Generic Trecator-sc

Introduction

Trecator‑sc is a synthetic antibiotic whose active ingredient is Ethionamide. It belongs to the class of second‑line anti‑tubercular agents and is used primarily for the treatment of multidrug‑resistant (MDR) and extensively drug‑resistant (XDR) tuberculosis in the United Kingdom. Ethionamide interferes with the synthesis of mycobacterial cell‑wall components, providing a therapeutic option when first‑line drugs such as isoniazid and rifampicin cannot be employed. The medication is marketed by several manufacturers; in the UK it is supplied as a sterile capsule formulation (sc = soft‑capsule).

What is Trecator‑sc?

Trecator‑sc is the generic version of the brand‑name product Trecator, both containing the same active compound Ethionamide. Our online pharmacy provides this generic alternative as a cost‑effective treatment option. The drug is classified as a thioamide antibiotic, and its development dates back to the 195s when it was first introduced for resistant mycobacterial infections. The product is manufactured under Good Manufacturing Practice (GMP) conditions and, in the UK, is subject to licensing by the Medicines and Healthcare products Regulatory Agency (MHRA).

How Trecator‑sc Works

Ethionamide is a pro‑drug that requires activation by the mycobacterial enzyme EthA, a mono‑oxygenase. Once activated, it forms a reactive intermediate that inhibits the enzyme InhA, essential for the synthesis of mycolic acids—key components of the Mycobacterium tuberculosis cell wall. By blocking mycolic‑acid production, the drug compromises cell‑wall integrity, leading to bacterial death. The antimicrobial effect usually becomes apparent after several days of therapy, reflecting the slow replication cycle of tubercle bacilli. Ethionamide is eliminated primarily by hepatic metabolism; its half‑life ranges from 2 to 5 hours, necessitating twice‑daily dosing for stable plasma concentrations.

Conditions Treated with Trecator‑sc

• Multidrug‑Resistant Tuberculosis (MDR‑TB) – resistance to at least isoniazid and rifampicin. Ethionamide is a core component of WHO‑recommended MDR‑TB regimens.
• Extensively Drug‑Resistant Tuberculosis (XDR‑TB) – resistance to first‑line agents plus any fluoroquinolone and one second‑line injectable. Ethionamide may be retained in individualized treatment plans when susceptibility testing confirms activity.
• Additional Indications (off‑label, limited evidence) – certain non‑tuberculous mycobacterial infections (e.g., Mycobacterium avium complex) where standard therapy fails.

In the UK, TB incidence remains low (≈5 cases per 100 000 population), but MDR‑TB accounts for ~2 % of cases, making access to effective second‑line drugs essential for public‑health containment.

Suitable Candidates for Trecator‑sc Treatment

• Adults diagnosed with culture‑confirmed MDR‑TB or XDR‑TB who have ethionamide‑susceptible isolates.
• Patients requiring an oral option to complement injectable agents, facilitating outpatient management.
• Individuals without severe hepatic impairment (baseline transaminases ≤ 2 × upper limit of normal) and without known hypersensitivity to thioamides.

Contra‑indications / Cautions

• Pregnant or breastfeeding women: limited safety data; use only if benefits outweigh risks.
• Severe liver disease (e.g., cirrhosis, active hepatitis) – increased risk of hepatotoxicity.
• Pre‑existing peripheral neuropathy or visual disturbances – ethionamide may exacerbate these conditions.

Risks, Side Effects, and Interactions

Common

• Nausea, vomiting, loss of appetite, abdominal discomfort.
• Central nervous system symptoms: headache, dizziness, mild confusion.
• Rash or pruritus.

Rare

• Peripheral neuropathy (tingling, numbness) – may be mitigated by pyridoxine supplementation.
• Visual disturbances such as blurred vision or photophobia.
• Thyroid dysfunction (hypothyroidism) reported in prolonged therapy.

Serious

• Hepatotoxicity – marked elevation of ALT/AST, jaundice, hepatic failure. Requires immediate cessation and hepatology review.
• Severe hypersensitivity reactions, including Stevens‑Johnson syndrome or toxic epidermal necrolysis.
• Hematologic abnormalities: leukopenia, thrombocytopenia, or pancytopenia.

Drug–Drug Interactions

• Rifampicin and other potent inducers (e.g., carbamazepine, phenobarbital) lower ethionamide plasma levels, potentially reducing efficacy.
• Isoniazid can increase the risk of neuro‑toxicity; concurrent pyridoxine (vitamin B6) is recommended.
• Warfarin – ethionamide may enhance anticoagulant effect; INR monitoring is advised.
• Antiretroviral agents (e.g., efavirenz) – possible pharmacokinetic interactions; clinicians should consider therapeutic drug monitoring.

Practical Use: Dosing, Missed Dose, Overdose

• Standard adult dose: 15–20 mg/kg/day divided into two equal doses, not to exceed 1 g per day. Typical regimens use 500 mg soft‑capsules taken twice daily. Dose adjustments are required for hepatic impairment or body‑weight extremes.
• Administration: Swallow capsules whole with a glass of water; taking with food reduces gastrointestinal irritation.
• Missed dose: If a dose is missed by less than 8 hours, take it as soon as remembered. If > 8 hours have elapsed, skip the missed dose and resume the regular schedule; do not double‑dose.
• Overdose: Symptoms may include severe nausea, vomiting, abdominal pain, and hepatic dysfunction. Seek emergency medical care; supportive measures and activated charcoal may be employed if presentation is early.
• Precautions: Avoid alcohol, which can potentiate liver injury. Monitor liver function tests (ALT, AST, bilirubin) at baseline and every 2–4 weeks during the first two months, then monthly. Regular ophthalmologic and neurologic assessments are advisable for prolonged therapy.

