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Combutol (Myambutol)

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Combutol is an antibacterial agent. It works by stopping the growth of TB cells, which results in cell death. Combutol is used for treating tuberculosis (TB) infections of the lung along with other medicines. It may also be used to treat other conditions as determined by your doctor.

Other names for this medication:
Etambutol, Ethambutol, Myambutol, Rifafour, Rimstar

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Also known as:  Myambutol.


Combutol is a prescription medication used to treat tuberculosis (TB). Combutol belongs to a group of drugs called antimycobacterial antibiotics. TB is caused by a certain bacteria. Combutol works by stopping the bacteria from forming a cell wall, which kills the bacteria.

This medication comes in tablet form. It is taken once a day with or without food.

Common side effects of Combutol include loss of appetite, upset stomach, and numbness or tingling in hands and feet.


Combutol should not be used alone, in initial treatment or in retreatment. Combutol should be administered on a once every 24-hour basis only. Absorption is not significantly altered by administration with food. Therapy, in general, should be continued until bacteriological conversion has become permanent and maximal clinical improvement has occurred.

Combutol is not recommended for use in pediatric patients under thirteen years of age since safe conditions for use have not been established.


If you take too much Combutol, call your local Poison Control Center or seek emergency medical attention right away.


Store at room temperature between 20 and 25 degrees C (68 and 77 degrees F) away from moisture and heat. Throw away any unused medicine after the expiration date. Keep out of the reach of children.

Side effects

The most common side effects associated with Combutol are:

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Side effect occurrence does not only depend on medication you are taking, but also on your overall health and other factors.


Lab tests, including liver and kidney function, complete blood cell counts, and vision, may be performed while you use Combutol. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.

Combutol should not be used in CHILDREN younger than 13 years old; safety and effectiveness in these children have not been confirmed.

PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Combutol while you are pregnant. Combutol is found in breast milk. If you are or will be breast-feeding while you use Combutol, check with your doctor. Discuss any possible risks to your baby.

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We evaluated retrospectively the treatment outcomes of 39 patients who were treated for INH-resistant pulmonary TB. The treatment regimens consisted of a 12-month regimen of rifampin (RIF) and ethambutol (EMB), with pyrazinamide (PZA) given during the first 2 months (2HREZ/10RE) (n = 21), a 9-month regimen of RIF and EMB with PZA during the first 2 months (2HREZ/7RE) (n = 5), and a 6-month regimen of RIF, EMB, and PZA (2HREZ/4REZ) (n = 13). After drug susceptibility testing confirmed the INH-resistance of the isolated M. tuberculosis strains, INH was discontinued for all the patients.

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Rifapentine administered 5 days per week has potent activity in mouse models of antituberculosis chemotherapy, but efficacy and safety data are limited in humans. We compared the antimicrobial activity and safety of rifapentine vs rifampin during the first 8 weeks of pulmonary tuberculosis treatment.

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To assess the efficacy of the national tuberculosis control programme, a prospective study of primary drug resistance was conducted from April 1992 to July 1994 in Casablanca.

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The chance of incidence of XDR TB is on the rise due to improper use of second line anti-tubercular drugs. XDR-TB is very difficult to treat successfully and is often referred to as "virtually untreatable form of TB". We herein report a case of XDR TB confirmed by bacteriological examination in a WHO recognised laboratory who after 12 months of regular treatment improved both clinically and radiologically with sputum smear conversion. To the best of our knowledge, there has been no previous report of any similar case in literature.

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The authors report and discuss a rare case of the long-term course and treatment of cutaneous BCG infection in an HIV-negative, healthy nurse. Over 5 years we cured the wrist and lower leg cutaneous tuberculosis infection caused by an accident at work. Persistent antituberculous therapy and surgical procedure were applied, but after detection of an encapsulated abscess in the wrist followed by needle aspiration, antituberculous therapy was sufficient and our patient was cured. Failing the addition of local applications, antituberculous therapy with radical surgical treatment remains the recommended treatment in cutaneous infections.

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We report a bronchopulmonary infection with Mycobacterium malmoense in a patient with severe immunosuppression due to insulin-dependent diabetes mellitus, humoral immunodeficiency after thymoma (Good's syndrome) and prolonged immunosuppressive treatment after myasthenic crisis. It presented as non-resolving pneumonia of the left lower lobe. Bronchoscopically, a bronchoesophageal fistula was detected. Numerous acid-fast organisms were found in the sputum specimen and in the bronchial biopsy around the fistula. M. malmoense was isolated from sputum, bronchoalveolar lavage and bronchial biopsy. Whereas conventional in vitro susceptibility testing revealed susceptibility only to ethambutol, multi-drug susceptibility testing confirmed susceptibility to rifampicin, ethambutol, clarithromycin and prothionamide. The clinical outcome after 12 months of therapy resulted in a stable remission and considerable suppression of the mycobacterial load, but not in complete eradication.

