U.S. Department of Health & Human Services Divider Arrow National Institutes of Health Divider Arrow NCATS

Details

Stereochemistry ACHIRAL
Molecular Formula C5H5N3O
Molecular Weight 123.1127
Optical Activity NONE
Defined Stereocenters 0 / 0
E/Z Centers 0
Charge 0

SHOW SMILES / InChI
Structure of PYRAZINAMIDE

SMILES

NC(=O)C1=CN=CC=N1

InChI

InChIKey=IPEHBUMCGVEMRF-UHFFFAOYSA-N
InChI=1S/C5H5N3O/c6-5(9)4-3-7-1-2-8-4/h1-3H,(H2,6,9)

HIDE SMILES / InChI

Description
Curator's Comment: description was created based on several sources, including: http://www.drugbank.ca/drugs/DB00339 https://en.wikipedia.org/wiki/Pyrazinamide

Pyrazinamide is indicated for the initial treatment of active tuberculosis in adults and children when combined with other antituberculous agents. (The current recommendation of the CDC for drug-susceptible disease is to use a six-month regimen for initial treatment of active tuberculosis, consisting of isoniazid, rifampin and pyrazinamide given for 2 months, followed by isoniazid and rifampin for 4 months. Pyrazinamide should only be used in conjunction with other effective antituberculous agents. Pyrazinamide diffuses into M. tuberculosis, where the enzyme pyrazinamidase converts pyrazinamide to the active form pyrazinoic acid. Under acidic conditions, the pyrazinoic acid that slowly leaks out converts to the protonated conjugate acid, which is thought to diffuse easily back into the bacilli and accumulate. The net effect is that more pyrazinoic acid accumulates inside the bacillus at acid pH than at neutral pH. Pyrazinoic acid was thought to inhibit the enzyme fatty acid synthase (FAS) I, which is required by the bacterium to synthesise fatty acids. However, this theory was thought to have been discounted. However, further studies reproduced the results of FAS I inhibition as the putative mechanism first in whole cell assay of replicating M. tuberculosis bacilli which have shown that pyrazinoic acid and its ester inhibit the synthesis of fatty acids . This study was followed by in vitro assay of tuberculous FAS I enzyme that tested the activity with pyrazinamide, pyrazinoic acid and several classes of pyrazinamide analogs. Pyrazinamide and its analogs inhibited the activity of purified FAS I. It has also been suggested that the accumulation of pyrazinoic acid disrupts membrane potential and interferes with energy production, necessary for survival of M. tuberculosis at an acidic site of infection. Pyrazinoic acid has also been shown to bind to the ribosomal protein S1 (RpsA) and inhibit trans-translation. This may explain the ability of the drug to kill dormant mycobacteria

CNS Activity

Curator's Comment: Drugs like isoniazid, pyrazinamide and cycloserine cross the blood brain barrier (BBB) freely, but the behavior of rifampicin, ethambutol and streptomycin is less predictable in the presence of inflamed meninges. The CSF concentration of these drugs is at least equal to or higher than those in the noninflamed meninges

Originator

Curator's Comment: The discovery of pyrazinamide was announced by Kushner and coworkers of Lederle Laboratories in 1952

Approval Year

Targets

Targets

Primary TargetPharmacologyConditionPotency
Conditions

Conditions

ConditionModalityTargetsHighest PhaseProduct
Curative
PYRAZINAMIDE

Approved Use

Pyrazinamide

Launch Date

1971
Cmax

Cmax

ValueDoseCo-administeredAnalytePopulation
38.2 mg/L
27.8 mg/kg bw 3 times / day steady-state, oral
dose: 27.8 mg/kg bw
route of administration: Oral
experiment type: STEADY-STATE
co-administered: Isoniazid | Rifampicin | Ethambutol
PYRAZINAMIDE plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: FEMALE / MALE
food status: UNKNOWN
38.7 mg/L
27 mg/kg bw single, oral
dose: 27 mg/kg bw
route of administration: Oral
experiment type: SINGLE
co-administered:
PYRAZINAMIDE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
AUC

