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 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)

  • 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

 

 

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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