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To determine the prevalences of initial and acquired resistance to the main anti-tuberculosis drugs 2 years after the implantation of a tuberculosis control programme in the province.

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Prisons play a significant role in the epidemiology of drug-resistant tuberculosis. A total of 114 Mycobacterium tuberculosis isolates recovered from patients in the Archangel prison (Archangel, Russia) in 2001 were studied using restriction fragment-length polymorphism analysis and spoligotyping. Drug susceptibility was analyzed by the radiometric broth method (BACTEC; Becton Dickinson Diagnostic Systems). According to genotyping studies, 87 (76.3%) of the isolates belonged to the W-Beijing family. Nearly all (96.6%) W-Beijing isolates were part of a cluster, whereas only 25.9% of the other isolates were clustered (P<.001). The largest cluster comprised 43 patients. Multidrug resistance was high among new (34.0%) and previously treated (55.0%) cases. Resistance to ethambutol (OR, 3.4; 95% CI, 1.0-12.7; P=.03) and streptomycin (OR, 4.2; 95% CI, 1.5-11.6; P=.001) was significantly associated with infection with W-Beijing isolates. Tuberculosis due to drug-resistant W-Beijing isolates is a major problem in the Archangel prison.

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Ethambutol is an essential medication in the management of tuberculosis. However, it can cause an optic neuropathy of uncertain etiology. Ethambutol toxicity was therefore studied in rodent retinal cells, and agents that might block its toxicity were considered.

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Daily rifapentine plus isoniazid-pyrazinamide in mice infected with Mycobacterium tuberculosis produces cure in 3 months. Whether cure corresponds to latent infection contained by host immunity or true tissue sterilization is unknown.

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Thirty six cases with multidrug-resistant tuberculosis were retrospectively studied to define the causes attributable to the emergence of multidrug-resistant M. tuberculosis. All these tuberculosis cases were microbiologically confirmed and resistant to at least isoniazid and rifampicin. Data analysis using matched-pair sampling methods (1:3) demonstrated that the followings are the significant risk factors for the emergence of multidrug-resistant tuberculosis; incompliance to treatment (Odds ratio 21.0: 95% CI 4.10-107.63), alcohol abuse (Odds ratio 15.0: 95% CI 2.34-96.1) and the history of previous treatment (Odds ratio 5.0: 95% CI 2.04-12.21), while diabetes mellitus is not statistically significant. The incompliance to treatment which is primarily thought to be patient's responsibility results in non-optimal administration of antituberculous agents, leading to the multidrug-resistant tuberculosis. Other factors that may have contributed to the emergence of resistance included the unnecessary change of regimen before completion of chemotherapy. This is patient-unrelated situation where responsibility lies in the medical side. A clinical case presented here is an example. In this case RFP was replaced with ethambutol 3-months after the initiation of regimen including SM, INH and RFP because of abnormal elevation of GOT and GPT without any supporting evidence that RFP was causative. The readministration of RFP after 1-year cessation did not induce liver dysfunction, while the drug resistance was observed not only to RFP but also to INH. This case suggests unnecessary interruption of RFP could lead to the emergence of resistance to INH as well as RFP. One known mechanism of drug resistance is random mutation and the selection by drugs administered during the course of chemotherapy. The cases with advanced cavitary lesions would have a higher probability of the occurrence of mutation. The more the number of mutant bacilli, the higher the probability of emergence of multidrug resistance. Those cases in which longer period of time is needed for the negative conversion of M. tuberculosis should be treated with potent chemotherapy regimens under the intense supervision. Since both INH and RFP are the most potent among currently available antituberculous agents. It is crucial to preserve the potency of these essential agents before novel antituberculous are developed.

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In order to study certain epidemiological features of multidrug-resistant tuberculosis (MDR-TB) carriers and their influence on the control and treatment, a group of patients was evaluated over a four-year period, selected by: Mycobacterium tuberculosis isolation from sputum; resistance to Rifampin, Isoniazid and one more drug, or, failure of reserve regimen, all cases were from a tuberculosis reference unit in the City of S o Paulo. A total of 182 patients were reviewed, with a mean age of 35.7 +/- 6.8 years and 112 (61.5%) were male. These patients was classified according to therapeutic history, as: primary MDR-TB (with initial sensitivity test) 11 (6%); post primary MDR-TB (after irregular use previous treatment) 134 (74%), and indeterminate MDR-TB (failure after regular use of initial and reserve regimens) 37 (20%). Contagion was identified in 41/170 patients, acquired through domiciliary rather than institutional transmission. There were four familial outbreaks and none were institutional. The most frequent condition associated with these cases was abandonment of therapy (45%) followed by alcoholism (27%), sequential failure in the treatment regimens (23%), MDR contagion (15%), drug reaction (6%), HIV positive (4%) and diabetes (3%). There was resistance to Rifampin+Isoniazid in 100%, Streptomycin in 83% and Ethambutol in 47%. Conventional X-ray revealed cavities in all, though only 35 (19%) were unilateral. These cases are discussed and some suggestions presented.

