Special Precautions:

FOR THE INTERNIST

Consider a lower dosage or outright exclusion of EMB in the following situations where the risk for ETON is likely higher than usual:

FOR THE OPHTHALMOLOGIST

These high-risk situations may warrant stricter monitoring of visual parameters (more frequent and/or more sophisticated tests like Automated Visual Field Examination and Contrast Sensitivity Testing):

  1. Pre-existing eye pathology with baseline vision poor enough that precludes a patient from noticing further decrease in visual acuity once ETON sets in;
  2. Children too young for objective eye exams and in those with language and communication problems who may not be able to communicate visual disturbances;
  3. Presence of renal dysfunction;
  4. Presence of nutritional and vitamin deficiency (+/- alcohol abuse);
  5. Low body weight (commercially available "fixed-preparations" may contain too high a dosage of EMB); and
  6. (additional for the ophthalmologist): In cases of Extra-pulmonary TB, Multi-drug-resistant TB (MDR-TB), Extensively/Extremely Drug-resistant TB (XDR-TB), where the EMB treatment dosage is higher than usual and/or given for longer periods.