $115.24 (14%) | 🛒 Add to cart |
| 90 | $1.86 | $201.24 $167.70 (17%) | 🛒 Add to cart |
| 120 | $1.83 | $268.32 $220.16 (18%) | 🛒 Add to cart |
| 180 | $1.81
Best per pill | $402.48 $325.08 (19%) | 🛒 Add to cart |
Synonyms | |||
Trecator SC (ethionamide) is a second-line antituberculosis agent specifically formulated for the treatment of drug-resistant tuberculosis (TB) when first-line regimens have proven ineffective or intolerable. As a critical component of multidrug therapy protocols, it works by inhibiting the synthesis of mycolic acids, essential components of the mycobacterial cell wall. Its use is strictly supervised by specialists in infectious diseases or pulmonology, typically within complex, individualized treatment plans designed to combat multidrug-resistant (MDR-TB) and extensively drug-resistant (XDR-TB) tuberculosis. Adherence to the prescribed regimen is paramount to achieving microbial eradication and preventing further resistance development.
Features
- Active ingredient: Ethionamide 250 mg per scored tablet
- Pharmacologic class: Thioamide derivative antibacterial
- Mechanism: Inhibits mycolic acid synthesis in Mycobacterium tuberculosis
- Administration: Oral tablet formulation
- Prescription status: Requires specialist prescription and monitoring
- Compatibility: Designed for use within WHO-recommended MDR-TB regimens
Benefits
- Effectively targets and eliminates drug-resistant Mycobacterium tuberculosis strains
- Provides a critical therapeutic option when first-line TB medications fail or cause intolerance
- Works synergistically with other second-line antituberculosis agents to enhance treatment efficacy
- Helps prevent transmission of resistant tuberculosis strains within communities
- Contributes to reduced morbidity and mortality in complex tuberculosis cases
- Supports completion of therapy through manageable dosing schedule when properly monitored
Common use
Trecator SC is specifically indicated for the treatment of active pulmonary and extrapulmonary tuberculosis caused by Mycobacterium tuberculosis strains resistant to isoniazid or other first-line antituberculous drugs. It is never used as monotherapy but always as part of a carefully constructed combination regimen tailored to the patient’s drug susceptibility testing results. Typical companion drugs include other second-line agents such as cycloserine, para-aminosalicylic acid, fluoroquinolones, or injectable aminoglycosides, depending on resistance patterns and treatment guidelines. Its use is particularly crucial in managing multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB) cases under direct supervision of tuberculosis specialists.
Dosage and direction
The recommended adult dosage is 15-20 mg/kg body weight per day, typically administered as 250-500 mg once daily or in divided doses, not to exceed 1 gram daily. Initiation at lower doses with gradual escalation helps improve gastrointestinal tolerance. Tablets should be swallowed whole with water, preferably with food to minimize gastric irritation. Dosing in pediatric patients (>12 years) follows similar weight-based calculations under expert supervision. Treatment duration typically extends for 18-24 months or until sputum culture conversion and clinical resolution, followed by appropriate monitoring. Dosage adjustments are necessary in hepatic impairment, while no specific renal adjustment is typically required. Administration always occurs under direct observation therapy (DOT) protocols for resistant TB management.
Precautions
Hepatic function must be monitored before initiation and regularly throughout therapy due to potential hepatotoxicity. Baseline and periodic ophthalmologic examinations are recommended as neuropathic effects may occur. Diabetic patients require careful glucose monitoring as ethionamide may interfere with diabetes control. Use with caution in patients with a history of psychiatric disorders, as neuropsychiatric reactions have been reported. Alcohol consumption should be avoided due to increased risk of adverse reactions and hepatotoxicity. Pregnancy requires careful risk-benefit assessment (Category C), with use only if potential benefit justifies potential fetal risk. Breastfeeding is generally not recommended due to secretion into breast milk.
Contraindications
Trecator SC is contraindicated in patients with known hypersensitivity to ethionamide or any component of the formulation. Severe hepatic impairment or active liver disease represents an absolute contraindication. Concurrent administration with isoniazid is contraindicated due to increased hepatotoxicity risk. It should not be used in patients with severe psychiatric disorders that may be exacerbated by treatment. Use is contraindicated in patients with porphyria. The medication must not be administered as monotherapy under any circumstances due to rapid resistance development.
