Pyrazinamide

Pyrazinamide (PZA) is a relative of nicotinamide, stable, slightly soluble in water. Drug is taken up by macrophages and kills bacilli residing within this acidic environment. PZA is well absorbed from the gastrointestinal tract and widely distributed in body tissues, including inflamed meninges. Tubercle bacilli develop resistance to pyrazinamide fairly readily. Major adverse effects of pyrazinamide include hepatotoxicity, nausea, vomiting, drug fever, and hyperuricemia. Hyperuricemia may provoke acute gouty arthritis.