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Pyrazinamide Disease Interactions

There are 6 disease interactions with pyrazinamide:

Pza (Includes Pyrazinamide) ↔ Gout

Severe Potential Hazard, High plausibility

Applies to: Gout

The use of pyrazinamide is contraindicated in patients with acute gout. Pyrazinamide inhibits the renal excretion of uric acid, which may frequently result in precipitation or exacerbation of gout. Therapy with pyrazinamide should be administered cautiously in patients with hyperuricemia or a history of gout. Serum uric acid levels should be monitored regularly, and appropriate measures (e.g., administration of uricosuric agents) taken to prevent the development of gout. If gouty arthritis occurs, pyrazinamide should be discontinued.

References

  1. "Product Information. Pyrazinamide (pyrazinamide)." VersaPharm Inc, Marietta, GA.
  2. Amodio MI, Bengualid V, Lowy FD "Development of acute gout secondary to pyrazinamide in a patient without a prior history of gout." DICP 24 (1990): 1115-6

Pza (Includes Pyrazinamide) ↔ Hepatotoxicity

Severe Potential Hazard, High plausibility

Applies to: Alcoholism, Liver Disease

The use of pyrazinamide is contraindicated in patients with severe liver damage. Pyrazinamide may cause hepatocellular injury, particularly in patients with underlying liver disease and during coadministration with other hepatotoxic agents including other antituberculous drugs such as isoniazid and rifampin. Therapy with pyrazinamide should be administered cautiously and under strict medical supervision in patients with liver disease or a history of alcoholism. Serum transaminases (ALT, AST) and bilirubin should be measured at baseline and monitored closely during therapy. Patients should be instructed to discontinue the drug promptly and seek medical attention if signs and symptoms of hepatic injury develop, including fever, rash, anorexia, nausea, vomiting, fatigue, right upper quadrant pain, dark urine, and jaundice. To lessen the risk of hepatotoxicity, the maximum dosage should not exceed 2 g/day when treatment is administered daily or 3 g/day when administered twice weekly.

References

  1. "Product Information. Pyrazinamide (pyrazinamide)." VersaPharm Inc, Marietta, GA.
  2. Mandell GL, Bennett JE, Dolin R, eds.. "Mandell, Douglas and Bennett's Principles and Practice of Infectious Diseases. 4th ed." New York, NY: Churchill Livingston 1 (1995):
  3. Cohen CD, Sayed AR, Kirsch RE "Hepatic complications of antituberculosis therapy revisited." S Afr Med J 63 (1983): 960-3
View all 5 references

Pza (Includes Pyrazinamide) ↔ Liver Disease

Severe Potential Hazard, High plausibility

Applies to: Liver Disease

Pyrazinamide is primarily metabolized by the liver. Patients with liver disease may be at greater risk for adverse effects from pyrazinamide due to decreased drug clearance. Dosage reductions are recommended in these patients if the drug is used.

References

  1. "Product Information. Pyrazinamide (pyrazinamide)." VersaPharm Inc, Marietta, GA.
  2. Lacroix C, Tranvouez JL, Hoang T, Duwoos H, LaFont O "Pharmacokinetics of pyrazinamide and its metabolites in patients with hepatic cirrhotic insufficiency." Arzneimittelforschung 40 (1990): 76-9
  3. Ellard GA "Absorption, metabolism and excretion of pyrazinamide in man." Tubercle 50 (1969): 144-58

Pza (Includes Pyrazinamide) ↔ Renal Dysfunction

Severe Potential Hazard, Moderate plausibility

Applies to: Renal Dysfunction

The half-life of pyrazinamide may be prolonged in patients with renal impairment. In addition, the drug's metabolites, at least one of which is pharmacologically active, may accumulate. Therapy with pyrazinamide should be administered cautiously in patients with renal dysfunction. Dosage adjustments may be necessary.

References

  1. Stamatakis G, Montes C, Trouvin JH, et al "Pyrazinamide and pyrazinoic acid pharmacokinetics in patients with chronic renal failure." Clin Nephrol 30 (1988): 230-4
  2. "Product Information. Pyrazinamide (pyrazinamide)." VersaPharm Inc, Marietta, GA.
  3. Ellard GA "Absorption, metabolism and excretion of pyrazinamide in man." Tubercle 50 (1969): 144-58
View all 4 references

Pza (Includes Pyrazinamide) ↔ Diabetes Mellitus

Moderate Potential Hazard, Moderate plausibility

Applies to: Diabetes Mellitus

The use of pyrazinamide may be associated with poor diabetic control. Patients with diabetes mellitus should be monitored more closely during therapy with pyrazinamide, and their antidiabetic regimen adjusted accordingly.

References

  1. "Product Information. Pyrazinamide (pyrazinamide)." VersaPharm Inc, Marietta, GA.

Pza (Includes Pyrazinamide) ↔ Hemodialysis

Moderate Potential Hazard, High plausibility

Applies to: hemodialysis

Pyrazinamide is removed by hemodialysis and should be administered after dialysis.

References

  1. Woo J, Leung A, Chan K, Lai KN, Teoh R "Pyrazinamide and rifampicin regimens for patients on maintenance dialysis." Int J Artif Organs 11 (1988): 181-5
  2. "Product Information. Pyrazinamide (pyrazinamide)." VersaPharm Inc, Marietta, GA.

You should also know about...

pyrazinamide drug Interactions

There are 25 drug interactions with pyrazinamide

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.

Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.

Do not stop taking any medications without consulting your healthcare provider.

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