Pulna/Pulna Forte Actions

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Consists of Ethambutol HCl, INH, vit B6

Actions of Ethambutol HCl (Pulna/Pulna Forte) in details

The action of the drug on the human body is called Pharmacodynamics in Medical terminology. To produce its effect and to change the pathological process that is happening the body and to reduce the symptom or cure the disease, the medicine has to function in a specific way. The changes it does to the body at cellular level gives the desired result of treating a disease. Drugs act by stimulating or inhibiting a receptor or an enzyme or a protein most of the times. Medications are produced in such a way that the ingredients target the specific site and bring about chemical changes in the body that can stop or reverse the chemical reaction which is causing the disease.

Description: Ethambutol HCl (Pulna/Pulna Forte) appears to inhibit the synthesis of 1 or more metabolites in susceptible bacteria resulting in impairment of cellular metabolism, arrest of multiplication, and cell death. It is active against susceptible bacteria only when they are undergoing cell division.


Absorption: 80% is absorbed from the GI tract. Time to peak plasma concentration: W/in 4 hr.

Distribution: Distributed in most tissues, including lungs, kidneys, erythrocytes. Approx 10-50% may diffuse into CSF when meninges are inflamed. Crosses the placenta and enters breast milk.

Metabolism: Undergoes partial hepatic metabolism;, converted to the aldehyde and dicarboxylic acid derivatives (inactive).

Excretion: Via urine (as unchanged drug, 8-15% as metabolites) and faeces (20% as unchanged drug). Elimination half-life: Approx 3-4 hr.

How should I take Ethambutol HCl (Pulna/Pulna Forte)?

Ethambutol HCl (Pulna/Pulna Forte) may be taken with food if Ethambutol HCl (Pulna/Pulna Forte) upsets your stomach.

To help clear up your tuberculosis (TB) completely, it is very important that you keep taking Ethambutol HCl (Pulna/Pulna Forte) for the full time of treatment, even if you begin to feel better after a few weeks. You may have to take it every day for as long as 1 to 2 years or more. It is important that you do not miss any doses.


The dose of Ethambutol HCl (Pulna/Pulna Forte) will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of Ethambutol HCl (Pulna/Pulna Forte). If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (tablets):
    • For the treatment of tuberculosis (TB):
      • Adults and children 13 years of age and older—15 to 25 milligrams (mg) per kilogram (kg) (6.8 to 11.4 mg per pound) of body weight once a day. Instead, your doctor may tell you to take 50 mg per kg (22.8 mg per pound) of body weight, up to a total of 2.5 grams, two times a week. Another dose that your doctor may tell you to take is 25 to 30 mg per kg (11.4 to 13.6 mg per pound) of body weight, up to a total of 2.5 grams, three times a week. Ethambutol HCl (Pulna/Pulna Forte) must be taken with other medicines to treat tuberculosis.
      • Infants and children up to 13 years of age—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of Ethambutol HCl (Pulna/Pulna Forte), take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.


Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ethambutol HCl (Pulna/Pulna Forte) administration

Administration of drug is important to know because the drug absorption and action varies depending on the route and time of administration of the drug. A medicine is prescribed before meals or after meals or along with meals. The specific timing of the drug intake about food is to increase its absorption and thus its efficacy. Few work well when taken in empty stomach and few medications need to be taken 1 or 2 hrs after the meal. A drug can be in the form of a tablet, a capsule which is the oral route of administration and the same can be in IV form which is used in specific cases. Other forms of drug administration can be a suppository in anal route or an inhalation route.

Take Ethambutol HCl (Pulna/Pulna Forte) exactly as directed by your doctor. If you do not understand these instructions, ask your pharmacist, nurse, or doctor to explain them to you.

Take each dose with a full glass (8 ounces) of water.

Ethambutol HCl (Pulna/Pulna Forte) can be taken with or without food. Taking Ethambutol HCl (Pulna/Pulna Forte) with food may decrease stomach upset.

Take all of the Ethambutol HCl (Pulna/Pulna Forte) that has been prescribed for you even if you begin to feel better. Your symptoms may begin to improve before the infection is completely treated.

Ethambutol HCl (Pulna/Pulna Forte) is usually combined with one or more other tuberculosis medicines.

Store this medication at room temperature away from moisture and heat.

