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Pyrazinamide is used to treat tuberculosis. Common side effects include nausea, vomiting, decreased appetite, and increased uric acid levels. High uric acid levels can lead to gout. Call your health care provider right away if you have any sudden redness, swelling, or pain in your joints. It is important to complete your prescribed course of pyrazinamide, even if your symptoms get better or go away. This will reduce the risk that future infections are resistant to pyrazinamide or other similar medicines.

Uses

What is pyrazinamide used for?

Pyrazinamide is commonly used to treat tuberculosis (along with other medicine).

Pyrazinamide may also be used for other conditions as determined by your health care provider.

Pyrazinamide may not be the right drug for some of the infections listed above, depending on which germs are causing the infection. Bacteria in some locations may have developed resistance to pyrazinamide, which will make it not work as well.

How does pyrazinamide work (mechanism of action)?

Pyrazinamide seems to reduce the growth of the tuberculosis bacteria. This makes it easier for your body to fight off the infection and get rid of the bacteria.

How is pyrazinamide supplied (dosage forms)?

Brands and other names

  • Zinamide

Dosage forms and strengths

  • 500 mg oral tablets

How should I store pyrazinamide?

Pyrazinamide should be stored at room temperature, between 68 F and 77 F (20 C and 25 C). It can be exposed to temperatures between 59 F and 86 F (15 C and 30 C) for shorter periods of time, such as when you’re transporting it. Store it in a cool, dry place, and protect it from light.

Side Effects

What are the most common side effects of pyrazinamide?

The most common side effects of pyrazinamide are listed below. Tell your health care provider if you have any of these side effects that bother you.

  • Increased uric acid levels (see below)
  • Nausea
  • Vomiting
  • Loss of appetite
  • Muscle and joint pain

There may be other side effects of pyrazinamide that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of pyrazinamide?

While less common, the most serious side effects of pyrazinamide are described below, along with what to do if they happen.

Liver Damage. Liver damage, also called hepatotoxicity, can happen when taking pyrazinamide. Call your health care provider right away if you have any of the following symptoms of liver damage.

  • Nausea or vomiting
  • Stomach or belly pain
  • Fever
  • Weakness or unusual tiredness
  • Itching
  • Loss of appetite
  • Light-colored poop
  • Dark-colored urine (pee)
  • Your skin or the whites of your eyes turning yellowish in color (also called jaundice)

Increased Uric Acid Levels. Pyrazinamide may increase your blood uric acid levels and risk of having a gout flare. Call your health care provider right away if you have any sudden redness, swelling, or pain in your joints. 

Severe Allergic Reactions. Pyrazinamide may cause allergic reactions, which can be serious. Stop taking pyrazinamide and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Warnings & Precautions

Who should not use pyrazinamide?

Allergies to Ingredients. People who are allergic to any of the following should not take pyrazinamide.

  • Zinamide
  • Pyrazinamide
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific pyrazinamide products they stock.

Liver Problems. Pyrazinamide should not be used if your liver is not working as well as it should be. If there is a concern about the health of your liver, your health care provider may do tests to find out if it is working well enough to take this medicine.

Gout. Pyrazinamide should not be used in people currently having a gout flare.

What should I know about pyrazinamide before using it?

Do not take pyrazinamide unless it has been prescribed to you by a health care provider. Take it as prescribed.

Do not share pyrazinamide with other people, even if they have the same condition as you. It may harm them.

Keep pyrazinamide out of the reach of children.

Your health care provider will likely do bloodwork before starting this medicine and while you are taking it to monitor the health of your liver and check your blood uric acid levels. It is important to keep all appointments for bloodwork.

It is important to complete your prescribed course of pyrazinamide, even if your symptoms get better or go away. This will reduce the risk that future infections are resistant to pyrazinamide or other similar medicines.

What should I tell my health care provider before using pyrazinamide?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them know if pyrazinamide is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your health care provider if you have any of the following.

  • History of taking medicine to treat tuberculosis
  • Kidney problems
  • Diabetes
  • Gout
  • Porphyria or other blood disorders
  • Drink alcohol often or in large amounts

Other Medicines and Supplements. Pyrazinamide may interact with other medicines and supplements. Before taking pyrazinamide, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Pregnancy. It is not known if or how pyrazinamide could affect pregnancy or harm an unborn baby. Tell your health care provider if you are pregnant or plan to become pregnant. Your health care provider will let you know if you should take pyrazinamide while you are pregnant or trying to get pregnant.

Breastfeeding. Pyrazinamide passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed. Your health care provider will let you know if you should take pyrazinamide while breastfeeding.

Interactions

Does pyrazinamide interact with foods or drinks?

There are no known interactions between pyrazinamide and foods or drinks.

It is unknown if drinking alcohol will affect pyrazinamide. The risk of liver damage may be increased if you drink alcohol while taking pyrazinamide. It is best to avoid drinking alcohol while taking pyrazinamide.

Does pyrazinamide interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before taking pyrazinamide.

  • Cyclosporine (Gengraf, Neoral, Sandimmune, and others), which is a medicine that suppresses your immune system
  • Probenecid, which is a medicine commonly used for gout
  • Rifampin (Rifadin), which is a medicine commonly used to treat an infection called tuberculosis

This may not be a complete list of medicines that can interact with pyrazinamide. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much pyrazinamide?

If you or someone else has used too much pyrazinamide, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of pyrazinamide?

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only take the next dose. Do not take double or extra doses. 

It is important to complete your prescribed course of pyrazinamide, even if your symptoms get better or go away. This will reduce the risk that future infections are resistant to pyrazinamide or other similar medicines.