Pyrazinamide (Z)

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    Update: January 2022

     

    Forms and strengths

    • 400 mg tablet
    • 150 mg dispersible tablet, to be dispersed in 10 ml water

    Dosage

    • Child under 30 kg: 35 mg/kg (30 to 40 mg/kg) once daily
    • Child 30 kg and over and adult: 25 mg/kg (20 to 30 mg/kg) once daily
    • Maximum dose: 2000 mg daily
    • Renal insufficiency: 25 mg/kg 3 times a week

     

    Weight
    (kg)

    Daily dose
    (mg)

    400 mg
    tablet

    150 mg
    dispersible tablet

    5

    150-200

    –

    		 1 tab

    6

    180-240

    –

    		 1 tab

    7

    210-280

    –

    		 2 tab

    8

    240-320

    –

    		 2 tab

    9

    270-360

    –

    		 2 tab

    10

    300-400

    –

    		 3 tab

    11

    330-440

    –

    		 3 tab

    12

    360-480

    –

    		 3 tab

    13

    390-520

    –

    		 3 tab

    14

    420-560

    –

    		 3 tab

    15

    450-600

    –

    		 3 tab

    16

    480-640

    –

    		 4 tab

    17

    510-680

    –

    		 4 tab

    18

    540-720

    –

    		 4 tab

    19

    570-760

    –

    		 4 tab

    20

    600-800

    –

    		 5 tab

    21

    630-840

    –

    		 5 tab

    22

    660-880

    –

    		 5 tab

    23

    690-920

    –

    		 5 tab

    24

    720-960

    2½ tab

    		 –

    25

    750-1000

    2½ tab

    		 –

    26

    780-1040

    2½ tab

    		 –

    27

    810-1080

    2½ tab

    		 –

    28

    840-1120

    2½ tab

    		 –

    29

    870-1160

    2½ tab

    		 –

     

    30-35

    800

    2 tab

    		 –

    36-45

    1000

    2½ tab

    		 –

    46-55

    1200

    3 tab

    		 –

    56-70

    1600

    4 tab

    		 –

    > 70

    2000

    5 tab

    		 –

     

    Contra-indications, adverse effects, precautions

    • Do not administer to patients with severe hepatic impairment or severe gout.
    • May cause:
      • gout and arthralgias; 
      • hepatotoxicity, gastrointestinal disturbances (epigastric pain, nausea and vomiting);
      • hypersensitivity reactions;
      • rarely, photosensitivity.
    • For the management of adverse effects, see Appendix 17.
    • Pregnancy: no contra-indication 
    • Breastfeeding: no contra-indication

    Monitoring

    • Symptomatic monitoring.
    • Liver function in patients with hepatic impairment or on drug-resistant TB treatment.  

    Patient instructions

    • Take with or without food.
    • 150 mg tablets should be dispersed in 10 ml water.
    • Protect your skin from sun.

    Remarks

    • For patients on drug-susceptible TB treatment, pyrazinamide is given as part of a fixed-dose combination.
    • For the 6HRZEto regimen for drug-susceptible TB meningitis, the dose of pyrazinamide is 40 mg/kg once daily (max. 2000 mg daily).

    Storage

     
    – 
     
    –  Below 25 °C
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