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2D Structure
Also known as: 536-33-4, 2-ethylpyridine-4-carbothioamide, Ethioniamide, Trecator, 2-ethylthioisonicotinamide, Ethyonomide
Molecular Formula
C8H10N2S
Molecular Weight
166.25  g/mol
InChI Key
AEOCXXJPGCBFJA-UHFFFAOYSA-N
FDA UNII
OAY8ORS3CQ

A second-line antitubercular agent that inhibits mycolic acid synthesis.
Ethionamide is an Antimycobacterial.
1 2D Structure

2D Structure

2 Identification
2.1 Computed Descriptors
2.1.1 IUPAC Name
2-ethylpyridine-4-carbothioamide
2.1.2 InChI
InChI=1S/C8H10N2S/c1-2-7-5-6(8(9)11)3-4-10-7/h3-5H,2H2,1H3,(H2,9,11)
2.1.3 InChI Key
AEOCXXJPGCBFJA-UHFFFAOYSA-N
2.1.4 Canonical SMILES
CCC1=NC=CC(=C1)C(=S)N
2.2 Other Identifiers
2.2.1 UNII
OAY8ORS3CQ
2.3 Synonyms
2.3.1 MeSH Synonyms

1. Amidazine

2. Ethioniamide

3. Trecator

4. Trecator Sc

5. Trecator-sc

2.3.2 Depositor-Supplied Synonyms

1. 536-33-4

2. 2-ethylpyridine-4-carbothioamide

3. Ethioniamide

4. Trecator

5. 2-ethylthioisonicotinamide

6. Ethyonomide

7. Amidazine

8. Ethinamide

9. Etionamid

10. Etioniamid

11. Thioamide

12. Ethylisothiamide

13. Trecator-sc

14. Nizotin

15. 4-pyridinecarbothioamide, 2-ethyl-

16. Amidazin

17. Ethimide

18. Etiocidan

19. Etionizin

20. Etionizina

21. Etionizine

22. Fatoliamid

23. Iridocin

24. Iridozin

25. Isotiamida

26. Itiocide

27. Nicotion

28. Rigenicid

29. Sertinon

30. Thianide

31. Thioniden

32. Trekator

33. Trescatyl

34. Trescazide

35. Tubenamide

36. Tubermin

37. Tuberoid

38. Tuberoson

39. Aetina

40. Aetiva

41. Ethina

42. Etimid

43. Etionid

44. Isothin

45. Teberus

46. Thianid

47. Tianid

48. Atina

49. Bayer 5312

50. Ethionamid Prothionamid

51. Iridocin Bayer

52. Ethionamidum

53. Nisotin

54. Thiomid

55. Etionamide [dcit]

56. Etionamida

57. Etionamide

58. Tiomid

59. 2-ethylisothionicotinamide

60. 2-ethyl-4-pyridinecarbothioamide

61. 2-ethylisonicotinothioamide

62. Ethionamidum [inn-latin]

63. Etionamida [inn-spanish]

64. 1314 Th

65. 2-ethyl-4-thiocarbamoylpyridine

66. 2-ethyl-4-thiopyridylamide

67. 2-ethyl-thioisonicotinamide

68. 2-ethylisonicotinic Acid Thioamide

69. Th 1314

70. Nci-c01694

71. 1314-th

72. F.i. 58-30

73. 1314th

74. 2-ethyl-4-thioamidylpyridine

75. Isonicotinamide, 2-ethylthio-

76. Oay8ors3cq

77. Aethionamidum

78. Etp

79. Nsc-255115

80. Tio-mid

81. Mls000069764

82. Chebi:4885

83. .alpha.-ethylisothionicotinamide

84. .alpha.-ethylthioisonicotinamide

85. .alpha.-ethylisonicotinoylthioamide

86. Trecator Sc

87. Nsc255115

88. 1314 Tn

89. .alpha.-ethylisonicotinic Acid Thioamide

90. Ethina (van)

91. Ncgc00016497-05

92. Cas-536-33-4

93. Smr000058716

94. Dsstox_cid_577

95. Dsstox_rid_75669

96. Dsstox_gsid_20577

97. Alpha-ethylisothionicotinamide

98. Alpha-ethylthioisonicotinamide

99. Alpha-ethylisonicotinoylthioamide

100. 2-ethylisonicotinic Thioamide

101. Alpha-ethylisonicotinic Acid Thioamide

102. Ccris 287

103. Hsdb 7473

104. Bayer5312

105. Sr-01000759219

106. Unii-oay8ors3cq

107. Einecs 208-628-9

108. Nsc 255115

109. Brn 0116474

110. Thiodine

111. Trecator (tn)

112. Prestwick_842

113. Isonicotinimidic Acid, 2-ethylthio-

114. Mfcd00057361

115. Ethionamide [usan:usp:inn:ban:jan]

116. Spectrum_001082

117. Cpd001370750

118. Opera_id_632

119. Ethionamide [mi]

120. Prestwick0_000526

121. Prestwick1_000526

122. Prestwick2_000526

123. Prestwick3_000526

124. Spectrum2_000994

125. Spectrum3_000428

126. Spectrum4_000547

127. Spectrum5_000979

128. 2-ethylisonicotinothiamide

129. 2-ethylisonicotinthioamide

130. Ethionamide [inn]

131. Ethionamide [jan]

132. E0695

133. Ethionamide [hsdb]

134. Ethionamide [iarc]

135. Ethionamide [usan]

136. Ethionamide [vandf]

137. Chembl1441

138. Ethionamide [mart.]

139. Schembl27007

140. Bspbio_000511

141. Bspbio_002016

142. Ethionamide [usp-rs]

143. Ethionamide [who-dd]

144. Ethionamide [who-ip]

145. Kbiogr_001213

146. Kbioss_001562

147. 5-22-02-00360 (beilstein Handbook Reference)