AUC

ValueDoseCo-administeredAnalytePopulation
344 mg × h/mL
27.8 mg/kg bw 3 times / day steady-state, oral
dose: 27.8 mg/kg bw
route of administration: Oral
experiment type: STEADY-STATE
co-administered: Isoniazid | Rifampicin | Ethambutol
PYRAZINAMIDE plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: FEMALE / MALE
food status: UNKNOWN
520 mg × h/L
27 mg/kg bw single, oral
dose: 27 mg/kg bw
route of administration: Oral
experiment type: SINGLE
co-administered:
PYRAZINAMIDE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
T1/2

T1/2

ValueDoseCo-administeredAnalytePopulation
5.5 h
27.8 mg/kg bw 3 times / day steady-state, oral
dose: 27.8 mg/kg bw
route of administration: Oral
experiment type: STEADY-STATE
co-administered: Isoniazid | Rifampicin | Ethambutol
PYRAZINAMIDE plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: FEMALE / MALE
food status: UNKNOWN
Doses

Doses

DosePopulationAdverse events​
1500 mg 1 times / day multiple, oral
Recommended
Dose: 1500 mg, 1 times / day
Route: oral
Route: multiple
Dose: 1500 mg, 1 times / day
Co-administed with::
ofloxacin, p.o(800 mg/day; 6 months)
Sources:
healthy
n = 16
Health Status: healthy
Population Size: 16
Sources:
Disc. AE: Arthralgia, Distress gastrointestinal...
AEs leading to
discontinuation/dose reduction:
Arthralgia (43.75%)
Distress gastrointestinal (37.5%)
Pruritus (25%)
Fatigue (25%)
Generalized maculopapular rash (18.8%)
Insomnia (18.8%)
Vertigo (12.5%)
Sources:
20 mg/kg 1 times / day multiple, oral
Recommended
Dose: 20 mg/kg, 1 times / day
Route: oral
Route: multiple
Dose: 20 mg/kg, 1 times / day
Co-administed with::
rifampin, p.o(600 mg/d; 2 months)
Sources: Page: p.643
unhealthy
n = 207
Health Status: unhealthy
Condition: Tuberculosis
Sex: M+F
Population Size: 207
Sources: Page: p.643
Disc. AE: Hepatotoxicity...
AEs leading to
discontinuation/dose reduction:
Hepatotoxicity (5.8%)
Sources: Page: p.643
30 mg/kg 1 times / day multiple, oral (max)
Recommended
unhealthy
Disc. AE: Hepatotoxicity...
AEs

