Trecator
Trecator (ethionamide) is useful for treating tuberculosis (TB) that is resistant to usual, first-choice antibiotics. It often causes upset stomach, and it isn't available as a generic.
What is Trecator (ethionamide)?
What is Trecator (ethionamide) used for?
Tuberculosis (TB) that is resistant (doesn't respond to) to first-choice anti-TB antibiotics (e.g., isoniazid or rifampin (Rifadin))
TB infection in people who can't take other anti-TB antibiotics
How Trecator (ethionamide) works
Trecator (ethionamide) is an antitubercular agent. It prevents TB bacteria from making the building blocks they need to multiply and survive.
Drug Facts
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What are the side effects of Trecator (ethionamide)?
Common Side Effects
- Upset stomach
- Nausea
- Vomiting
- Diarrhea
- Stomach pain
- Extra saliva
- Metallic taste in the mouth
- Swelling or sores inside the mouth
- Poor appetite
Other Side Effects
- Mental health problems
- Sleepiness
- Dizziness
- Restlessness
- Headache
- Low blood pressure upon standing
- Allergic reaction
- Large breasts in men
- Erection problems in men
- Acne
Serious Side Effects
- Serious skin reaction
Source: DailyMed
The following side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Less common
Clumsiness or unsteadiness
confusion
mental depression
numbness, tingling, burning, or pain in the hands and feet
yellow eyes or skin
Rare
Blindness or vision changes
blue-yellow color blindness
blurred vision or loss of vision, with or without eye pain
burning, crawling, itching, numbness, painful, prickling, "pins and needles", or tingling feelings
changes in menstrual periods
coldness
decreased sexual ability (in males)
decreased vision
difficulty in concentrating
dry, puffy skin
fast heartbeat
hoarseness
increased hunger
increased sensitivity of the skin to sunlight
irritation
joint pain, stiffness, or swelling
redness or other discoloration of the skin
severe sunburn
shakiness
swelling of the eyelids, face, lips, hands, or feet
swelling of the front part of the neck
tightness in the chest
troubled breathing or swallowing
weakness in the hands or feet
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Abdominal or stomach pain
increased watering of the mouth
loss of appetite
metallic taste
swelling or inflammation of the mouth
Incidence not known
Blemishes on the skin
decreased interest in sexual intercourse
enlargement of the breasts (in males)
inability to have or keep an erection
loss in sexual ability, desire, drive, or performance
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Pros and cons of Trecator (ethionamide)
Pros
Helps treat TB that is resistant to (doesn't respond to) other antibiotics
Can be taken in divided daily doses, if taking it once-daily causes upset stomach
Can be taken with or without food
Cons
Must be taken with other anti-TB antibiotics
Often causes upset stomach, especially with higher doses
Only available as a brand-name medication, so it might be expensive
Pharmacist tips for Trecator (ethionamide)
Take Trecator (ethionamide) with or without food. Upset stomach is a common side effect, and taking it with food may help prevent this problem.
Make sure to follow up with your provider regularly to monitor for side effects, such as liver injury and vision changes.
Don't drink alcohol while you are taking Trecator (ethionamide), since this can raise your risk of mental health side effects and liver damage.
Your provider may want you to take Trecator (ethionamide) with vitamin B6 (pyridoxine) to prevent nerve problems.
It's very important not to miss any doses of Trecator (ethionamide) or other anti-TB medications. Skipping doses can make the bacteria resistant to antibiotics, which then makes the infection much harder to treat. You may need to take each dose of Trecator (ethionamide) in front of a healthcare provider.
Frequently asked questions about Trecator (ethionamide)
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What are the risks and warnings for Trecator (ethionamide)?
Trecator (ethionamide) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Drug-resistant bacteria
Risk factors: Taking Trecator (ethionamide) by itself | Missing doses of anti-TB antibiotics
Trecator (ethionamide) must be used in combination with other anti-TB medications. Taking Trecator (ethionamide) by itself will cause the bacteria to become resistant and much harder to treat. Your provider will decide which antibiotic combination is best for you based on tests (cultures) on the bacteria that are causing your specific infection. It's very important to take Trecator (ethionamide) and other anti-TB medications exactly as prescribed. Don't miss any doses or stop taking them unless specifically instructed by your provider. You may need to take each dose of Trecator (ethionamide) with supervision from a healthcare provider. Only take Trecator (ethionamide) when it's necessary for a TB infection.
Severe skin reaction
Anti-TB medications like Trecator (ethionamide) can cause severe (serious) skin reactions. If you get a rash while taking Trecator (ethionamide), let your provider know right away since this side effect can affect your organs and become life-threatening.
Vision problems
Trecator (ethionamide) can cause vision problems, so you may need regular eye exams while you're taking this medication. Let your provider know right away if you notice a change in your eyesight.
Mental health problems
Avoid alcohol while taking Trecator (ethionamide). Rarely, mixing this medication with too much alcohol can cause a psychotic reaction (mental health problems).
Liver injury
Anti-TB medications can cause liver injury. You will need regular blood tests to make sure that your liver is healthy while you are taking Trecator (ethionamide) and other anti-TB antibiotics.
Low blood sugar
Risk factors: Diabetes
Trecator (ethionamide) can cause low blood sugar (hypoglycemia). Low blood sugar can cause sweating, shakiness, dizziness, racing heart, and confusion. If you have diabetes, monitor your sugar closely, and let your provider know if your blood sugar drops or if you have symptoms of low blood sugar. If you feel any symptoms, test your levels as soon as possible. If your blood sugar is low (less than 70 mg/dL), follow the “15-15-15 Rule" to help get your sugars back up.
Low thyroid function
Trecator (ethionamide) can cause low thyroid thyroid function (hypothyroidism). This can cause tiredness, weight gain, sensitivity to cold, and goiter (enlarged thyroid gland). You will need regular blood tests to make sure that your thyroid is healthy while you are taking Trecator (ethionamide).
Trecator (ethionamide) dosage forms
| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 250mg | 30 tablets | $173.48 | $5.78 |
Typical dosing for Trecator (ethionamide)
Adults: Take 15 to 20 mg/kg by mouth once daily. The dose can be divided into 2 or 3 times a day to prevent upset stomach. The maximum daily dose is 1,000 mg. Your provider will start you at 250 mg daily, then slowly raise the dose to your goal weight-based dose or until you can no longer tolerate the medication.
Children: Take 10 to 20 mg/kg by mouth once daily in 2 or 3 divided doses after meals. It can also be taken as 15 mg/kg as a single dose every 24 hours.
Interactions between Trecator (ethionamide) and other drugs
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
How much does Trecator (ethionamide) cost?
What are alternatives to Trecator (ethionamide)?
Tuberculosis (TB) that is resistant (doesn't respond to) to first-choice anti-TB antibiotics (e.g., isoniazid or rifampin (Rifadin))
TB infection in people who can't take other anti-TB antibiotics
Tuberculosis (TB) lung infection that is resistant (doesn't respond to) to other anti-TB antibiotics
Tuberculosis (TB) that's hard to treat with first-choice antibiotics
Urinary tract infections (UTIs), after first-choice options haven't worked
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