Buying Trecator‑sc from Our Online Pharmacy

Trecator‑sc can be purchased from our online pharmacy in the UK with a focus on safety, affordability, and discretion.

• Affordable pricing: We source the medication close to manufacturer cost, passing savings directly to you.
• Verified quality: All batches are supplied by MHRA‑approved overseas licensed pharmacies, ensuring authenticity and compliance with international standards.
• Guaranteed delivery: Discreet packaging is sent via a reliable carrier; express shipping arrives within 7 days, while standard airmail typically reaches the UK in about 3 weeks.
  -Online‑only access: For patients who encounter limited availability through local pharmacies or national insurance schemes, our pharmacy broker service bridges the gap by collaborating with internationally accredited suppliers.

We respect patient privacy; shipping labels contain only essential information, and no medication details are visible externally.

FAQ

• Is Trecator‑sc available in both brand‑name and generic forms in the UK?
  Yes. The original brand‑name product is marketed as Trecator, while Trecator‑sc is a generic formulation containing the same active compound, Ethionamide, and is usually offered at a lower price.

• Does Trecator‑sc require any special storage conditions?
  The capsules should be stored at controlled room temperature (15–30 °C), protected from moisture, heat, and direct sunlight. No refrigeration is needed, but the product must be kept in the original container until use.

• What does the soft‑capsule of Trecator‑sc look like?
  Trecator‑sc capsules are typically opaque, white to off‑white, and labeled with the strength (e.g., 500 mg) on the side. The outer shell contains inert excipients such as gelatin, enabling easy swallowing.

• Can I travel internationally with Trecator‑sc?
  Yes, provided you carry a copy of the prescription (or a physician’s letter where required) and keep the medication in its original packaging. Check the destination country’s import regulations for controlled substances before departure.

• Are there any known differences in formulation between regions (e.g., US vs EU)?
  While the active ingredient (Ethionamide) remains constant, excipient composition may vary to meet local regulatory standards. For example, European formulations may use lactose as a filler, whereas some Asian versions employ sorbitol. These differences do not affect therapeutic efficacy but could be relevant for patients with specific excipient intolerances.

• What clinical trials supported the use of Ethionamide in MDR‑TB?
  Large‑scale WHO‑endorsed studies, such as the Bangladesh Regimen and the STREAM‑2 trial, demonstrated that Ethionamide, when incorporated into an optimized background regimen, contributed to higher sputum‑culture conversion rates in MDR‑TB patients.

• Does Ethionamide interact with over‑the‑counter supplements?
  High‑dose vitamin B6 (pyridox ≥ 100 mg) is recommended to mitigate neuropathy; however, some herbal products like St. John’s wort can induce hepatic enzymes, potentially lowering Ethionamide levels. Discuss any supplement use with your healthcare provider.

• Is therapeutic drug monitoring (TDM) required for Ethionamide?
  Routine TDM is not standard, but in cases of severe liver disease, renal impairment, or when used with strong enzyme inducers, measuring plasma concentrations can help tailor dosing and avoid toxicity.

• Can Ethionamide cause abnormalities in routine blood tests?
  Yes. Hepatotoxicity may elevate transaminases, while rare hematologic effects can lower white‑cell or platelet counts. Periodic complete blood counts (CBC) and liver function tests are therefore part of standard monitoring.

• What is the impact of smoking on Ethionamide effectiveness?
  Smoking can impair pulmonary drug distribution and may increase the risk of treatment failure in TB. Patients are advised to quit smoking and avoid exposure to second‑hand smoke during therapy.

• Does Ethionamide have any effect on pregnancy outcomes?
  Data are limited; animal studies suggest potential teratogenicity at high doses. Use is generally limited to situations where no safer alternative exists and the benefit to the mother outweighs fetal risk.

Glossary

Ethionamide

A synthetic thioamide antibiotic that inhibits mycolic‑acid synthesis in Mycobacterium tuberculosis, used as a second‑line agent for resistant TB.

MDR‑TB (Multidrug‑Resistant Tuberculosis)

Tuberculosis strain resistant to at least isoniazid and rifampicin, the two most potent first‑line anti‑TB drugs.

Hepatotoxicity

Liver injury caused by a drug, manifested by elevated liver enzymes (ALT, AST), jaundice, or, in severe cases, liver failure.

Therapeutic adherence

The extent to which a patient correctly follows the prescribed dosing schedule, crucial for preventing resistance in TB treatment.

⚠️ Disclaimer

The information provided about Trecator‑sc is for general knowledge only. It does not replace professional medical consultation. All treatment decisions should be made under the supervision of a qualified healthcare provider. We assume all readers are responsible adults capable of making informed decisions about their health. Our online pharmacy offers access to Trecator‑sc for individuals who may have limited availability through traditional pharmacies, prescription‑based insurance schemes, or who are seeking affordable generic alternatives. Always consult your doctor before starting, changing, or discontinuing any medication.