Pyrazinamide (Canadian brand: Tebrazid)

Category:

• Miscellaneous

Description:

• Antituberculosis agent

Indications:

• 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)

• After treatment failure with other primary drugs in any form of active tuberculosis

Contraindications:

• Severe liver disease

• Acute gout

Precautions:

• Pregnancy category C; excreted into breast milk

• History of gout, renal and hepatic function impairment

• Alcoholism, elderly

• HIV, infection (may require longer courses of therapy), diabetes mellitus

Adverse Reactions (Side Effects):

• CNS: fever

• GI: anorexia, hepatotoxicity, nausea, vomiting

• GU: dysuria, interstitial nephritis (rare)

• HEME: blood clotting abnormalities, increased serum iron concentration, porphyria, sideroblastic anemia, thrombocytopenia

• METAB: gout, hyperuricemia

• MS: arthralgia, myalgia

• SKIN: acne, photosensitivity, pruritus, rash, urticaria

Dosage:

Administered orally

• Adult:   PO 15-30 mg/kg  every day for 1^st 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)

• 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