Ethambutol HCl (Pulna/Pulna Forte) pharmacology

Pharmacokinetics of a drug can be defined as what body does to the drug after it is taken. The therapeutic result of the medicine depends upon the Pharmacokinetics of the drug. It deals with the time taken for the drug to be absorbed, metabolized, the process and chemical reactions involved in metabolism and about the excretion of the drug. All these factors are essential to deciding on the efficacy of the drug. Based on these pharmacokinetic principles, the ingredients, the Pharmaceutical company decides dose and route of administration. The concentration of the drug at the site of action which is proportional to therapeutic result inside the body depends on various pharmacokinetic reactions that occur in the body.

Ethambutol HCl (Pulna/Pulna Forte) hydrochloride, following a single oral dose of 25 mg/kg of body weight, attains a peak of 2 to 5 mcg/mL in serum 2 to 4 hours after administration. When the drug is administered daily for longer periods of time at this dose, serum levels are similar. The serum level of Ethambutol HCl (Pulna/Pulna Forte) falls to undetectable levels by 24 hours after the last dose except in some patients with abnormal renal function. The intercellular concentrations of erythrocytes reach peak values approximately twice those of plasma and maintain this ratio throughout the 24 hours.

During the 24-hour period following oral administration of Ethambutol HCl (Pulna/Pulna Forte) approximately 50 percent of the initial dose is excreted unchanged in the urine, while an additional 8 to 15 percent appears in the form of metabolites. The main path of metabolism appears to be an initial oxidation of the alcohol to an aldehydic intermediate, followed by conversion to a dicarboxylic acid. From 20 to 22 percent of the initial dose is excreted in the feces as unchanged drug. No drug accumulation has been observed with consecutive single daily doses of 25 mg/kg in patients with normal kidney function, although marked accumulation has been demonstrated in patients with renal insufficiency.

Ethambutol HCl (Pulna/Pulna Forte) diffuses into actively growing mycobacterium cells such as tubercle bacilli. Ethambutol HCl (Pulna/Pulna Forte) appears to inhibit the synthesis of one or more metabolites, thus causing impairment of cell metabolism, arrest of multiplication, and cell death. No cross resistance with other available antimycobacterial agents has been demonstrated.

Ethambutol HCl (Pulna/Pulna Forte) has been shown to be effective against strains of Mycobacterium tuberculosis but does not seem to be active against fungi, viruses, or other bacteria. Mycobacterium tuberculosis strains previously unexposed to Ethambutol HCl (Pulna/Pulna Forte) have been uniformly sensitive to concentrations of 8 or less mcg/ mL, depending on the nature of the culture media. When Ethambutol HCl (Pulna/Pulna Forte) has been used alone for treatment of tuberculosis, tubercle bacilli from these patients have developed resistance to Ethambutol HCl (Pulna/Pulna Forte) hydrochloride by in-vitro susceptibility tests; the development of resistance has been unpredictable and appears to occur in a step-like manner. No cross resistance between Ethambutol HCl (Pulna/Pulna Forte) and other antituberculous drugs has been reported. Ethambutol HCl (Pulna/Pulna Forte) has reduced the incidence of the emergence of mycobacterial resistance to isoniazid when both drugs have been used concurrently. An agar diffusion microbiologic assay, based upon inhibition of Mycobacterium smegmatis (ATCC 607) may be used to determine concentrations of Ethambutol HCl (Pulna/Pulna Forte) in serum and urines.


Toxicological studies in dogs on high prolonged doses produced evidence of myocardial damage and failure, and depigmentation of the tapetum lucidum of the eyes, the significance of which is not known. Degenerative changes in the central nervous system, apparently not dose-related, have also been noted in dogs receiving Ethambutol HCl (Pulna/Pulna Forte) hydrochloride over a prolonged period. In the rhesus monkey, neurological signs appeared after treatment with high doses given daily over a period of several months. These were correlated with specific serum levels of Ethambutol HCl (Pulna/Pulna Forte) and with definite neuroanatomical changes in the central nervous system. Focal interstitial carditis was also noted in monkeys which received Ethambutol HCl (Pulna/Pulna Forte) hydrochloride in high doses for a prolonged period.



  1. DailyMed. "ETHAMBUTOL HYDROCHLORIDE: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
  2. NCIt. "Ethambutol: NCI Thesaurus (NCIt) provides reference terminology for many systems. It covers vocabulary for clinical care, translational and basic research, and public information and administrative activities.". https://ncit.nci.nih.gov/ncitbrowser... (accessed September 17, 2018).
  3. EPA DSStox. "Ethambutol: DSSTox provides a high quality public chemistry resource for supporting improved predictive toxicology.". https://comptox.epa.gov/dashboard/ds... (accessed September 17, 2018).


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Information checked by Dr. Sachin Kumar, MD Pharmacology

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