Brands of Pyrazinamide in Kenya
PZA®, Cosmos Limited
Mechanism of Action of Pyrazinamide:
Pyrazinamide is a prodrug that stops the growth of M. tuberculosis. Pyrazinamide diffuses into the granuloma of M. tuberculosis, where the tuberculosis enzyme pyrazinamidase converts pyrazinamide to the active form pyrazinoic acid.
INDICATIONS:
Pyrazinamide is indicated for the initial treatment of active tuberculosis in adults and children when combined with other antituberculous agents.
DOSAGE AND ADMINISTRATION
Recommended dosage for standard unsupervised 2-month treatment:
Adults: Under 50kg bodyweight: maximum of 3 tablets or 1.5g daily. 50kg and over bodyweight: maximum of 4 tablets or 2g daily.
Children: 35mg/kg daily.
Recommended dosage for intermittent supervised 2-month treatment:
Adults: Under 50kg bodyweight: maximum of 4 tablets or 2g 3 times a week. 50kg and over bodyweight: maximum of 5 tablets or 2.5g 3 times a week.
Children: 50mg/kg 3 times a week.
Pyrazinamide should be administered with at least one other effective antituberculous drug. The use of Pyrazinamide in combination therapy does not modify the accepted dosages of other antituberculous agents.
Use in the elderly: The general considerations outlined above should also apply to elderly patients.
Immunocompromised patients: Multi-resistant M. tuberculosis may be present in immunocompromised patients. The organism should always be cultured to confirm its type and drug sensitivity. Confirmed M. Tuberculosis infection sensitive to first-line drugs should be treated with a standard 6 month regimen; after completing treatment, patients should be closely monitored. The regimen may need to be modified if infection is caused by resistant organisms and specialist advice is needed.
In meningeal or pericardial tuberculosis, a corticosteroid should be started at the same time as antituberculosis therapy.
CONTRAINDICATIONS:
Pyrazinamide is contra-indicated in patients with:
- Hypersensitivity to pyrazinamide or to any of the excipients
- Hepatic disease
- Hyperuricaemia and/or gouty arthritis
- Acute porphyria.
Pyrazinamide is also contra-indicated in breast-feeding mothers
DRUG INTERACTIONS:
Pyrazinamide antagonizes the effect of uricosuric agents such as probenecid and sulfinpyrazone. Pyrazinamide may reduce the contraceptive effects of oestrogens and should be avoided 3 days before and after oral typhoid vaccination since it may inactivate the vaccine.
ADVERSE DRUG REACTIONS:
General
Fever, porphyria and dysuria have rarely been reported. Gout
Gastrointestinal
The principal adverse effect is a hepatic reaction . Hepatotoxicity appears to be dose related, and may appear at any time during therapy. GI disturbances including nausea, vomiting and anorexia have also been reported.
Hematologic and Lymphatic
Thrombocytopenia and sideroblastic anemia with erythroid hyperplasia, vacuolation of erythrocytes and increased serum iron concentration have occurred rarely with this drug. Adverse effects on blood clotting mechanisms have also been rarely reported.
Other
Mild arthralgia and myalgia have been reported frequently. Hypersensitivity reactions including rashes, urticaria, and pruritus have been reported. Fever, acne, photosensitivity, porphyria, dysuria and interstitial nephritis have been reported rarely.
Reporting of suspected adverse reactions:
The PPB Department of Pharmacovigilance was set up with a vision to develop, implement and continuously upgrade an appropriate system for detecting, reporting, and monitoring adverse drug reactions (ADRs) and other relevant problems with medicines in Kenya. The department strives to ensure the safety and efficacy of pharmaceutical products in Kenya.
Reporting suspected adverse reactions after authorization of the medicinal product are important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals/ Patients are encouraged to report any suspected adverse reactions via Pharmacovigilance Yellow Form, pv@pharmacyboardkenya.org or clicking below button:
Pyrazinamide in Kenya
Pyrazinamide in Kenya
Pyrazinamide in Kenya
Pyrazinamide in Kenya
Clinical | Pharmacokinetic data
Pregnancy Category:
Routes of Administration: Oral
Bioavailability: >90%
Protein Binding: ~10%
Metabolosim: Liver
Onset of Action:
Elimination Half life: 9 to 10 hours
Excretion: Kidneys
Legal Status | Dosage forms & Strengths
Prescription Category:
Prescription only Medicine (POM) , â„ž-only
Narcotic Drugs and Psychotropic Substances (Control ) Act Schedule:
This drug is not a controlled substance under Narcotic Drugs and Psychotropic Substances (Control ) Act
Dosage Forms | Strengths:
Tablets
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Drug Images
References/ Citation:
- PPB Retention Register
- Zhang, Ying, and D. Mitchison. “The curious characteristics of pyrazinamide: a review.” The international journal of tuberculosis and lung disease 7.1 (2003): 6-21.
- Shi, Wanliang, et al. “Pyrazinamide inhibits trans-translation in Mycobacterium tuberculosis.” Science 333.6049 (2011): 1630-1632.
- Konno, Kiyoshi, Floyd M. Feldmann, and Walsh McDermott. “Pyrazinamide susceptibility and amidase activity of tubercle bacilli.” American Review of Respiratory Disease 95.3 (1967): 461-469.