Possible side effect
Gastrointestinal disturbances are most frequent, including nausea (approximately 50% of patients), vomiting, abdominal pain, diarrhea, metallic taste, and excessive salivation. Neurological effects may include peripheral neuropathy, dizziness, headache, drowsiness, asthenia, and rarely, convulsions. Psychiatric manifestations such as depression, emotional instability, and psychosis may occur. Hepatotoxicity presents as elevated transaminases, jaundice, or hepatitis. Dermatological reactions include rash, photosensitivity, and acneiform eruptions. Endocrine effects may include hypothyroidism, gynecomastia, menstrual irregularities, and hypoglycemia. Ophthalmologic changes including optic neuritis and diplopia have been reported.
Drug interaction
Ethionamide may potentiate the neurotoxic effects of cycloserine and other neurotoxic medications. Concurrent use with isoniazid significantly increases hepatotoxicity risk and is contraindicated. It may enhance the effects of oral hypoglycemics and insulin, requiring dosage adjustment. Alcohol consumption potentiates both neurotoxic and hepatotoxic effects. Ethionamide may reduce the efficacy of oral contraceptives, necessitating alternative contraception methods. It may interact with phenytoin, increasing serum levels of both drugs. Concurrent use with other hepatotoxic medications requires extreme caution and enhanced monitoring.
Missed dose
If a dose is missed, it should be taken as soon as remembered unless it is almost time for the next scheduled dose. In that case, the missed dose should be skipped, and the regular dosing schedule resumed. Patients should never double the dose to make up for a missed one. Given the critical nature of tuberculosis treatment, especially for drug-resistant strains, any missed doses should be immediately reported to the healthcare provider supervising treatment. Consistent adherence is essential to prevent treatment failure and development of further resistance.
Overdose
Symptoms of overdose may include severe gastrointestinal distress (nausea, vomiting), neurological manifestations (dizziness, headache, peripheral neuropathy), and potential hepatotoxicity. There is no specific antidote for ethionamide overdose. Management is supportive and symptomatic, including gastric lavage if presentation is early after ingestion, activated charcoal administration, and appropriate symptomatic treatment. Hepatic function should be closely monitored, and supportive care for any neurological symptoms provided. Hemodialysis is not effective for ethionamide removal. In case of suspected overdose, immediate medical attention should be sought, and poison control center contacted.
Storage
Store at controlled room temperature between 20-25°C (68-77°F), with excursions permitted between 15-30°C (59-86°F). Protect from light and moisture. Keep in the original container with the lid tightly closed. Do not store in bathroom or other humid areas. Keep out of reach of children and pets. Do not use after the expiration date printed on the packaging. Proper disposal of unused medication is essential to prevent accidental ingestion or environmental contamination.
Disclaimer
This information is provided for educational purposes only and does not constitute medical advice. Treatment decisions must be made by qualified healthcare professionals based on individual patient circumstances. The prescribing physician should be consulted for complete information regarding indications, contraindications, warnings, precautions, and adverse effects. Medication should only be taken under appropriate medical supervision. Actual product characteristics and prescribing information may vary by region and regulatory approval.
Reviews
“After developing resistance to first-line TB drugs, Trecator SC became part of my salvage regimen. The gastrointestinal side effects were challenging initially, but with dose adjustment and antiemetics, I tolerated it adequately. Most importantly, after 20 months of treatment, I achieved culture conversion and eventual cure.” - Patient with MDR-TB
“As an infectious disease specialist, ethionamide remains a valuable weapon in our arsenal against drug-resistant TB. While its side effect profile requires careful management, its efficacy against resistant strains makes it indispensable in complex cases when properly integrated into combination therapy.” - TB Specialist, University Hospital
“The neuropathic effects required pyridoxine supplementation, but the medication was essential to my recovery from XDR-TB. Regular monitoring helped manage side effects while ensuring treatment effectiveness.” - Patient completing 24-month regimen