Dosing and uses of Pyrazinamide
Adult dosage forms and strengths
tablet
- 500mg
Tuberculosis Treatment For HIV Negative
Daily therapy
- 15-30 mg/kg PO qDay; not to exceed 2 g/day
Twice weekly therapy
- 50 mg/kg PO twice weekly; not to exceed 2 g/dose
Tuberculosis Treatment For HIV Exposed/Infected
20-40 mg/kg/dose PO qDay; not to exceed 2 g/day
See Also Combo
With isoniazid & rifampin
Other Indications & Uses
Tuberculosis; should always be admin with other anti-TB drugs
Pediatric dosage forms and strengths
tablet
- 500mg
Tuberculosis Treatment
Daily therapy
- 15-30 mg/kg PO qD; not to exceed 2000 mg/day
Twice weekly therapy
- 50 mg/kg/dose; not to exceed 3000 mg/day
Pyrazinamide adverse (side) effects
1-10%
Malaise
Nausea
Vomiting
Anorexia
Arthralgia
Myalgia
<1%
Fever
Rash
Itching
Acne
Photosensitivity
Gout
Dysuria
Porphyria
Thrombocytopenia
Hepatotoxicity
Interstitial nephritis
Warnings
Contraindications
Severe hepatic damage, acute gout, hypersensitivity
Cautions
See pkg insert for complete dosage info
Pregnancy and lactation
Pregnancy category: C
Lactation: enters breast milk
Pregnancy categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.
Pharmacology of Pyrazinamide
Absorption: well absorbed
Distribution: widely into body tissues and fluids including liver, lung, and CSF
Relative diffusion from blood into CSF: adequate with or without inflammation (exceeds usual MICs)
CSF:blood level ratio: inflamed meninges: 100%
Protein binding: 50%
Metabolism: hepatic
Half-life elimination: 9-10 hr
Time to peak, serum: within 2 hr
Excretion: urine (4% as unchanged drug)
Mechanism of action
Unknown; bacteriostatic or -cidal for Mycobacterium