AEs

AESignificanceDosePopulation
Vertigo 12.5%
Disc. AE
1500 mg 1 times / day multiple, oral
Recommended
Dose: 1500 mg, 1 times / day
Route: oral
Route: multiple
Dose: 1500 mg, 1 times / day
Co-administed with::
ofloxacin, p.o(800 mg/day; 6 months)
Sources:
healthy
n = 16
Health Status: healthy
Population Size: 16
Sources:
Generalized maculopapular rash 18.8%
Disc. AE
1500 mg 1 times / day multiple, oral
Recommended
Dose: 1500 mg, 1 times / day
Route: oral
Route: multiple
Dose: 1500 mg, 1 times / day
Co-administed with::
ofloxacin, p.o(800 mg/day; 6 months)
Sources:
healthy
n = 16
Health Status: healthy
Population Size: 16
Sources:
Insomnia 18.8%
Disc. AE
1500 mg 1 times / day multiple, oral
Recommended
Dose: 1500 mg, 1 times / day
Route: oral
Route: multiple
Dose: 1500 mg, 1 times / day
Co-administed with::
ofloxacin, p.o(800 mg/day; 6 months)
Sources:
healthy
n = 16
Health Status: healthy
Population Size: 16
Sources:
Fatigue 25%
Disc. AE
1500 mg 1 times / day multiple, oral
Recommended
Dose: 1500 mg, 1 times / day
Route: oral
Route: multiple
Dose: 1500 mg, 1 times / day
Co-administed with::
ofloxacin, p.o(800 mg/day; 6 months)
Sources:
healthy
n = 16
Health Status: healthy
Population Size: 16
Sources:
Pruritus 25%
Disc. AE
1500 mg 1 times / day multiple, oral
Recommended
Dose: 1500 mg, 1 times / day
Route: oral
Route: multiple
Dose: 1500 mg, 1 times / day
Co-administed with::
ofloxacin, p.o(800 mg/day; 6 months)
Sources:
healthy
n = 16
Health Status: healthy
Population Size: 16
Sources:
Distress gastrointestinal 37.5%
Disc. AE
1500 mg 1 times / day multiple, oral
Recommended
Dose: 1500 mg, 1 times / day
Route: oral
Route: multiple
Dose: 1500 mg, 1 times / day
Co-administed with::
ofloxacin, p.o(800 mg/day; 6 months)
Sources:
healthy
n = 16
Health Status: healthy
Population Size: 16
Sources:
Arthralgia 43.75%
Disc. AE
1500 mg 1 times / day multiple, oral
Recommended
Dose: 1500 mg, 1 times / day
Route: oral
Route: multiple
Dose: 1500 mg, 1 times / day
Co-administed with::
ofloxacin, p.o(800 mg/day; 6 months)
Sources:
healthy
n = 16
Health Status: healthy
Population Size: 16
Sources:
Hepatotoxicity 5.8%
Disc. AE
20 mg/kg 1 times / day multiple, oral
Recommended
Dose: 20 mg/kg, 1 times / day
Route: oral
Route: multiple
Dose: 20 mg/kg, 1 times / day
Co-administed with::
rifampin, p.o(600 mg/d; 2 months)
Sources: Page: p.643
unhealthy
n = 207
Health Status: unhealthy
Condition: Tuberculosis
Sex: M+F
Population Size: 207
Sources: Page: p.643
Hepatotoxicity Disc. AE
30 mg/kg 1 times / day multiple, oral (max)
Recommended
unhealthy
Sourcing

Sourcing

Vendor/AggregatorIDURL
PubMed

PubMed

TitleDatePubMed
Use of genomics and combinatorial chemistry in the development of new antimycobacterial drugs.
2000 Feb 1
[Isoniazid-induced hepatic failure. Report of a case].
2000 Jan-Mar
Activity of poloxamer CRL-1072 against drug-sensitive and resistant strains of Mycobacterium tuberculosis in macrophages and in mice.
