Pyrazinamide

Brand names of pyrazinamide

  • PMS-Pyrazinamide
  • Rifater [CD]
  • Tebrazid

Pyrazinamide is a generic medicament that is primarily used to treat tuberculosis (TB). This generic medicament is basically an antibiotic and it is present in a number of branded medicines, including Rifater and Pyrazinamide Systemic. Pyrazinamide is generally available in 50 mg tablet form and it constitutes the large part of the typical treatment for tuberculosis. In fact, pyrazinamide tablets are so big that several patients find it difficult to gulp down. Hence, they may alternately use pyrazinamide syrup for convenience.

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Pyrazinamide, known to be the pyrazine equivalent of nicotinamide, is an effective anti-tuberculosis agent. In other words, this white crystalline powder, which remains stable at normal room temperature and rarely dissolves in water, is one of the best remedies for tuberculosis.

It is essential to exercise great caution while using the generic drug pyrazinamide on patients who are suffering from type 1 diabetes (diabetes mellitus) for it may often become very difficult to control the use of this medication in such patients.

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On very rare situations, Mycobacterium tuberculosis (MTB), a pathogenic bacterial species that is responsible for causing tuberculosis in most cases, has been found to be resilient to the generic antibiotic drug pyrazinamide. However, in cases of this bacterium's resistance to identified or suspected medicaments, it is essential to undertake in vitro examinations with latest cultures of Mycobacterium tuberculosis or M. tuberculosis set against pyrazinamide as well as the standard primary drugs. It may be noted that there are actually only a few in vitro tests for resistance to the generic drug pyrazinamide that can be relied upon. In all such cases, the in vitro test ought to be performed in a reference laboratory competent enough to undertake such studies.

Things you need to tell your physician before taking pyrazinamide

Before you start taking the generic drug pyrazinamide for treating tuberculosis, it is important to consult your physician to know if this medication is appropriate for you. In addition, you should tell your healthcare provider about all your other health conditions, medical history as well as the prescription, over-the-counter and herbal medications as well as supplements, including vitamins, being taken by you. This is important because using pyrazinamide should not only be avoided if the patients have certain medical history and health conditions, but also because this generic drug is known to interact with certain other medications.

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People who are allergic to pyrazinamide, any of its ingredients or other medications such as niacin, ethionamide (Trecator-SC) should tell their physician about it before they start using pyrazinamide to cure tuberculosis. You should also inform your physician if you are taking any of the prescription or over-the-counter medications, especially ethionamide (Trecator-SC), allopurinol (Zyloprim), colchicines and/ or probenecid (Col-Probenecid, Benemid) and any vitamins for other health conditions you may be enduring. People suffering from health conditions, such as liver or kidney ailments, diabetes or gout or if they had any of these ailments in the past should also inform their healthcare provider about it.

Women tuberculosis patients planning to start taking pyrazinamide ought to especially tell their physician if they are pregnant or planning to get pregnant. In case any woman becomes pregnant while using pyrazinamide, they should immediately consult their doctor regarding their latest condition. Even nursing mothers ought to consult their physician prior to using pyrazinamide.

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Tuberculosis patients using the generic drug pyrazinamide should exercise some precautions; especially avoid needless and prolonged exposure to sunlight. In addition, they should also wear protecting clothes, sunglasses and use sunscreen with a view to avoid sunlight. This is essential because using pyrazinamide has the potential to make the patient's skin susceptible to sunlight.

Usage

In order to treat active cases of tuberculosis, the generic medicament pyrazinamide should never be used independently, but in combination with other remedies for tuberculosis, for instance streptomycin, isoniazid and rifampin.

As mentioned earlier, the generic medicament pyrazinamide is an antibiotic and it works by preventing bacterial growth. The antibiotic pyrazinamide is only effective in treating bacterial infections and is not meant for use or is not useful in treating viral infections like flu and common cold. It is important to note that needless use or misuse of any antibiotic results in diminished efficacy of the medication.

How to use pyrazinamide

There is no standard dosage of the generic drug pyrazinamide and the dose of this medicine is determined by your physician on the basis of your age, weight, medical condition as well as the patient's response to the treatment. However, one 50 mg table of pyrazinamide may be taken every day or twice every week. Your doctor may prescribe a separate dosage of the medication depending on the issues mentioned above. Pyrazinamide is an oral drug which can be taken with or without food. It is important to note that all antibiotics work best when there is a steady level of the medicine in your body all through the treatment regimen. Hence, it is important to continue taking this generic medicament at regular intervals, as recommended by your physician.

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Patients who are taking pyrazinamide every day ought to take this antibiotic at round the same time daily. On the other hand, patients taking this generic drug on a weekly schedule ought to take the medication on the same day and at the same time every week. The best way to remember when you are supposed to take this medication is to mark the day and time on a calendar. Even if the symptoms of tuberculosis fade away, it is important to continue taking pyrazinamide as well as the other anti-tuberculosis drugs for the complete period prescribed by your physician.

Never stop taking this medication without talking to your physician. If you stop taking this medicine suddenly or miss any of the doses, it will only help the bacteria to continue their growth. In such a situation, the infection is likely to reappear or the condition will relapse and this time it would become even more difficult to treat the ailment as the bacterium may become resilient to the antibiotic treatment. In case your conditions and associated symptoms persist or worsen even after taking pyrazinamide and other anti-tuberculosis medications, immediately contact your physician for help. Your physician may alter the doses or even make some changes in the medications. It is also important to note that while you are taking pyrazinamide, you should not start or stop taking any other medication without consulting your doctor or healthcare provider.