148. Mls001074114

149. Mls002454402

150. Divk1c_000145

151. Spectrum1500292

152. Wln: T6nj B2 Dyzus

153. Spbio_001087

154. Spbio_002432

155. Bpbio1_000563

156. Ethionamide (jp17/usp/inn)

157. Dtxsid0020577

158. Aeocxxjpgcbfja-uhfffaoysa-

159. Hms500h07

160. Kbio1_000145

161. Kbio2_001562

162. Kbio2_004130

163. Kbio2_006698

164. Kbio3_001236

165. .alpha.-ethyl-thioisonicotinamide

166. Ethionamide [orange Book]

167. Isonicotinamide, 2-ethyl, Thio-

168. Ethionamide For System Suitability

169. Ninds_000145

170. Ethionamide [ep Monograph]

171. Hms1569j13

172. Hms1920m22

173. Hms2091f03

174. Hms2096j13

175. Hms2231f10

176. Hms2233j11

177. Hms3259k17

178. Hms3370i18

179. Hms3371d12

180. Hms3655m10

181. Hms3713j13

182. Pharmakon1600-01500292

183. Ethionamide [usp Monograph]

184. Bcp29626

185. Ethionamidum [who-ip Latin]

186. Hy-b0276

187. Zinc3872520

188. Tox21_110458

189. Tox21_202409

190. Tox21_302769

191. Ccg-40212

192. Nsc757028

193. S1777

194. Akos006220662

195. Tox21_110458_1

196. Db00609

197. Fs-1770

198. Nc00508

199. Nsc-757028

200. Idi1_000145

201. Ncgc00016497-01

202. Ncgc00016497-02

203. Ncgc00016497-03

204. Ncgc00016497-04

205. Ncgc00016497-06

206. Ncgc00016497-08

207. Ncgc00016497-09

208. Ncgc00091074-01

209. Ncgc00091074-02

210. Ncgc00091074-03

211. Ncgc00091074-04

212. Ncgc00256600-01

213. Ncgc00259958-01

214. Ac-13715

215. Smr001370750

216. Sbi-0051377.p003

217. Db-049945

218. 2-ethylpyridine-4-carbothioamide;ethionamide

219. Ab00051990

220. Sw196973-3

221. C07665

222. D00591

223. F15438

224. Ab00051990-09

225. Ab00051990_10

226. Ab00051990_11

227. A829694

228. Q414767

229. Sr-01000759219-2

230. Sr-01000759219-5

231. W-105719

232. Brd-k33710385-001-05-4

233. Brd-k51207550-001-09-9

234. Ethionamide, European Pharmacopoeia (ep) Reference Standard

235. Ethionamide, United States Pharmacopeia (usp) Reference Standard

236. Ethinamide; 2-ethylthioisonicotinamide; 2-ethylpyridine-4-carbothioamide

237. Ethionamide For System Suitability, European Pharmacopoeia (ep) Reference Standard

238. Trecator;2-ethylthioisonicotinamide;ethinamide; Ethioniamide; Trecator Sc; Trecator-sc

2.4 Create Date
2005-03-25
3 Chemical and Physical Properties
Molecular Weight 166.25 g/mol
Molecular Formula C8H10N2S
XLogP31.1
Hydrogen Bond Donor Count1
Hydrogen Bond Acceptor Count2
Rotatable Bond Count2
Exact Mass166.05646950 g/mol
Monoisotopic Mass166.05646950 g/mol
Topological Polar Surface Area71 Ų
Heavy Atom Count11
Formal Charge0
Complexity147
Isotope Atom Count0
