PYRAZINAMIDE (Z)

Antituberculosis antibacterial. Abbreviated as Z in treatment regimens

Dosage Forms

▼

Tablet

Pyrazinamide 500 mg

Fixed Dose Combinations (FDC)

Rifampicin 70 mg + isoniazid 50 mg + pyrazinamide 150 mg
Rifampicin 150 mg + isoniazid 75 mg + pyrazinamide 400 mg + ethambutol 275 mg

Uses

▼
  • Tuberculosis (TB)

Dose and Duration

▼
Intensive phase TB treatment (in combination with rifampicin, isoniazid and ethambutol)

Give for 2–3 months as in the table below (2RHZE)

Adult and child ≥ 12 years:

Weight (kg) Pyrazinamide (mg)
30–37 800
38–54 1200
55–70 1600
>70 2000

Child 0–12 years:

Weight (kg) Pyrazinamide (mg)
4–7 150
8–11 300
12–15 450
16–24 600
>25 Use adult formulation

Contra-indications

▼
  • Severe liver disease

Side Effects

▼
  • Joint pain
  • Gout
  • Pain on urination
  • Stomach upset
  • Liver disorders (jaundice, fever, anorexia, enlarged liver, enlarged spleen)
  • Allergic reactions
  • Low platelet count, anaemia

Patient Instructions

▼
  • Take with a small meal or the last thing at night to reduce risk of stomach upset
  • Take plenty of fluids during treatment
  • Do not take alcohol during treatment
  • Report to health worker immediately in case of persistent nausea, vomiting, feeling of sickness, yellowing of skin and eyes, or severe joint pain that does not go away after taking paracetamol

Pregnancy

▼
  • Can be used

Breast-feeding

▼
  • Can be used

⚠️ Caution

▼
  • Pyrazinamide is not used in the continuation phase of TB treatment
  • For severe joint pain or arthralgia, change to a regimen without pyrazinamide