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What is Pyrazinamide
Pyrazinamide (PZA) is used in the treatment of tuberculosis.
Pyrazinamide is considered a first-line agent when used in addition to isoniazid, ethambutol, rifampin, and/or streptomycin for treatment of isoniazid-susceptible organisms and when resistance to isoniazid or rifampin has been confirmed.
Pyrazinamide appears to be less toxic and more effective than other antitubercular agents including aminosalicylic acid, capreomycin, cycloserine, ethionamide, and kanamycin; however, liver function must be carefully monitored during PZA use.
While the drug has been used in combination with a rifamycin as an alternative for latent tuberculosis, the Centers for Disease Control and Prevention (CDC) and the American Thoracic Society (ATS) no longer recommend the 2-month regimen of rifampin plus PZA for this indication (see Contraindications/Precautions).
Pyrazinamide was approved by the FDA in 1955.
Indications
- Mycobacterium tuberculosis
- tuberculosis infection
Side Effects
- acneiform rash
- angioedema
- anorexia
- arthralgia
- dysuria
- elevated hepatic enzymes
- fever
- gout
- hepatic failure
- hepatic necrosis
- hepatitis
- hepatomegaly
- hyperbilirubinemia
- hyperuricemia
- interstitial nephritis
- jaundice
- malaise
- myalgia
- nausea
- photosensitivity
- porphyria
- pruritus
- rash
- sideroblastic anemia
- splenomegaly
- thrombocytopenia
- urticaria
- vomiting
Monitoring Parameters
- LFTs
- serum uric acid
Contraindications
- alcoholism
- breast-feeding
- gout
- hepatic disease
- hepatitis
- hyperuricemia
- jaundice
- pregnancy
Interactions
- Allopurinol
- Aminosalicylate sodium, Aminosalicylic acid
- Colchicine
- Colchicine; Probenecid
- Ethambutol
- Ethanol
- Ethionamide
- Isoniazid, INH
- Isoniazid, INH; Pyrazinamide, PZA; Rifampin
- Isoniazid, INH; Rifampin
- Lesinurad; Allopurinol
- Omeprazole; Amoxicillin; Rifabutin
- Pexidartinib
- Probenecid
- Rifabutin
- Rifampin
- Riluzole
- Sulfinpyrazone
