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Related to pyrazinamide: ethambutol


an antibacterial derived from nicotinic acid, used in treatment of tuberculosis.


PMS Pyrazinamide (CA), Tebrazid (CA)

Pharmacologic class: Niacinamide derivative

Therapeutic class: Antitubercular

Pregnancy risk category C


Unknown. Thought to exert bacteriostatic activity.


Tablets: 500 mg

Indications and dosages


Adults and children: 15 to 30 mg/kg/day P.O., not to exceed 2 g/day; or 50 to 70 mg/kg P.O. twice weekly, up to a maximum of 4 g/dose; or 50 to 70 mg/kg/dose P.O. three times weekly, up to a maximum of 3 g/dose

Dosage adjustment

• Renal impairment


• Hypersensitivity to drug

• Severe hepatic disease

• Acute gout


Use cautiously in:

• renal failure, diabetes mellitus, porphyria, chronic gout, history of gout

• pregnant or breastfeeding patients

• children younger than age 13.


• Give with other antituberculars, as prescribed, to reduce risk of resistant organisms.

• Be aware that drug therapy may last 6 months or longer.

Adverse reactions

CNS: headache

GI: nausea, vomiting, diarrhea, peptic ulcer, abdominal cramps, anorexia

GU: dysuria, increased uric acid secretion

Hematologic: hemolytic anemia

Hepatic: hepatotoxicity

Metabolic: hyperuricemia, gout

Musculoskeletal: joint pain

Skin: urticaria, photosensitivity


Drug-drug. Ethionamide: increased risk of hepatotoxicity

Probenecid: decreased probenecid efficacy (possibly precipitating gout)

Drug-diagnostic tests. Acetest or Ketostix urine test: false interpretation

Liver function tests: abnormal results

Uric acid: increased level

Patient monitoring

• Monitor CBC, uric acid level, and liver and kidney function tests.

• Assess for signs and symptoms of gout, hepatic failure, and hemolytic anemia.

Discontinue at first sign of hepatic impairment or hyperuricemia accompanied by acute gouty arthritis.

Patient teaching

• Advise patient to take regularly with other antituberculars, as prescribed.

Teach patient to recognize and immediately report signs and symptoms of gout and liver impairment.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs and tests mentioned above.


/pyr·a·zin·amide/ (pir″ah-zin´ah-mīd) an antibacterial derived from nicotinic acid, used as a tuberculostatic.


an antimycobacterial.
indications It is prescribed in combination chemotherapy in the treatment of tuberculosis of hospitalized patients who fail to respond to other medications.
contraindications Severe liver damage, acute gout, or known hypersensitivity to this drug prohibits its use. Use with caution in renal failure, chronic gout, diabetes mellitus, or porphyria.
adverse effects Common side effects include malaise, nausea, GI upset, and arthralgia and myalgia. Among the more serious adverse reactions are hepatotoxicity and hyperuricemia.


An antituberculosis drug that diffuses well into the CEREBRO-SPINAL FLUID and is used to treat tuberculous MENINGITIS. The drug is on the WHO official list. A brand name, with other antituberculosis drugs, is Rifater.

pyrazinamide, pyrazinecarboxamide

an antibacterial agent used for the oral treatment of tuberculosis in humans. Also used in a biochemical test for the identification of mycobacteria.
References in periodicals archive ?
Relationship between Pyrazinamide Resistance, Loss of Pyrazinamidase Activity, and Mutations in the pncA Locus in Multidrug-Resistant Clinical Isolates of Mycobacterium tuberculosis.
Drugs responsible for this side effect, are either Pyrazinamide, Rifampicin or Isoniazid.
Comprehensive assay for pyrazinamide, Rifampicin and isoniazid with its hydrazine metabolites in human plasma by column liquid chromatography.
The hepatic toxicity of antitubercular regimens containing isoniazid, rifampicin and pyrazinamide.
The initial treatment should be three or four drugs combinations including isoniazid, rifampicin, pyrazinamide or/and ethambutol, and the clinical healing is initiated to be seen in 4-6 weeks.
The infants were started on standard DOT with rifampin, isoniazid, ethambutol, and pyrazinamide.
The next step forward was the recognition that the inclusion of pyrazinamide (PZA) allowed a reduction in the duration required to achieve predictable cures.
Of these, 13 had termination of ethionamide, 4 of ofloxacin, and 1 each had kanamycin, ethambutol, pyrazinamide or cycloserine terminated.
If the drug responsible for the reaction is pyrazinamide, ethambutol or streptomycin, TB treatment is resumed without the offending drug.
Granich's study, 71 (17%) were resistant only to isoniazid and rifampin, and 86 (21%) were resistant to all four first-line drugs--isoniazid, rifampin, ethambutol, and pyrazinamide.
SUMMARY: Although being used for years in the treatment of tuberculosis, no data are available in the literature on the safety of pyrazinamide during pregnancy.