How pyrazinamide works

The generic drug pyrazinamide is an antibiotic that is used to cure tuberculosis along with other anti-tuberculosis agents. This antibiotic works by killing M. tuberculosis, the bacterium responsible for tuberculosis. Being a prodrug (a compound that is inactive biologically, but is converted into a therapeutic drug owing to the action of enzymes in the body), pyrazinamide prevents the growth of Mycobacterium tuberculosis - the cause behind the ailment.

Mycobacterium tuberculosis, the bacterium responsible for tuberculosis, contains the enzyme called pyrazinamidase that is only vigorous in acidic environs. The enzyme pyrazinamidase actually helps the generic drug pyrazinamide to become active and transform into pyrazinoic acid that builds up in the bacilli (any bacterium having the shape of a rod or cylinder belonging to the genus Bacillus and consisting spore-producing bacteria). Earlier, it was believed that pyrazinoic acid slowed down the action of the enzyme fatty acid synthase (FAS) I that the bacterium needs to synthesize fatty acids. However, this theory no longer holds water.

Another school of thought hinted that the build-up of pyrazinoic acid actually interrupts the potential of the membrane and also gets in the way of energy generation - something essential for the survival and growth of Mycobacterium tuberculosis in any acidic site of contagion. Other studies on the subject actually replicated the effects of FAS I slow down as the supposed mechanism first in the entire cell examination to reproduce Mycobacterium tuberculosis bacilli that have displayed that pyrazinoic acid as well as its ester (an organic compound) hinders the amalgamation of fatty acids. Subsequent to these researchers, there were in vitro tests of tuberculosis FAS I enzyme that examined the actions with pyrazinamide, pyrazinoic acid as well as quite a few groups that are similar or equivalent to the generic drug pyrazinamide.

It may be noted that the generic antibiotic pyrazinamide as well as its equivalents slowed down the action of disinfected FAS I. It has also been established during the researches and in vitro tests that any mutation or transformation of pyrazinamidase gene (pncA) is actually accountable for Mycobacterium tuberculosis' resistance to the generic medicament pyrazinamide.

Side effects

Serious
Common
  • hepatitis
  • joint pain
Less common

Possible interactions

Other medicaments
Pyrazinamide may reduce the effects of:The generic medicament pyrazinamide is usually not used independently, but along with other anti-tuberculosis medications. However, this antibiotic is known to interact with certain medications and, hence, should not be used in the following combinations:
  • When pyrazinamide is taken alongside medications, such as phenytoin (Dilantin) or fosphenytoin (Cerebyx), it may result in generation of phenytoin (an anticonvulsant drug usually used to treat epilepsy) or fosphenytoin (a prodrug that turns out phenytoin and is taken to prevent or treat seizures) noxiousness and cause harm to the body.
  • Similarly, when pyrazinamide is used together with zidovudine (AZT) it may result in low levels of pyrazinamide. In such cases your physician may change your dose of the generic drug or AZT.
Herbal medicines or minerals
There are a number of tuberculosis patients who use Echinacea with a view to augment their immune systems. However, it is unfortunate to know that people who are enduring impaired immune systems ought not to use Echinacea. In fact, using the herb Echinacea may actually deteriorate any immune system if it is used very frequently or for a prolonged period. In addition, tuberculosis patients taking the generic drug pyrazinamide should also not take herbal medicines, such as marshmallow root, oak bark, mistletoe, licorice and/ or woody nightshade. In addition, taking pyrazinamide concurrently with St.John's wort is likely to result in augmented susceptibility to sunlight. Hence, such patients need to exercise great caution.
Alcohol
People taking the generic medicament pyrazinamide to treat tuberculosis should generally avoid using alcohol and alcoholic beverages. Even if such patients are unable to quit their alcohol addiction, it is advisable to use them in moderation with a view to diminish the toxicity of the liver.
Exposure to sun
Patients using pyrazinamide for treating tuberculosis should avoid exposure to sunlight and use protective clothing, sunscreen and sunglasses to prevent exposure to sunlight. In fact, they ought to exercise caution while using this generic drug since it may result in photosensitivity or cause the skin to become susceptible to sunlight.

Discontinuation

If the use of the generic drug pyrazinamide suits the tuberculosis patient, the treatment regimen with this antibiotic generally continues for a minimum period of two months. People taking pyrazinamide to treat tuberculosis ought to continue using this generic drug regularly as prescribed by the physician or healthcare provider. In addition, it is important to note that patients taking pyrazinamide should never stop taking this antibiotic without consulting their physician even if the symptoms disappear. Stopping this medication suddenly may result in the reappearance of the infection and this time treating the condition may be even more difficult, as M. tuberculosis, the bacterium responsible for tuberculosis, may become resilient to the drug.

Storage instructions

The generic drug pyrazinamide should be stored very carefully. It must always be kept in the container it comes in. Always keep the container firmly closed and beyond the reach of children and pets. This medication should always be stored in room temperature and kept in a place away from excess heat, light and moisture. Pyrazinamide should never be kept in the bathroom. All medications that are no longer needed or have expired validity should be discarded immediately. Unless there is any specific instruction, never throw the medication in a drain or flush it down the toilet. In fact, it is advisable to discuss with your pharmacist regarding the proper manner of disposing this generic medicament.

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