2000 Jun
[Effectiveness of chemotherapy of intrathoracic tuberculosis in children: late follow-up data].
2001
The role of fluoroquinolones in tuberculosis today.
2001
Utility of PCR assays for rapid diagnosis of BCG infection in children.
2001 Apr
Ion interaction reagent reversed-phase high-performance liquid chromatography determination of anti-tuberculosis drugs and metabolites in biological fluids.
2001 Apr 25
Renal handling of uric acid assessed by means of pharmacological tests in obese women.
2001 Aug
Can serial qualitative polymerase chain reaction monitoring predict outcome of pulmonary tuberculosis treatment?
2001 Dec
Side effects of antituberculosis treatment.
2001 Dec
Postantibiotic effects of antituberculosis agents alone and in combination.
2001 Dec
New mutations in pncA of in vitro selected pyrazinamide-resistant strains of Mycobacterium tuberculosis.
2001 Fall
Normouricemia in the syndrome of inappropriate antidiuretic hormone secretion.
2001 Jan
Pattern of some haematological indices in newly diagnosed pulmonary tuberculosis cases in Iwo, Nigeria: diagnostic and therapeutic implications.
2001 Jan-Mar
Routine use of rapid molecular methods to detect antibiotic resistance in Mycobacterium tuberculosis.
2001 Mar
[Central nervous system tuberculosis in children: 2. Treatment and outcome].
2001 Mar
Acceptability of short-course rifampin and pyrazinamide treatment of latent tuberculosis infection among jail inmates.
2001 Mar
[Two cases of exercise-induced acute renal failure with idiopathic renal hypouricemia].
2001 May
Tuberculous peritonitis--reports of 26 cases, detailing diagnostic and therapeutic problems.
2001 May
From the Centers for Disease Control and Prevention. Fatal and severe hepatitis associated with rifampin and pyrazinamide for the treatment of latent tuberculosis infection--New York and Georgia, 2000.
2001 May 23-30
Tuberculosis infection in Chinese patients undergoing continuous ambulatory peritoneal dialysis.
2001 Nov
Rapamycin and less immunosuppressive analogs are toxic to Candida albicans and Cryptococcus neoformans via FKBP12-dependent inhibition of TOR.
2001 Nov
[Orchiectomy for tuberculous epididymitis: a report of two cases with intractable to antituberculosis treatment].
2001 Oct
Characterization of pncA mutations of pyrazinamide-resistant Mycobacterium tuberculosis in Korea.
2001 Oct
Modulating effect of Liv.100, an ayurvedic formulation on antituberculosis drug-induced alterations in rat liver microsomes.
2001 Sep
Tuberculosis: guidelines changed for latent TB treatment.
2001 Sep 21
Treatment of childhood tuberculosis with a six month directly observed regimen of only two weeks of daily therapy.
2002 Feb
High rates of tuberculosis in end-stage renal failure: the impact of international migration.
2002 Jan
Surveillance for antimicrobial resistance in Croatia.
2002 Jan
Rapidly progressive glomerulonephritis due to rifampicin therapy.
2002 Jan
Patents

