Pyrazinamide
Uses of Pyrazinamide
The primary use of Pyrazinamide is in managing all forms of active tuberculosis alongside other anti-TB medicines. This antibiotic medication is a vital component of the first-line treatment regimen for TB.
Pyrazinamide, due to its bactericidal properties, effectively kills the TB bacteria, Mycobacterium tuberculosis, allowing for a shorter total treatment duration of six months as opposed to 9-12 months.
Side effects of Pyrazinamide
Nausea and vomiting
Loss of appetite
Fatigue and fever
Joint pains
How Pyrazinamide works
Pyrazinamide is an antimycobacterial medication used in the management of tuberculosis.
After it is taken orally, it gets absorbed and spreads throughout the body. It then undergoes a chemical transformation inside the body into its active form, which is pyrazinoic acid. This transformation happens due to an enzyme known as pyrazinamidase/nicotinamidase. The active form, pyrazinoic acid, creates disruptions in the bacterial cell membrane of Mycobacterium tuberculosis (the bacteria causing tuberculosis). It blocks the membrane transport function of these bacteria which is crucial for their growth and multiplication. Another key action of pyrazinoic acid is that it obstructs an important enzyme called fatty acid synthase I. This enzyme plays a vital role in the synthesis of fatty acids in Mycobacterium tuberculosis, which are needed for energy generation and the production of key cell components. By hindering the functioning of this enzyme, Pyrazinamide curbs the growth and multiplication of these TB bacteria.
Certified content
Written By
Doctor of Medicine
Reviewed By
BMS, FMC, MD Resident
Expert Advice
Dosage Forms Available
Pyrazinamide can be taken orally (tablet).
Age and Dose Restrictions
This medicine is recommended for use in adults and children.
Contraindications
Pyrazinamide is contraindicated in patients with severe liver damage or acute gout.
Other Medications to Avoid
Pyrazinamide may interact with medicines used to manage gout and hyperuricemia (such as probenecid, allopurinol, and colchicine).
Overdose and Missed Dose
An overdose of Pyrazinamide might cause liver damage and increase uric acid levels in the blood leading to gout flare-ups. If you suspect an overdose, immediately contact your doctor.
If you miss a dose, take it as soon as you remember. If it is near the time for your next dose, skip the missed dose. Do not double the dose to catch up.
Management of Side Effects
Most side effects are temporary and generally harmless and resolve after discontinuing this medicine. However, if you experience any severe side effects or worsening of any of the symptoms, please consult your doctor.
Drinking plenty of water may help manage nausea and vomiting.
Taking this medicine with food may help reduce stomach upset.
Use in Driving and Operating Machinery
Pyrazinamide does not affect your ability to drive or operate heavy machinery unless side effects like dizziness or fatigue occur.
Use in Pregnancy and Lactation
It is advised to consult your doctor before using this medicine during these periods.
Caution in Other Conditions
Patients with liver disease, or conditions like gout and hyperuricemia, should exercise caution when taking this medicine. Frequent monitoring of liver function and uric acid levels may be required during treatment with Pyrazinamide.
Special Dietary and Lifestyle Recommendations
Regular monitoring of blood sugar levels is advised for patients with diabetes as Pyrazinamide may cause difficulty in blood sugar control.
If you have gout, a low-purine diet can help manage your condition. Foods high in purine include certain meats and fish, like liver, anchovies, mackerel, and scallops.
Frequently asked questions
Is there any impact of Pyrazinamide on my sleep patterns?
No specific effect of Pyrazinamide on sleep has been reported in medical literature. However, if you notice any significant changes in your sleep patterns while taking this medication, consult your doctor.
Can taking Pyrazinamide have an effect on my fertility?
Pyrazinamide does not typically affect fertility. However, it is advised to discuss any concerns about fertility with your doctor before starting the medication.
Can I take Pyrazinamide every day for a longer period?
Pyrazinamide is typically given daily only during the first 2 months of tuberculosis treatment, which is the intensive phase. It should be taken as per your doctor's guidance and prescription.
How long does it take for Pyrazinamide to start working after administration?
After oral administration, Pyrazinamide is well absorbed and starts working within the body fairly quickly. However, clinical improvement in symptoms may take a few weeks.
What would be the best time to take my dose of Pyrazinamide?
Pyrazinamide can be taken at any time of the day but ideally should be taken at the same time each day for best results. Your doctor will guide you about the best time to take this medicine.
Can I stop taking Pyrazinamide if I feel better?
No, you should continue taking Pyrazinamide for the full duration prescribed by your doctor. Stopping the medication early may allow the bacteria causing tuberculosis to continue to grow, which may result in a relapse of the infection.
Can I drink alcohol while taking Pyrazinamide?
You should avoid alcohol while taking Pyrazinamide as it can increase your risk of liver damage. You should also be aware of the symptoms of liver damage, such as jaundice, dark urine, light-coloured stools, severe nausea and vomiting, and abdominal pain.
Pyrazinamide in other salts
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