Pyrazinamide for tuberculosis (Zinamide)

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Pyrazinamide is one of several medicines that you will need to take to treat tuberculosis (TB).

It is important that you take the tablets regularly.

Pyrazinamide can sometimes cause liver problems. Let your doctor know straightaway if you develop sickness, a high temperature, tenderness in your abdomen, or jaundice (yellowing of your skin or the whites of your eyes).

Type of medicineAn antituberculosis medicine
Used forTuberculosis (TB)
Also calledZinamide®
Combination brands: Rifater® (isoniazid with rifampicin and pyrazinamide); Voractiv® (isoniazid with rifampicin, pyrazinamide and ethambutol)
Available asTablets

Pyrazinamide is used to treat tuberculosis (TB). TB is a bacterial infection which mostly affects the lungs, but which can affect any part of your body. It is treatable with a course of medicines which usually lasts for six months in total. You will need to take several medicines to treat TB - pyrazinamide is just one of the medicines prescribed. You will be prescribed pyrazinamide to take during the first two months of your treatment.

Pyrazinamide is usually prescribed as a tablet which contains a combination of three or four medicines to treat TB. The brand names of these are Rifater® and Voractiv®. Taking a combination brand helps to reduce the total number of tablets you need to take each day. You may be prescribed one of these combination brands, or alternatively you may be prescribed a tablet containing only pyrazinamide (brand name Zinamide®). This brand must be taken alongside other medicines for TB.

Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking pyrazinamide it is important that your doctor knows:

  • If you are pregnant or breast-feeding.
  • If you have any problems with the way your kidneys work, or the way your liver works.
  • If you have gout or diabetes.
  • If you drink a lot of alcohol.
  • If you have porphyria. (This is a rare inherited blood disorder.)
  • If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, such as herbal and complementary medicines.
  • If you have ever had an allergic reaction to a medicine.
  • Before you start treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about the brand of tablets you have been given and will provide you with a full list of the side-effects which you may experience.
  • It is important that you take the medicines to treat TB exactly as your doctor tells you to. You will normally be asked to take pyrazinamide every day. Your doctor will explain to you how many tablets to take each day, and this information will be printed on the label of the pack of tablets to remind you. If when you collect your supply of tablets you are unclear about how to take them, ask your pharmacist to explain. If you are undergoing directly observed therapy (DOT), you will be asked to take pyrazinamide three times a week while you are being supervised by a healthcare observer.
  • It is usually recommended that you take pyrazinamide at the same time of day as your other antituberculosis medicines.
  • It is important that you keep your regular appointments with your doctor. This is so your doctor can check on your progress. Your doctor may want you to have blood tests from time to time during treatment to make sure that your liver stays healthy.
  • Continue to take the tablets regularly unless your doctor tells you to stop. This is because it is important for you to complete the treatment course so that the infection does not come back. If for any reason you stop taking the tablets (such as if you think you may be developing side-effects - see also below) then you must let your doctor know about it straightaway.
  • Pyrazinamide may stop the oral typhoid vaccine from working. If you are having any vaccinations, make sure the person treating you knows that you are taking this medicine.
  • If you are having an operation or any dental treatment, tell the person carrying out the treatment which medicines you are taking.
  • If you buy any medicines, check with a pharmacist that they are suitable for you to take with your other medicines.

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains the most common one associated with pyrazinamide - please contact your doctor straightaway if you experience these symptoms. You will find a list of other side-effects associated with pyrazinamide in the manufacturer's information leaflet supplied with your medicine.

Common pyrazinamide side-effectWhat can I do if I experience this?
Feeling or being sick, lack of appetite, high temperature, feeling generally unwell, tender abdomen, jaundice (yellowing of your skin or the whites of your eyes)Stop taking pyrazinamide and contact your doctor straightaway. These are signs of a problem with your liver and your doctor will want it investigating as soon as possible

If you experience any other symptoms which you think may be due to the medicine, speak with your doctor or pharmacist for further advice.

  • Keep all medicines out of the reach and sight of children.
  • Store in a cool, dry place, away from direct heat and light.

Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.

This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.

Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.

If you have any questions about this medicine ask your pharmacist.

Further reading & references

  • Manufacturer's PIL, Zinamide® 500 mg Tablets; Genus Pharmaceuticals, The electronic Medicines Compendium. Dated February 2010.
  • British National Formulary; 67th Edition (March 2014) British Medical Association and Royal Pharmaceutical Society of Great Britain, London

Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.

Original Author:
Helen Allen
Current Version:
Peer Reviewer:
Dr John Cox
Document ID:
28884 (v1)
Last Checked:
Next Review:
The Information Standard - certified member

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