Patents

Sample Use Guides

In Vivo Use Guide
Curator's Comment: Three grams per day should not be exceeded. The CDC (Center for Disease Control ) recommendations do not exceed 2 g per day when given as a daily regimen
15 to 30 mg/kg once daily
Route of Administration: Oral
In Vitro Use Guide
Unknown
Name Type Language
PYRAZINAMIDE
EP   HSDB   INN   MART.   MI   ORANGE BOOK   USP   USP-RS   VANDF   WHO-DD   WHO-IP  
INN  
Official Name English
PYRAZINAMIDE [USP-RS]
Common Name English
D-50
Code English
PYRAZIDE
Common Name English
PYRAZINAMIDE [MART.]
Common Name English
PYRAZINAMIDE COMPONENT OF RIFATER
Common Name English
PYRAZINAMIDE [HSDB]
Common Name English
PYRAZINAMIDE [USP MONOGRAPH]
Common Name English
PYRAFAT
Common Name English
PYRAMIZADE
Common Name English
PIRAZINAMID
Common Name English
PYRAZINAMIDE [MI]
Common Name English
RIFATER COMPONENT PYRAZINAMIDE
Common Name English
Pyrazinecarboxamide
Systematic Name English
PYRAZINAMIDE [JAN]
Common Name English
ZINAMIDE
Common Name English
ALDINAMID
Common Name English
NOVAMID
Common Name English
PYRAZINAMIDE [VANDF]
Common Name English
ALDINAMIDE
Common Name English
PYRAZINAMIDE [USP IMPURITY]
Common Name English
FARMIZINA
Common Name English
NSC-14911
Code English
pyrazinamide [INN]
Common Name English
PYRAZINAMIDE [ORANGE BOOK]
Common Name English
UNIPYRANAMIDE
Common Name English
PIRAZIMIDA
Common Name English
PYRAZINAMIDUM [WHO-IP LATIN]
Common Name English
PYRAZINAMIDE [EP MONOGRAPH]
Common Name English
MK-56
Code English
PYRAZINE CARBOXYLAMIDE
Common Name English
.ALPHA.-PYRAZINAMIDE
Common Name English
ISOPAS
Common Name English
PYRAZINAMIDE [WHO-IP]
Common Name English
ROZIDE
Common Name English
TEBRAZID
Common Name English
Pyrazinamide [WHO-DD]
Common Name English
EPRAZIN
Common Name English
Classification Tree Code System Code
NCI_THESAURUS C280
Created by admin on Fri Dec 15 15:22:42 GMT 2023 , Edited by admin on Fri Dec 15 15:22:42 GMT 2023
WHO-VATC QJ04AM05
Created by admin on Fri Dec 15 15:22:42 GMT 2023 , Edited by admin on Fri Dec 15 15:22:42 GMT 2023
WHO-ESSENTIAL MEDICINES LIST 6.2.4 (ISO/PYR/RIF)
Created by admin on Fri Dec 15 15:22:42 GMT 2023 , Edited by admin on Fri Dec 15 15:22:42 GMT 2023
WHO-ATC J04AM06
Created by admin on Fri Dec 15 15:22:42 GMT 2023 , Edited by admin on Fri Dec 15 15:22:42 GMT 2023
WHO-ATC J04AK01
Created by admin on Fri Dec 15 15:22:42 GMT 2023 , Edited by admin on Fri Dec 15 15:22:42 GMT 2023
WHO-ATC J04AM05
Created by admin on Fri Dec 15 15:22:42 GMT 2023 , Edited by admin on Fri Dec 15 15:22:42 GMT 2023
WHO-ESSENTIAL MEDICINES LIST 6.2.4 (ETH/ISO/PYR/RIF)
Created by admin on Fri Dec 15 15:22:42 GMT 2023 , Edited by admin on Fri Dec 15 15:22:42 GMT 2023
WHO-ESSENTIAL MEDICINES LIST 6.2.4
Created by admin on Fri Dec 15 15:22:42 GMT 2023 , Edited by admin on Fri Dec 15 15:22:42 GMT 2023
WHO-VATC QJ04AM06
Created by admin on Fri Dec 15 15:22:42 GMT 2023 , Edited by admin on Fri Dec 15 15:22:42 GMT 2023
LIVERTOX NBK547856
Created by admin on Fri Dec 15 15:22:42 GMT 2023 , Edited by admin on Fri Dec 15 15:22:42 GMT 2023
NDF-RT N0000175483
Created by admin on Fri Dec 15 15:22:42 GMT 2023 , Edited by admin on Fri Dec 15 15:22:42 GMT 2023
WHO-VATC QJ04AK01
Created by admin on Fri Dec 15 15:22:42 GMT 2023 , Edited by admin on Fri Dec 15 15:22:42 GMT 2023
FDA ORPHAN DRUG 6585
Created by admin on Fri Dec 15 15:22:42 GMT 2023 , Edited by admin on Fri Dec 15 15:22:42 GMT 2023
