Dosing & Uses
Dosage Forms & Strengths
tablet
- 500mg
Tuberculosis Treatment For HIV Negative
Daily therapy
Twice weekly therapy
- 50 mg/kg PO twice weekly; not to exceed 2 g/dose
Tuberculosis Treatment For HIV Exposed/Infected
20-40 mg/kg/dose PO qDay; not to exceed 2 g/day
See Also Combo
With isoniazid & rifampin
Other Indications & Uses
Tuberculosis; should always be admin with other anti-TB drugs
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (0)
Serious - Use Alternative (3)
- pexidartinib
pyrazinamide and pexidartinib both increase inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Pexidartinib can cause hepatotoxicity. Avoid coadministration of pexidartinib with other products know to cause hepatoxicity.
- pretomanid
pyrazinamide, pretomanid. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Pretomanid regimen associated with hepatotoxicity. Avoid alcohol and hepatotoxic agents, including herbal supplements and drugs other than bedaquiline and linezolid.
- rifampin
rifampin, pyrazinamide. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Additive hepatotoxicity.
Monitor Closely (3)
- cyclosporine
pyrazinamide decreases levels of cyclosporine by unknown mechanism. Use Caution/Monitor. A case reported demonstrated a decrease in cyclosporine plasma levels after pyrazinamide was added onto a renal transplant patient's therapy.
- mipomersen
mipomersen, pyrazinamide. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Both drugs have potential to increase hepatic enzymes; monitor LFTs.
- probenecid
pyrazinamide decreases effects of probenecid by unknown mechanism. Use Caution/Monitor.
Minor (2)
- isoniazid
isoniazid, pyrazinamide. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive hepatotoxicity.
- tacrolimus
pyrazinamide decreases levels of tacrolimus by unknown mechanism. Minor/Significance Unknown.
Adverse Effects
1-10%
Malaise
Nausea
Vomiting
Anorexia
Arthralgia
Myalgia
<1%
Fever
Rash
Itching
Acne
Photosensitivity
Gout
Dysuria
Porphyria
Thrombocytopenia
Hepatotoxicity
Interstitial nephritis
Warnings
Contraindications
Severe hepatic damage, acute gout, hypersensitivity
Cautions
Patients started on this therapy should have baseline serum uric acid and liver function determinations; those patients with preexisting liver disease or those at increased risk for drug-related hepatitis (eg, alcohol abusers) should be followed closely
Discontinue therapy and do not resume if signs of hepatocellular damage or hyperuricemia accompanied by acute gouty arthritis appear
This drug inhibits renal excretion of urates, frequently resulting in hyperuricemia which is usually asymptomatic; if hyperuricemia is accompanied by acute gouty arthritis, discontinue therapy
Use with caution in patients with a history of diabetes mellitus, as management may be more difficult
Primary resistance of M. tuberculosis to therapy is uncommon; in cases with known or suspected drug resistance, in vitro susceptibility tests with recent cultures of M. tuberculosis against this drug and usual primary drugs should be performed
There are few reliable in vitro tests for pyrazinamide resistance; a reference laboratory capable of performing these studies must be employed
Patients should be instructed to notify their physicians promptly if they experience fever, loss of appetite, malaise, nausea and vomiting, darkened urine, yellowish discoloration of the skin and eyes, pain or swelling of the joints
Emphasize compliance with full course of therapy; the importance of not missing any doses must be stressed
Pregnancy & Lactation
Pregnancy
Animal reproduction studies have not been conducted with this drug; it is also not known whether therapy can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity; this drug should be given to a pregnant woman only if clearly needed
Lactation
Pyrazinamide has been found in small amounts in breast milk; it is advised that the drug be used with caution in nursing mothers taking into account the risk-benefit of this therapy
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Pharmacology
Absorption: well absorbed
Distribution: widely into body tissues and fluids including liver, lung, and CSF
Relative diffusion from blood into CSF: adequate with or without inflammation (exceeds usual MICs)
CSF:blood level ratio: inflamed meninges: 100%
Protein binding: 50%
Metabolism: hepatic
Half-life elimination: 9-10 hr
Time to peak, serum: within 2 hr
Excretion: urine (4% as unchanged drug)
Mechanism of Action
Unknown; bacteriostatic or -cidal for Mycobacterium
Images
| BRAND | FORM. | UNIT PRICE | PILL IMAGE |
|---|---|---|---|
| pyrazinamide oral - | 500 mg tablet |  | |
| pyrazinamide oral - | 500 mg tablet |  | |
| pyrazinamide oral - | 500 mg tablet |  |
Copyright © 2010 First DataBank, Inc.
Patient Handout
pyrazinamide oral
PYRAZINAMIDE - ORAL
(pir-uh-ZIN-uh-mide)
USES: Pyrazinamide is used with other medications to treat tuberculosis (TB). It is an antibiotic and works by stopping the growth of bacteria.This antibiotic treats only bacterial infections. It will not work for viral infections (such as common cold, flu). Using any antibiotic when it is not needed can cause it to not work for future infections.
HOW TO USE: Take this medication by mouth with or without food as directed by your doctor, usually once daily or twice weekly.Dosage is based on your age, weight, medical condition, and response to treatment.For the best effect, take this antibiotic at evenly spaced times. If you are taking this medication daily, take it at the same time each day. If you are taking this medication on a weekly schedule, take it on the same days of the week and at the same time each day. Mark the days on the calendar when you need to take the medication.Continue to take this medication (and other TB medications) until the full prescribed amount is finished, even if symptoms disappear. Stopping the medication too early or skipping doses may allow the bacteria to continue to grow, which may result in a return of the infection and cause the infection to be more difficult to treat (resistant).Tell your doctor if your condition lasts or gets worse.
SIDE EFFECTS: Nausea, vomiting, loss of appetite, or mild muscle/joint pain may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: symptoms of liver disease (such as nausea/vomiting that doesn't stop, unusual tiredness/weakness, severe stomach/abdominal pain, yellowing eyes/skin, dark urine), painful/swollen joints, signs of kidney problems (such as change in the amount of urine), easy bleeding/bruising, fast heartbeat.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: fever that doesn't go away, new or worsening lymph node swelling, rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
PRECAUTIONS: Before taking pyrazinamide, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: liver disease, kidney disease, diabetes, gout, high uric acid level in the blood, alcohol use.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).Alcohol may increase the risk of liver disease. Avoid alcoholic beverages while using this medication.Pyrazinamide may cause live bacterial vaccines (such as typhoid vaccine) to not work well. Tell your health care professional that you are using pyrazinamide before having any immunizations/vaccinations.During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.This medication passes into breast milk but the effect on a nursing infant is unknown. Discuss the risks and benefits with your doctor before breast-feeding.
DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.This medication may interfere with certain laboratory tests (including urine ketone tests), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug.
OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.
NOTES: Do not share this medication with others.Lab and/or medical tests (such as sputum test, kidney/liver function, uric acid levels, complete blood count) should be done while you are taking this medication. Keep all medical and lab appointments. Consult your doctor for more details.
MISSED DOSE: It is important to take each dose of this medication as scheduled. If you are taking this medication daily and miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.If you are taking this drug on a weekly schedule and miss a dose, take it as soon as you remember if it is on the same day. If you remember on the next day or later, ask your doctor or pharmacist right away for a new dosing schedule. Do not double the dose to catch up.
STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.
Information last revised February 2023. Copyright(c) 2023 First Databank, Inc.
IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.
Formulary
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