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combutol 400 mg tab 2017-05-22

Since the late 1960s, tuberculosis has been successfully cured with antibiotics. With the introduction of rifampin, "short course" regimens using isoniazid and rifampin together with either streptomycin, ethambutol or pyrazinamide, for 6-9 months, have been successfully adopted. The spread of drug resistant M. tuberculosis strains in large urban areas has made this armamentarium of drugs insufficient, calling for the development of new drugs. Among rifamycin derivatives, rifabutin is more active than rifampin in vitro and in experimental animals, and allows sputum conversion rats of 95-100%. It is effective in treating multidrug-resistant tuberculosis. Rifapentine is more active than rifampin in vitro and has a longer half-life, but it is not active against rifampin-resistant strains. Fluoroquinolones concentrate within macrophages, are effective against M. tuberculosis and act synergistically with rifampin and isoniazid. Ofloxacin, ciprofloxacin, sparfloxacin and lomefloxacin have been evaluated as antimycobacterial agents, and no cross-resistance with major antituberculous drugs has been found. Several other drugs, including new inhibitors of beta-lactamase and new beta-lactamase-resistant antibiotics, the aminoglycoside antibiotic, paromomycin, and the new nitroimidazole, 2-ethyl-5-intro-2.3-dihydro imidazo-oxazole, have been found to be Unixime Dose active in vitro against M. tuberculosis.

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The activity of clarithromycin alone and in combination with other antimycobacterial agents was evaluated in the beige (C57BL/6J bgj/bgj) mouse model of disseminated Mycobacterium avium complex (MAC) infection. A dose-response experiment was performed with clarithromycin at 50, 100, 200, or 300 mg/kg of body weight administered daily by gavage to mice infected with approximately 10(7) viable MAC. A dose-related reduction in spleen and liver cell counts was noted with treatment at 50, 100, and 200 mg/kg. The difference in cell counts between treatment at 200 and 300 mg/kg was not significant. Clarithromycin at 200 mg/kg of body weight was found to have activity against three additional MAC isolates (MICs for the isolates ranged from 1 to 4 micrograms/ml by broth dilution). Clarithromycin at 200 mg/kg in combination with amikacin, ethambutol, temafloxacin, or rifampin did not result in increased activity beyond that seen with clarithromycin alone. Clarithromycin in Tab Tambac Cv combination with clofazimine or rifabutin resulted in an increase in activity beyond that seen with clarithromycin alone. The combination of clarithromycin with clofazimine or rifabutin should be considered for evaluation in the treatment of human MAC infections.

tab combutol 800 mg 2015-05-15

EPTB accounts for 10-15 percent of all cases of tuberculosis. Mycobacterium was present in 10.5 percent samples. 48 isolates out of 54 samples were found to be M. tuberculosis. The maximum numbers Metrogyl Tablet Usage of M. tuberculosis were isolated from lymph node aspiration.

combutol 400 mg 2017-07-28

As part of an ongoing effort to develop highly potent anti-tuberculosis agents, fourteen pentacyclo-undecane (PCU) tetra-amine compounds were synthesized and screened for their in vitro anti-mycobacterial activity against two TB strains, H37Rv and XDR 194 [an extensively drug-resistant strain of tuberculosis]. Using the broth Macrol 250 Tablet macrodilution method, nitrofuranylamide based compounds (6a and 6b) showed almost similar activities against the H37Rv strain of Mycobacterium tuberculosis when compared with the control drug, ethambutol. N-Geranyl piperazine PCU (8a) and trans-trans farnesyl piperazine PCU (8b) were 3.2 and 3.7 times more potent than commercially available ethambutol. Both isoprenyl PCU tetra-amine derivatives and N-decyl piperazine PCU (9a) were highly active against the XDR 194 strain of tuberculosis with MICs in the range of 0.63-3.02 microM. Cytotoxicities (IC(50)) of isoprenyl based compounds (8a, 8b) and compound 9a were tested on a mammalian cell line [MDBK (Madin Darby bovine kidney epithelium)] with values of 30, 24 and 25 microM respectively.