Code System Code Type Description
EPA CompTox
DTXSID9021215
Created by admin on Fri Dec 15 15:22:42 GMT 2023 , Edited by admin on Fri Dec 15 15:22:42 GMT 2023
PRIMARY
ChEMBL
CHEMBL614
Created by admin on Fri Dec 15 15:22:42 GMT 2023 , Edited by admin on Fri Dec 15 15:22:42 GMT 2023
PRIMARY
DRUG CENTRAL
2328
Created by admin on Fri Dec 15 15:22:42 GMT 2023 , Edited by admin on Fri Dec 15 15:22:42 GMT 2023
PRIMARY
LACTMED
Pyrazinamide
Created by admin on Fri Dec 15 15:22:42 GMT 2023 , Edited by admin on Fri Dec 15 15:22:42 GMT 2023
PRIMARY
WIKIPEDIA
PYRAZINAMIDE
Created by admin on Fri Dec 15 15:22:42 GMT 2023 , Edited by admin on Fri Dec 15 15:22:42 GMT 2023
PRIMARY
WHO INTERNATIONAL PHARMACOPEIA
PYRAZINAMIDE
Created by admin on Fri Dec 15 15:22:42 GMT 2023 , Edited by admin on Fri Dec 15 15:22:42 GMT 2023
PRIMARY Description: A white or almost white, crystalline powder; odourless. Solubility: Sparingly soluble in water; slightly soluble in ethanol (~750 g/l) TS. Category: Antituberculosis drug. Storage: Pyrazinamide should be kept in a well-closed container. Definition: Pyrazinamide contains not less than 98.5% and not more than 101.0% of C5H5N3O, calculated with reference to the anhydrous substance.
ECHA (EC/EINECS)
202-717-6
Created by admin on Fri Dec 15 15:22:42 GMT 2023 , Edited by admin on Fri Dec 15 15:22:42 GMT 2023
PRIMARY
PUBCHEM
1046
Created by admin on Fri Dec 15 15:22:42 GMT 2023 , Edited by admin on Fri Dec 15 15:22:42 GMT 2023
PRIMARY
EVMPD
SUB10163MIG
Created by admin on Fri Dec 15 15:22:42 GMT 2023 , Edited by admin on Fri Dec 15 15:22:42 GMT 2023
PRIMARY
INN
786
Created by admin on Fri Dec 15 15:22:42 GMT 2023 , Edited by admin on Fri Dec 15 15:22:42 GMT 2023
PRIMARY
IUPHAR
7287
Created by admin on Fri Dec 15 15:22:42 GMT 2023 , Edited by admin on Fri Dec 15 15:22:42 GMT 2023
PRIMARY
MESH
D011718
Created by admin on Fri Dec 15 15:22:42 GMT 2023 , Edited by admin on Fri Dec 15 15:22:42 GMT 2023
PRIMARY
HSDB
3576
Created by admin on Fri Dec 15 15:22:42 GMT 2023 , Edited by admin on Fri Dec 15 15:22:42 GMT 2023
PRIMARY
DAILYMED
2KNI5N06TI
Created by admin on Fri Dec 15 15:22:42 GMT 2023 , Edited by admin on Fri Dec 15 15:22:42 GMT 2023
PRIMARY
NSC
14911
Created by admin on Fri Dec 15 15:22:42 GMT 2023 , Edited by admin on Fri Dec 15 15:22:42 GMT 2023
PRIMARY
CHEBI
45285
Created by admin on Fri Dec 15 15:22:42 GMT 2023 , Edited by admin on Fri Dec 15 15:22:42 GMT 2023
PRIMARY
SMS_ID
100000080846
Created by admin on Fri Dec 15 15:22:42 GMT 2023 , Edited by admin on Fri Dec 15 15:22:42 GMT 2023
PRIMARY
DRUG BANK
DB00339
Created by admin on Fri Dec 15 15:22:42 GMT 2023 , Edited by admin on Fri Dec 15 15:22:42 GMT 2023
PRIMARY
CAS
98-96-4
Created by admin on Fri Dec 15 15:22:42 GMT 2023 , Edited by admin on Fri Dec 15 15:22:42 GMT 2023
PRIMARY
RXCUI
8987
Created by admin on Fri Dec 15 15:22:42 GMT 2023 , Edited by admin on Fri Dec 15 15:22:42 GMT 2023
PRIMARY RxNorm
MERCK INDEX
m9337
Created by admin on Fri Dec 15 15:22:42 GMT 2023 , Edited by admin on Fri Dec 15 15:22:42 GMT 2023
PRIMARY Merck Index
RS_ITEM_NUM
1585006
Created by admin on Fri Dec 15 15:22:42 GMT 2023 , Edited by admin on Fri Dec 15 15:22:42 GMT 2023
PRIMARY
FDA UNII
2KNI5N06TI
Created by admin on Fri Dec 15 15:22:42 GMT 2023 , Edited by admin on Fri Dec 15 15:22:42 GMT 2023
PRIMARY
NCI_THESAURUS
C29395
Created by admin on Fri Dec 15 15:22:42 GMT 2023 , Edited by admin on Fri Dec 15 15:22:42 GMT 2023
PRIMARY