Adult

Pyrazinamide

General Information

See National Shortage of Antimicrobial Agents used in Tuberculosis (TB) Treatment guidance 

Restricted formulary antimicrobial: For details see OUH netFormulary

For all information regarding contra-indications, interactions, contraception, pregnancy and breastfeeding and additional information, see BNF and Summary of Product Characteristics (SPC).

Standard dose

See Pyrazinamide - TB DRUG MONOGRAPHS

Renal and hepatic impairment

Renal impairment

eGFR (mL/min/1.73m2)

Oral dose

 10 or more

Dose as in normal renal function

less than 10 

Use 50-100% of normal dose

HD/HDF/High Flux

 Discuss with pharmacist

PD

Not dialysed

Dose as in eGFR less than 10ml/min/1.73m2

Note: Doses are based on Renal Drug Database

  • Monitor for gout in patients with renal impairment.

 

Hepatic impairment

  • Avoid in severe hepatic impairment, acute hepatic disease and for up to 6 months after occurrence of hepatitis.
  • Baseline LFTs should be established before therapy and then every 2-4 weeks during therapy. Those with pre-existing liver disease or alcohol dependence or taking other potentially hepatotoxic medications should have more frequent LFT checks.

Therapeutic Drug Monitoring

See Pyrazinamide - TB DRUG MONOGRAPHS

References

  1. Morningside Healthcare Ltd. Pyrazinamide 500mg tablets summary of product characteristics. Electronic Medicines Compendium. Last revision of the text 6/2/25. Accessed via www.medicines.org.uk Accessed 30/9/26.
  2. The Renal Drug Database. Pyrazinamide. Last updated 14/11/24. Accessed via https://renaldrugdatabase.com Accessed 30/9/26.
  3. British National Formulary. Pyrazinamide. BNF online, accessed via www.medicinescomplete.com. Accessed 30/9/26.
  4. Sanford Guide [online]. Pyrazinamide. Last updated 9/7/26. Accessed via https://webedition.sanfordguide.com Accessed 30/9/26

Editorial Information

Last reviewed: 30 Sept 2026

Next review date: 28 Sept 2029

Author(s): AMST.