Trecator: What It Is, How It Works, and What You Need to Know

When second-line tuberculosis treatment is needed, Trecator, a brand name for ethionamide, an antibiotic used to treat drug-resistant TB. Also known as ethionamide, it's not a first-choice drug—but when other antibiotics stop working, it becomes critical. Trecator doesn't kill TB bacteria outright. Instead, it stops them from building their cell walls, slowing the infection so your immune system or other drugs can finish the job. It’s used almost always in combination with at least three other TB meds, because using it alone leads to resistance fast.

Trecator is part of a bigger group of drugs called second-line anti-TB agents. These are the backup weapons when first-line drugs like isoniazid or rifampin fail, usually because the bacteria have adapted. People who’ve had TB before, lived in high-resistance areas, or didn’t take their meds correctly are the ones most likely to need Trecator. It’s not for mild cases. You won’t find it in a regular pharmacy—it’s prescribed only by specialists who track drug-resistant infections closely. Side effects? They’re real: nausea, vomiting, liver stress, and a strong metallic taste that makes some people quit. That’s why it’s paired with pyridoxine (vitamin B6) to protect nerves and liver function.

Trecator doesn’t work in isolation. It’s tied to other drugs like cycloserine, capreomycin, and fluoroquinolones. These form the backbone of multidrug-resistant TB (MDR-TB) regimens. The World Health Organization lists Trecator as essential for treating MDR-TB, especially in regions where newer drugs are too expensive or hard to get. While newer options like bedaquiline and delamanid are becoming more common, Trecator remains widely used because it’s affordable and proven over decades.

What you’ll find below are real comparisons and guides from people who’ve used Trecator—or been prescribed it. You’ll see how it stacks up against other TB antibiotics, what side effects actually look like in practice, how patients manage the nausea, and why some switch to newer drugs. There are no fluff articles here. Just clear, honest takes on what works, what doesn’t, and what to watch out for when TB treatment gets complicated.