pyrazinamide at a glance
Medicine class
Antituberculosis antibiotic
Main use
Active tuberculosis caused by Mycobacterium tuberculosis
Combination treatment
Used with other antituberculosis agents
Alcohol
Avoid because it can increase liver injury risk
What is pyrazinamide used for?
The selected product is licensed for active tuberculosis caused by Mycobacterium tuberculosis. It must be combined with other antituberculosis agents and is not active against atypical mycobacteria.
Active tuberculosis caused by Mycobacterium tuberculosis
How does pyrazinamide work?
Pyrazinamide enters tuberculosis bacteria and is converted by bacterial pyrazinamidase into its active form, pyrazinoic acid. Its complete mechanism is uncertain. Mutations affecting this activation pathway are an important cause of resistance.
pyrazinamide preparations and strengths
Tablet
Route: Oral
Strengths: 500 mg
How to take pyrazinamide
Take pyrazinamide exactly as directed by the specialist TB team, together with the other prescribed TB medicines. Do not stop treatment without discussing it with them.
Avoid alcohol during treatment.
Limit strong sunlight exposure because photosensitivity can occur.
The tablet score may help swallowing but is not intended to create part doses.
pyrazinamide side effects
Common or expected effects
- Loss of appetite, nausea, vomiting, heartburn or abdominal discomfort
- Raised liver enzymes or impaired liver function
- Increased blood urate
- Increased sensitivity to sunlight
Get urgent medical advice
- Persistent nausea or vomiting, profound tiredness, jaundice or other possible signs of liver injury
- Swelling of the face or throat, breathing difficulty, or other severe allergic symptoms
- A severe or widespread skin reaction
- A suddenly painful, red and swollen joint suggesting acute gout
pyrazinamide in pregnancy
The selected product information advises cautious use during pregnancy after an individual benefit–risk assessment because direct pregnancy data are limited. Active tuberculosis should be assessed and treated promptly by a specialist team.
pyrazinamide while breastfeeding
The selected product information contraindicates breastfeeding because pyrazinamide enters breast milk. Discuss treatment and feeding plans with the TB, maternity and infant-care teams; do not stop treatment or breastfeeding without discussing it with them.
pyrazinamide interactions
The TB team should review prescribed, non-prescription and complementary products before treatment.
Alcohol and other potentially hepatotoxic substances
May increase the risk of liver injury and should be avoided or closely reviewed.
Probenecid or sulfinpyrazone
Pyrazinamide can oppose their urate-lowering effect, so gout control and serum urate may need closer review.
Glucose-lowering medicines
Blood glucose control may change, requiring closer monitoring in people with diabetes.
Common questions about pyrazinamide
Answers are fully visible for fast scanning and source review.
Why is pyrazinamide given with other tuberculosis antibiotics?
Using it alone allows resistance to develop rapidly. Companion antibiotics help protect the regimen from resistance.
Can pyrazinamide be used on its own?
No. The selected product licence requires it to be used with other antituberculosis agents.
Can pyrazinamide damage the liver?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.