Defined Atom Stereocenter Count0
Undefined Atom Stereocenter Count0
Defined Bond Stereocenter Count0
Undefined Bond Stereocenter Count0
Covalently Bonded Unit Count1
4 Drug and Medication Information
4.1 Drug Information
1 of 2  
Drug NameTrecator
PubMed HealthEthionamide (By mouth)
Drug ClassesAntitubercular
Drug LabelTrecator (ethionamide tablets, USP) is used in the treatment of tuberculosis. The chemical name for ethionamide is 2-ethylthioisonicotinamide with the following structural formula: Ethionamide is a yellow crystalline, nonhygroscopic compound with a...
Active IngredientEthionamide
Dosage FormTablet
RouteOral
Strength250mg
Market StatusPrescription
CompanyWyeth Pharms

2 of 2  
Drug NameTrecator
PubMed HealthEthionamide (By mouth)
Drug ClassesAntitubercular
Drug LabelTrecator (ethionamide tablets, USP) is used in the treatment of tuberculosis. The chemical name for ethionamide is 2-ethylthioisonicotinamide with the following structural formula: Ethionamide is a yellow crystalline, nonhygroscopic compound with a...
Active IngredientEthionamide
Dosage FormTablet
RouteOral
Strength250mg
Market StatusPrescription
CompanyWyeth Pharms

4.2 Therapeutic Uses

Antibacterial (tuberculostatic)

O'Neil, M.J. (ed.). The Merck Index - An Encyclopedia of Chemicals, Drugs, and Biologicals. 13th Edition, Whitehouse Station, NJ: Merck and Co., Inc., 2001., p. 666


Ethionamide is indicated in combination with other antituberculosis medications in the treatment of tuberculosis, including tuberculous meningitis, after failure with the primary medications (streptomycin, isoniazid, rifampin, and ethambutol) or when these cannot be used because of toxicity or development of resistant tubercle bacilli. Ethionamide is effective only against mycobacteria. /Included in US product label/

Thomson/Micromedex. Drug Information for the Health Care Professional. Volume 1, Greenwood Village, CO. 2006.


Ethionamide is used in combination with other antileprosy agents in the treatment of Hansen's disease. /Not included in US product label/

Thomson/Micromedex. Drug Information for the Health Care Professional. Volume 1, Greenwood Village, CO. 2006.


Ethionamide is used in the treatment of atypical mycobacterial infections, such as Mycobacterium avium complex (MAC). /Not included in US product label/

Thomson/Micromedex. Drug Information for the Health Care Professional. Volume 1, Greenwood Village, CO. 2006.


Ethionamide and prothionamide are thioamides used as second-line antituberculosis drugs for treatment of multi-drug resistant tuberculosis.

