Pyrazinamide

Indications
Oral
Tuberculosis
Adult: As part of a mulitdrug regimen, 20-25 mg/kg (max: 2 g) daily or 1.5-3 g 3 times wkly.
Child: As part of a mulitdrug regimen, 35 mg/kg daily or 50 mg/kg 3 times wkly or 75 mg/kg twice wkly. Max dose: 3 g daily.
Renal impairment: May need dose reduction.

Special Populations: Reduce dose in patients with renal impairment.
Contraindications
Hypersensitivity; existing liver disease; acute gout or hyperuricaemia. Porphyria. Pregnancy and lactation.
Warnings / Precautions
Diabetes, renal failure, history of gout, children. Monitor liver function and serum uric acid regularly.
Adverse Reactions
Hepatotoxicity (hepatomegaly, splenomegaly and jaundice may develop and in rare case fulminating acute yellow atrophy and death). Anorexia, nausea, vomiting, arthralgia, malaise, fever, hyperuricaemia, abnormal LFT, skin rashes.
Potentially Fatal: Severe liver damage, fulminant hepatitis.
Drug Interactions
Excretion may be blocked by probenecid.
See Below for More pyrazinamide Drug Interactions
Mechanism of Actions
Pyrazinamide has bactericidal action against M. tuberculosis in acid environment present in macrophages and inflammed tissue. Together with rifampicin provides greatest sterilising action with reduction in relapse rate. Reduces tubular secretion of uric acid.
Absorption: Readily absorbed from the GI tract (oral); peak plasma concentrations after 2 hr.
Distribution: Body fluids and tissues (wide), CSF, enters breast milk.
Metabolism: Hepatic; hydrolysed to pyrazinoic acid (active) then hydroxylated to 5-hydroxypyrazinoic acid (major excretory product).
Excretion: Via urine by glomerular filtration (70% as metabolites, 4-14% as unchanged); 9-10 hr (elimination half-life), removed by dialysis.
Administration
Should be taken with food.
Storage Conditions
Oral: Store at 15-30°C.
ATC Classification
J04AK01 - pyrazinamide ; Belongs to the class of other drugs used in the systemic treatment of tuberculosis.
Storage
Oral: Store at 15-30°C.
Available As
  • Pyrazinamide 1000 mg
  • Pyrazinamide 1000 mg (2 tab)
  • Pyrazinamide 1200 mg
  • Pyrazinamide 150 mg
  • Pyrazinamide 1500 mg
  • Pyrazinamide 225 mg
  • Pyrazinamide 250 mg
  • Pyrazinamide 300 mg
  • Pyrazinamide 350 mg
  • Pyrazinamide 375 mg
  • Pyrazinamide 400 mg
  • Pyrazinamide 500 mg
  • Pyrazinamide 750 mg
  • Pyrazinamide 750 mg (2 tab)
  • Pyrazinamide 800 mg
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