Pyrazinamide

Pyrazinamide is a prescription medication used to treat Tuberculosis in HIV Negative and HIV exposed or infected individuals. 

• Pyrazinamide is available under the following different brand names:

Adult and pediatric dosage

Tablet

• 500mg

Tuberculosis treatment for HIV Negative

Adult dosage

Daily therapy

• 15-30 mg/kg orally once daily; not to exceed 2 g/day

Twice weekly therapy

• 50 mg/kg orally twice weekly; not to exceed 2 g/dose

Tuberculosis treatment for HIV Exposed/Infected

Adult dosage

• 20-40 mg/kg/dose orally once daily; not to exceed 2 g/day

See Also Combo

• with isoniazid and rifampin

Tuberculosis Treatment

Pediatric dosage

Daily therapy

• 15-30 mg/kg orally once daily; not to exceed 2000 mg/day

Twice weekly therapy

• 50 mg/kg/dose; not to exceed 3000 mg/day

Dosage Considerations – Should be Given as Follows: 

• See "Dosages."

Common side effects of Pyrazinamide include:

• joint or muscle pain, 
• nausea, 
• vomiting, and 
• loss of appetite

Serious side effects of Pyrazinamide include:

• hives, 
• difficulty breathing, 
• swelling of the face, lips, tongue, or throat, 
• fever, 
• joint pain or swelling, 
• easy bruising, 
• unusual bleeding (nosebleeds, bleeding gums), 
• joint stiffness, 
• redness or swelling of the joints (especially at night), 
• nausea, 
• upper stomach pain, 
• itching, 
• tiredness, 
• loss of appetite, 
• dark urine, 
• clay-colored stools, and
• yellowing of the skin or eyes (jaundice)

Rare side effects of Pyrazinamide include:

• none 

This is not a complete list of side effects and other serious side effects or health problems may occur as a result of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider or pharmacist first.

• Pyrazinamide has severe interactions with no other drugs.
• Pyrazinamide has serious interactions with the following drugs:
  • pexidartinib
  • pretomanid
  • rifampin
• Pyrazinamide has moderate interactions with the following drugs:
  • cyclosporine
  • mipomersen
  • probenecid
• Pyrazinamide has minor interactions with the following drugs:
  • isoniazid
  • tacrolimus 

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this drug, tell your doctor or pharmacist of all the drugs you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist. Check with your physician if you have health questions or concerns.

Contraindications

• Severe hepatic damage, acute gout, hypersensitivity

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Pyrazinamide?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Pyrazinamide?”

Cautions

• Pyrazinamide inhibits renal excretion of urates, frequently resulting in hyperuricemia which is usually asymptomatic. If hyperuricemia is accompanied by acute gouty arthritis, pyrazinamide should be discontinued. 
• Pyrazinamide should be used with caution in patients with a history of diabetes mellitus, as management may be more difficult. 
• Primary resistance of M. tuberculosis to pyrazinamide is uncommon. In cases with known or suspected drug resistance, in vitro susceptibility tests with recent cultures of M. tuberculosis against pyrazinamide and the 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.

Pregnancy and Lactation

• Use with caution if benefits outweigh risks during pregnancy.
• Lactation: Enters breast milk.