WHO; Guidelines for the Management of Drug-Resistant Tuberculosis (WHO/TB/96.210 REV.1) 1997. Available from, as of November 26, 2006: https://whqlibdoc.who.int/hq/1997/WHO_TB_96.210_(Rev.1).pdf


4.3 Drug Warning

Adverse GI effects, including nausea, vomiting, diarrhea, abdominal pain, excessive salivation, metallic taste, stomatitis, anorexia, and weight loss, are the most common adverse effects reported with ethionamide. Nausea and vomiting may be severe enough to necessitate discontinuance of ethionamide. GI effects appear to be dose related, and approximately 50% of patients are unable to tolerate a single 1-g dose of the drug.

McEvoy, G.K. (ed.). American Hospital Formulary Service. AHFS Drug Information. American Society of Health-System Pharmacists, Bethesda, MD. 2006., p. 567


Psychotic disturbances, mental depression, restlessness, drowsiness, dizziness, headache, postural hypotension, and asthenia occur occasionally with ethionamide. Rarely, peripheral neuritis, paresthesia, seizures, tremors, a pellagra-like syndrome, hallucinations, diplopia, optic neuritis, blurred vision, and olfactory disturbances have been reported.

McEvoy, G.K. (ed.). American Hospital Formulary Service. AHFS Drug Information. American Society of Health-System Pharmacists, Bethesda, MD. 2006., p. 567


The manufacturer of ethionamide recommends concomitant use of pyridoxine to prevent or relieve neurotoxic effects during ethionamide treatment.

McEvoy, G.K. (ed.). American Hospital Formulary Service. AHFS Drug Information. American Society of Health-System Pharmacists, Bethesda, MD. 2006., p. 568


Transient increases in serum bilirubin, AST (SGOT), and ALT (SGPT) concentrations have been reported in patients receiving ethionamide. Hepatitis (with or without jaundice) also has been reported. Hepatotoxicity generally is reversible following discontinuance of the drug.

McEvoy, G.K. (ed.). American Hospital Formulary Service. AHFS Drug Information. American Society of Health-System Pharmacists, Bethesda, MD. 2006., p. 568


For more Drug Warnings (Complete) data for ETHIONAMIDE (22 total), please visit the HSDB record page.


4.4 Drug Indication

For use in the treatment of pulmonary and extrapulmonary tuberculosis when other antitubercular drugs have failed.


FDA Label


5 Pharmacology and Biochemistry
5.1 Pharmacology

Ethinamate is bacteriostatic against M. tuberculosis. In a study examining ethionamide resistance, ethionamide administered orally initially decreased the number of culturable Mycobacterium tuberculosis organisms from the lungs of H37Rv infected mice. Drug resistance developed with continued ethionamide monotherapy, but did not occur when mice received ethionamide in combination with streptomycin or isoniazid.


5.2 MeSH Pharmacological Classification

Antitubercular Agents

Drugs used in the treatment of tuberculosis. They are divided into two main classes: "first-line" agents, those with the greatest efficacy and acceptable degrees of toxicity used successfully in the great majority of cases; and "second-line" drugs used in drug-resistant cases or those in which some other patient-related condition has compromised the effectiveness of primary therapy. (See all compounds classified as Antitubercular Agents.)


Fatty Acid Synthesis Inhibitors

Compounds that interfere with FATTY ACID SYNTHASE resulting in a reduction of FATTY ACIDS. This is a target mechanism in humans of some ANTINEOPLASTIC AGENTS and ANTI-OBESITY AGENTS and of some ANTI-INFECTIVE AGENTS which interfere with CELL WALL and CELL MEMBRANE formation. (See all compounds classified as Fatty Acid Synthesis Inhibitors.)


5.3 FDA Pharmacological Classification
5.3.1 Active Moiety
ETHIONAMIDE
5.3.2 FDA UNII
OAY8ORS3CQ
5.3.3 Pharmacological Classes
Antimycobacterial [EPC]
5.4 ATC Code

J - Antiinfectives for systemic use

J04 - Antimycobacterials

J04A - Drugs for treatment of tuberculosis

J04AD - Thiocarbamide derivatives

J04AD03 - Ethionamide


5.5 Absorption, Distribution and Excretion

Absorption

Essentially completely absorbed following oral administration and not subjected to any appreciable first pass metabolism. Bioavailability approximately 100%.


Route of Elimination

Less than 1% of the oral dose is excreted as ethionamide in urine. Ethionamide is extensively metabolized to active and inactive metabolites.


