Pyrazinamide
(Canadian brand: Tebrazid)
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Category:
Description:
Indications:
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Active
tuberculosis (as part of a 6 month regimen consisting of isoniazid,
rifampin, and pyrazinamide given for 2 months, followed by isoniazid
and rifampin for 4 months)
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After
treatment failure with other primary drugs in any form of active
tuberculosis
Contraindications:
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Severe
liver disease
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Acute
gout
Precautions:
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Pregnancy
category C; excreted into breast milk
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History
of gout, renal and hepatic function impairment
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Alcoholism,
elderly
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HIV,
infection (may require longer courses of therapy), diabetes mellitus
Adverse
Reactions (Side Effects):
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CNS:
fever
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GI:
anorexia, hepatotoxicity, nausea, vomiting
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GU:
dysuria, interstitial nephritis (rare)
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HEME:
blood clotting abnormalities, increased serum iron concentration,
porphyria, sideroblastic anemia, thrombocytopenia
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METAB:
gout, hyperuricemia
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MS:
arthralgia, myalgia
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SKIN:
acne, photosensitivity, pruritus, rash, urticaria
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Dosage:
Administered
orally
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Adult:
PO 15-30 mg/kg every day for 1st 2 months of 6 month regimen with
isoniazid and rifampin or as part of an individualized regimen for
drug-resistant disease, max 2g daily; alternatively 50-70 mg/kg can be
given twice weekly to improve compliance (base dose on lean body
weight)
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Child:
PO 15-40 mg/kg/day divided every 12-24 hours, max 2g daily;
alternatively 50-70 mg/kg based on lean body weight twice weekly, max
3g dose
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Source:
Operational Medicine 2001, Health
Care in Military Settings, NAVMED P-5139, May 1, 2001, Bureau
of Medicine and Surgery, Department of the Navy, 2300 E Street NW, Washington,
D.C., 20372-5300
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