Does pyrazinamide have the side effect of fever?

Most people do not have other symptoms when taking pyrazinamide, but a few people may experience loss of appetite, abnormal fever, or physical weakness after taking pyrazinamide. Patients may also feel cold and swollen and painful joints. Severe cases may cause liver damage and gastrointestinal reactions, and loss of appetite is more common. Therefore, you should pay attention to the side effects and precautions of drug conflicts in order to avoid side effects.

Adverse Reactions

The higher incidence rates include loss of appetite, fever, abnormal fatigue or weakness, yellow eyes or skin (hepatotoxicity); the lower incidence rates include chills, swollen and painful joints (especially the big toe, condyle, and knee joints), or tight and hot skin in the affected joints (acute gouty joint pain). During the treatment with this product, blood uric acid often increases, which may cause acute gout attacks, and serum uric acid measurement is required. Adverse reactions are related to the dosage and course of treatment. Currently, adverse reactions are rare after using conventional doses.

1. Liver damage: When taking 3 g of the drug daily, about 15% of patients developed liver damage, hepatomegaly, tenderness, elevated transaminase, jaundice, etc. Currently, 1.5 g is taken daily for 3 months, and hepatotoxic reactions are rare. If transaminase levels are elevated or jaundice occurs, which is related to the drug dosage, the drug can be stopped and active liver protection treatment can be given.

2. Joint pain: The metabolites of PZA can inhibit the excretion of uric acid, causing hyperuricemia and gout-like symptoms, which can be recovered after stopping the drug. Symptoms such as gout usually appear 1 to 2 months after taking the medication. This is because pyrazinamide promotes the reabsorption of uric acid by the renal tubules, resulting in an increase in serum uric acid.

3. Gastrointestinal reactions: loss of appetite, decreased appetite, nausea, and vomiting.

4. Allergic reactions: fever, rash, photosensitivity.

5. It is difficult for diabetic patients to control blood sugar when taking this product.

6. Allergic reaction. If fever and rash occur, it is advisable to stop the medication and treat allergies. Some patients are sensitive to light, and the exposed skin areas appear bright reddish-brown, which can be restored after stopping the medication.

7. Occasionally, anemia, ulcer attacks, difficulty urinating, etc. may occur.

Contraindications

Cross-allergy: patients who are allergic to ethionamide, isoniazid, niacin or other drugs with similar chemical structures may also be allergic to this product. Use with caution in patients with diabetes, gout or severe liver dysfunction. This product is highly toxic and should not be used by children. Pyrazinamide should not be used in patients with impaired liver function unless necessary. Not suitable for pregnant women. Not suitable for children under 3 years old. Use with caution in patients with diabetes, gout, or liver dysfunction. Check liver function regularly during medication.

interaction

(1) When used in combination with allopurinol, colchicine, probenecid, and sulfinpyrazone, pyrazinamide can increase the blood uric acid concentration and thus reduce the efficacy of the above drugs in treating gout. Therefore, the dosage of the above drugs should be adjusted when used in combination with pyrazinamide in order to control hyperuricemia and gout. (2) Side effects may be enhanced when used in combination with ethionamide. It has a synergistic effect when used in combination with isoniazid and rifampicin, and can delay the development of drug resistance.

Preparation: Pyrazinamide tablets (1) 0.25g (2) 0.5g Oral administration, 35mg per kg body weight per day, divided into 3-4 doses. Tablets: 0.25g/tablet.

Precautions

(1) Cross-allergy: patients who are allergic to ethionamide, isoniazid, niacin or other drugs with similar chemical structures may also be allergic to this product. (2) Interference with diagnosis: This product can react with sodium nitrocyanide to produce a reddish-brown color, affecting the results of urine ketone determination; it can increase the values ​​of alanine aminotransferase, aspartate aminotransferase, and blood uric acid concentration. (3) Use with caution in patients with diabetes, gout or severe liver dysfunction. (4) During the course of treatment with this product, blood uric acid often increases, which may cause acute gout attacks and serum uric acid measurement is required. (5) This product can also be administered intermittently, twice a week, 50 mg/kg each time. This product is highly toxic and should not be used by children. When it must be applied, the pros and cons must be weighed before deciding. Pregnant women with tuberculosis can first be treated with isoniazid, rifampicin and ethambutol for 9 months. If they are resistant to any of the above drugs but may be sensitive to this product, this product can be considered. This product is FDA Category C for pregnancy use.