18.02.5 Pyrazinamide

The mechanism of action of pyrazinamide is probably similar to isoniazid, but not identical as pyrazinamide is able to kill dormant cells i.e. it has a sterilising agent. Pyrazinamide, shares with isoniazid, the ability to cause hepatotoxicity. Hepatotoxicity is common with high doses of pyrazinamide. Consequently, pyrazinamide has to be used in low doses to avoid toxicity. Using low doses reduces the effectiveness, and this is why pyrazinamide is used in combination with other drugs in TB.