Ethambutol in pregnancy-foetal exposure

Avoidance and Management of Adverse Reactions to Antituberculosis Drugs

“…This does not appear to be associated with clinically important problems and is not a contraindication to breast feeding. There is insufficient information on the teratogenic potential of pyrazinamide, but it should be avoided in the first trimester of pregnancy unless absolutely necessary) 136] Neonates with glucose-6-phosphate dehydrogenase (G6PD) deficiency may have significant sensitivity to isoniazid, resulting in haemolysis during the neonatal period) 137] Shneerson and Francis [138] showed that the placenta was not a significant physiological barrier to the transfer of ethambutol to the fetus. Teratogenic effects of ethambutol or other antituberculosis drugs, can arise up to 23 weeks of pregnancy.…”

Ethambutol in tuberculosis: time to reconsider?

“…Regimens that include ethambutol are recommended for use in pregnancy 37. One case report that measured ethambutol concentrations in amniotic fluid, maternal, placental, and cord blood specimens suggests that the placenta is not a significant physiological barrier to the transfer of ethambutol to the fetus 38. We have found two reports of ocular malformations in newborn infants of mothers receiving ethambutol in the first trimester 39…”

Transplacental Pharmacokinetics of the Antituberculosis Drugs

“…Transplacental transfer of ethambutol has been documented to be at least 74.5% of that of maternal serum concentrations (Shneerson & Frances 1979). This pregnancy terminated at 38 weeks with the delivery of a normal female infant.…”