pyrazinamide

Generic Name: pyrazinamide (peer a ZIN a mide)
Brand Name:

What is pyrazinamide?

Pyrazinamide is an antibiotic. The exact way that pyrazinamide works is unknown.

Pyrazinamide is used to treat tuberculosis (TB).

Pyrazinamide may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about pyrazinamide?

Take all of the pyrazinamide that has been prescribed for you even if you begin to feel better. Your symptoms may begin to improve before the infection is completely treated.

Slideshow: View Frightful (But Dead Serious) Drug Side Effects

Call your doctor immediately if you experience a fever, loss of appetite, nausea and vomiting, painful or swollen joints, yellowing of your skin or eyes, or darkening of your urine.

Who should not take pyrazinamide?

Before taking pyrazinamide, tell your doctor if you have

  • ever had an allergic reaction to pyrazinamide,

  • liver disease,

  • gout,

  • kidney disease, or

  • diabetes mellitus.

You may not be able to take pyrazinamide, or you may require a lower dose or special monitoring during treatment if you have any of the conditions listed above.

Pyrazinamide is in the FDA pregnancy category C. This means that it is not known whether it will harm an unborn baby. Do not take this medication without first talking to your doctor if you are pregnant.

Pyrazinamide passes into breast milk and may affect a nursing baby. Do not take this medication without first talking to your doctor if you are breast-feeding a baby.

How should I take pyrazinamide?

Take pyrazinamide exactly as directed by your doctor. If you do not understand these instructions, ask your pharmacist, nurse, or doctor to explain them to you.

Take each dose with a full glass (8 ounces) of water.

Take all of the pyrazinamide that has been prescribed for you even if you begin to feel better. Your symptoms may begin to improve before the infection is completely treated.

Pyrazinamide is usually combined with one or more other tuberculosis medicines.

Store this medication at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. However, if it is almost time for your next regularly scheduled dose, skip the missed dose and take the next one as directed. Do not take a double dose of this medication.

What happens if I overdose?

Seek emergency medical attention.

Symptoms of an pyrazinamide overdose are not well known. Liver damage has been detected.

What should I avoid while taking pyrazinamide?

There are no restrictions on foods, beverages, or activities during treatment with pyrazinamide unless your doctor directs otherwise.

Pyrazinamide side effects

If you experience any of the following serious side effects, stop taking pyrazinamide and seek emergency medical attention or contact your doctor immediately:

  • an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives);

  • a fever;

  • unusual weakness or fatigue;

  • nausea, vomiting, or loss of appetite;

  • yellow skin or eyes;

  • dark urine;

  • difficult or painful urination;

  • painful or swollen joints;

  • worsening gout; or

  • a rash.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Pyrazinamide dosing information

Usual Adult Dose for Tuberculosis -- Active:

15 to 30 mg/kg (up to 2 g) orally once a day in combination with three other antituberculous drugs for the initial 2 months of a 6-month or 9-month treatment regimen, until drug susceptibility tests are known. An alternate dosing regimen of 50 to 75 mg/kg (up to 3 g) orally twice a week may be used after 2 weeks of daily therapy to increase patient compliance.

Alternatively, the CDC, The American Thoracic Society, and the Infectious Diseases Society of America suggest the following dosing based on estimated lean body weight:

Daily dosing:
40 to 45 kg: 1000 mg
56 to 75 kg: 1500 mg
76 to 90 kg: 2000 mg

Twice weekly dosing:
40 to 55 kg: 2000 mg
56 to 75 kg: 3000 mg
76 to 90 kg: 4000 mg

Thrice weekly dosing:
40 to 55 kg: 1500 mg
56 to 75 kg: 2500 mg
76 to 90 kg: 3000 mg

Usual Adult Dose for Tuberculosis -- Latent:

A public health expert should be consulted prior to the use of the combination regimen with rifampin.

15 to 20 mg/kg, based on actual body weight (lean), orally once daily (maximum 2 g) for 2 months. Alternatively, a dosage of 50 mg/kg may be administered orally twice-weekly (maximum 4 g).

Usual Pediatric Dose for Tuberculosis -- Active:

Tuberculosis:
(Used as part of a multidrug regimen. Treatment regimens consist of an initial 2-month phase, followed by a continuation phase of 4 or 7 additional months. Frequency of dosing may differ depending on phase of therapy)

Infants, Children less than 40 kg and Adolescents 14 years and younger and less than 40 kg:
Non-HIV patients:
Daily therapy: 15 to 30 mg/kg/dose (maximum: 2 g/dose) once daily
Directly observed therapy (DOT): 50 mg/kg/dose (maximum: 2 g/dose) twice weekly
HIV-exposed/infected patients:
Daily therapy: 20 to 40 mg/kg/dose once daily (maximum: 2 g/day)

What other drugs will affect pyrazinamide?

Pyrazinamide may decrease the effects of allopurinol (Zyloprim). A dosage adjustment may be necessary if you take pyrazinamide during treatment with allopurinol.

Pyrazinamide may affect the Acetest and Ketostix urine tests for ketones. This reaction can cause a pink-brown color to appear.

Drugs other than those listed here may also interact with pyrazinamide. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines.

Where can I get more information?

  • Your pharmacist can provide more information about pyrazinamide.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 3.02. Revision Date: 2010-12-15, 5:01:39 PM.

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