Volume of Distribution

93.5 L [healthy volunteers]


Rapidly absorbed from the gastrointestinal tract following oral administration. Bioavailability approximately 100%.

Thomson/Micromedex. Drug Information for the Health Care Professional. Volume 1, Greenwood Village, CO. 2006.


Ethionamide is essentially completely absorbed following oral administration and does not undergo any appreciable first-pass metabolism.

McEvoy, G.K. (ed.). American Hospital Formulary Service. AHFS Drug Information. American Society of Health-System Pharmacists, Bethesda, MD. 2006., p. 568


Following a single 250-mg oral dose of ethionamide given as film-coated tablets in fasting adults, peak plasma concentrations of ethionamide average 2.16 mcg/mL and are attained within 1 hour. When a single 250-mg oral dose of ethionamide is given as sugar-coated tablets (Trecator-SC; no longer commercially available in the US) in healthy adults, peak plasma concentrations average 1.48 mcg/mL and are attained within 1.5 hours.

McEvoy, G.K. (ed.). American Hospital Formulary Service. AHFS Drug Information. American Society of Health-System Pharmacists, Bethesda, MD. 2006., p. 568


Time to peak concentration: Approximately 1.8 hours; Peak serum concentration: Approximately 2.2 mcg/mL after a single oral 500-mg dose.

Thomson/Micromedex. Drug Information for the Health Care Professional. Volume 1, Greenwood Village, CO. 2006.


For more Absorption, Distribution and Excretion (Complete) data for ETHIONAMIDE (11 total), please visit the HSDB record page.


5.6 Metabolism/Metabolites

Hepatic and extensive. Metabolized to the active metabolite sulfoxide, and several inactive metabolites. The sulphoxide metabolite has been demonstrated to have antimicrobial activity against Mycobacterium tuberculosis.


Ethionamide is extensively metabolized to active and inactive metabolites. Metabolism is presumed to occur in the liver and thus far 6 metabolites have been isolated: 2-ethylisonicotinamide, carbonyl-dihydropyridine, thiocarbonyl-dihydropyridine, S-oxocarbamoyl dihydropyridine, 2-ethylthioiso-nicotinamide, and ethionamide sulphoxide. The sulphoxide metabolite has been demonstrated to have antimicrobial activity against Mycobacterium tuberculosis .

Physicians Desk Reference 60th ed, Thomson PDR, Montvale, NJ 2006., p. 3482


5.7 Biological Half-Life

2 to 3 hours


The plasma half-life of ethionamide following a 250-mg oral dose given as film-coated tablets is 1.92 hours.

McEvoy, G.K. (ed.). American Hospital Formulary Service. AHFS Drug Information. American Society of Health-System Pharmacists, Bethesda, MD. 2006., p. 568


Half-life: Approximately 2 to 3 hours.

Thomson/Micromedex. Drug Information for the Health Care Professional. Volume 1, Greenwood Village, CO. 2006.


5.8 Mechanism of Action

Ethionamide may be bacteriostatic or bactericidal in action, depending on the concentration of the drug attained at the site of infection and the susceptibility of the infecting organism. Ethionamide, like prothionamide and pyrazinamide, is a nicotinic acid derivative related to isoniazid. It is thought that ethionamide undergoes intracellular modification and acts in a similar fashion to isoniazid. Isoniazid inhibits the synthesis of mycoloic acids, an essential component of the bacterial cell wall. Specifically isoniazid inhibits InhA, the enoyl reductase from Mycobacterium tuberculosis, by forming a covalent adduct with the NAD cofactor. It is the INH-NAD adduct that acts as a slow, tight-binding competitive inhibitor of InhA.


Ethionamide may be bacteriostatic or bactericidal in action, depending on the concentration of the drug attained at the site of infection and the susceptibility of the infecting organism. The exact mechanism of action of ethionamide has not been fully elucidated, but the drug appears to inhibit peptide synthesis in susceptible organisms.

McEvoy, G.K. (ed.). American Hospital Formulary Service. AHFS Drug Information. American Society of Health-System Pharmacists, Bethesda, MD. 2006., p. 568