[4] Common side effects include problems with vision, joint pain, nausea, headaches, and feeling tired.

[5][6] In the United States the FDA has raised concerns about eye issues in the baby if used during pregnancy.

Ethambutol contains two constitutionally symmetrical chiral centers in its structure and exists in three stereoisomeric forms, the enantiomeric pair (+)-(S,S)- and (−)-(R,R)-ethambutol, along with the achiral stereoisomer called meso-form.

Mycolic acids attach to the 5'-hydroxyl groups of D-arabinose residues of arabinogalactan and form mycolyl-arabinogalactan-peptidoglycan complex in the cell wall.

Disruption of the arabinogalactan synthesis inhibits the formation of this complex and leads to increased permeability of the cell wall.