combutol 800 medicine 2015-02-03

We compared the effectiveness of 2 treatment regimens for isoniazid-resistant tuberculosis (TB) in 42 patients attending a TB referral centre in the Islamic Republic of Iran. The patients were divided into 2 treatment groups: 26 received the 6-month standard HRZE treatment and 16 received a modified treatment of RZE for 6 months. There were no significant differences in age or sex of the groups. With the standard Rulid Dose Pediatric method of treatment, 21 (80.8%) patients were cured, 4 (15.4%) resulted in treatment failure, and 1 (3.8%) died. In the modified treatment group, 16 (100%) patients were cured, These differences were not statistically significantly different (P = 0.194).

combutol tab 2016-03-31

Drug susceptibility testing for Mycobacterium tuberculosis (M. tuberculosis) is especially required in difficult cases of tuberculosis (TB) chemotherapy and in cases of multidrug resistance (MDR-TB; combined resistance to isonizid and rifampicin with or without resistance to any other drug). The methods for in vitro cultivation and drug susceptibility testing (DST) of M. tuberculosis are cumbersome and not readily adaptable in most routine laboratories, particularly those in Moxifloxacin Ophthalmic Generic the developing world due to limited resources and lack of political will in those countries. A simple and cost effective method, the nitrate reductase assay (NRA), was compared with the gold standard proportion (egg bases Lowenstein Jensen's [LJ]) method for DST of M. tuberculosis in order to substantiate its suitability for routine use in Nigeria and in other countries of the developing world with high TB endemicity.

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Chemotherapy of pulmonary disease due to Mycobacterium kansaii has not always been successful, and resectional surgery has been used frequently in the treatment of this infection. To ascertain the impact of new antimicrobial agents on the treatment of M. kansaii infection, we reviewed the clinical courses of 59 patients treated between 1971 and 1974. Over-all, 92 per cent of patients converted their sputum cultures Rapiclav Tablets while receiving drugs, with only one patient undergoing surgical resection. Regimens containing rifampin were universally effective in both initial and retreatment cases; however, they offered no significant advantage over monrifampin regimens in initial treatment cases. In vitro resistance to isoniazid and ethambutol did not adversely affect the results of treatment with these drugs. Owing to the effectiveness of current chemotherapy, parameters such as age, underlying lung disease, or extent of disease were not related to the outcome of therapy. Because 90 per cent of the conversions in successful regimens occur within 4 to 6 months of beginning therapy, patients whose cultures remain positive should be considered for alternate drugs. Because the frequency of relapse after current chemotherapy is not yet clear, and because rifampin appears to be particularly advantageous in retreatment programs, rifampin should be reserved for this role. The total course of treatment should probably span at least 18 months, or 6 months beyond any cultural or radiographic evidence of activity.

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Twenty patients with pulmonary tuberculosis received 7.35 mg/kg/day of aminophylline intravenously combined with anti-tuberculosis agents. The first theophylline serum concentration was measured before Macrozit 1200 Mg Susp administration of INH, RMP, EMB and PZA, and samples were obtained once daily for 6 consecutive days after initiation of treatment. All patients in this study were non-smokers with normal hepatic and renal function, and they were not given any other drugs that could affect the clearance of theophylline.

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Mycobacterium szulgai is an unusual pathogen that accounts for less than 1% of all cases of non-tuberculosis mycobacterial infection. Infections with this organism usually involve the lung but may involve soft tissues. Although similar to tuberculosis in its clinical presentation, infection due to M. szulgai requires different management, and it is therefore important to distinguish disease caused by M. szulgai from that caused by M. tuberculosis. Isolation of M. szulgai implies the presence of clinical disease, and when the organism is identified, treatment based on sensitivity testing should be initiated. Although no standard recommendations for treatment exist, most infections due to M. szulgai have been treated with combined high doses of isoniazid, ethambutol, and rifampin for 18-24 months. M. szulgai has been isolated worldwide; the first case of infection reported from Canada is described, and the clinical presentation Ceftinex 300 Mg , microbiologic diagnosis, and therapeutic management of M. szulgai infections are reviewed.

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The study involved the assessment of factors associated with treatment outcomes using a retrospective review of patient records, drug-susceptibility data and spoligotyping of isolates.

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Consecutive new tuberculous patients with positive smear were recruited from tuberculosis centres and rural health centres. Drug susceptibility testing was performed according to the proportion method. Positive cultures were tested against streptomycin, isoniazid, rifampicin, and ethambutol. All resistant strains and 10% of all randomly sampled cultures were sent to an external laboratory for quality control. Human immunodeficiency virus (HIV) tests were performed for consenting patients at the tuberculosis centres.