Drug Index


Mechanism :

Pyrazinamide, the pyrazine analogue of nicotinamide, is an antituberculosis agent. Pyrazinamide may be bacteriostatic or bactericidal against Mycobacterium tuberculosis depending on the concentration of the drug attained at the site of infection. The mechanism of action is unknown. In vitro and in vivo the drug is active only at a slightly acidic pH.

Indication :

  • Tuberculosis

Contraindications :

Contraindicated in known hypersensitivity, in severe hepatic damage, and acute gout. Monitor liver function before and during treatment. Baseline and regular monitoring of liver function is required in patients with known chronic liver disease and in those known to be hepatitis B or C antigen positive.

Dosing :

30-35 mg/kg/24 hours as single dose or in 2 divided doses PO (Max: 2 gm/day) for the first 2 months of the standard 6 month regimen.

Adverse Effect :

Hepatic cell function, fever, anorexia, malaise, liver tenderness, hepatomegaly and splenomegaly, active gout, sideroblastic anemia, arthralgias, anorexia, nausea and vomiting, dysuria, malaise, fever, urticaria, aggravation of peptic ulcer.

Interaction :

Probenecid and Sulfinpyrazone: Antagonises the effect of probenecid and sulfinpyrazone.

Renal Dose :

Dose in Renal Impairment GFR (mL/min)
20-50Dose as in normal renal function
10-20Dose as in normal renal function
<10Use 50–100% of dose

Dose in Patients undergoing Renal Replacement Therapies
CAPDNot dialysed. Dose as in GFR<10 mL/min
HD50–100% dialysed. Dose as in GFR<10 mL/min or 25–30 mg/kg post dialysis
HDF/High fluxDialysed. Dose as in GFR<10 mL/ min or 25–30 mg/kg post dialysis
CAV/VVHDUnknown dialysability. Dose as in normal renal function

Hepatic Dose :

Severe hepatic impairment: Contraindicated.
01/18/2024 18:02:41 Pyrazinamide
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