Drug interactions
Pretomanid + Pyrazinamide
Severity: Major
Pretomanid and Pyrazinamide: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Pretomanid-containing regimens are associated with hepatotoxicity, and pyrazinamide is itself hepatotoxic. Together they may increase the risk of liver injury, though pyrazinamide is part of an established regimen with bedaquiline and linezolid.
What this interaction means in plain words
Pretomanid and Pyrazinamide can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Pretomanid belongs to Anti Bacterial; Pyrazinamide belongs to Anti Bacterial.
Why it happens
Additive hepatotoxicity.
What to do
Monitor liver function at baseline and regularly during treatment. Interrupt therapy for significant transaminase rises or hepatitis symptoms, and avoid alcohol and other hepatotoxins.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Pyrazinamide
- Pexidartinib + Pyrazinamide Major
- Cyclosporine + Pyrazinamide Moderate
- Isoniazid + Pyrazinamide Moderate
- Mipomersen + Pyrazinamide Moderate
- Probenecid + Pyrazinamide Moderate
- Pyrazinamide + Rifampin Moderate
Other interactions of Pretomanid
Frequently asked questions
Can I take Pretomanid with Pyrazinamide?
MediHelp rates the interaction as major. Pretomanid and Pyrazinamide can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Pretomanid-containing regimens are associated with hepatotoxicity, and pyrazinamide is itself hepatotoxic. Together they may increase the risk of liver injury, though pyrazinamide is part of an established regimen with bedaquiline and linezolid.
How serious is the interaction between Pretomanid and Pyrazinamide?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor liver function at baseline and regularly during treatment. Interrupt therapy for significant transaminase rises or hepatitis symptoms, and avoid alcohol and other hepatotoxins.
What other medicines interact with Pyrazinamide?
MediHelp also lists interactions of Pyrazinamide with, for example, Pexidartinib, Cyclosporine, Isoniazid. The full list is on the Pyrazinamide page.
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