Drug interactions
Pyrazinamide + Rifampin
Severity: Moderate
Pyrazinamide and Rifampin: moderate 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
Both drugs can cause hepatotoxicity and are used together in standard tuberculosis regimens. Their combination increases the risk of drug-induced liver injury, particularly with preexisting liver disease. Benefit usually outweighs risk with monitoring.
What this interaction means in plain words
Pyrazinamide and Rifampin can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Why it happens
Additive hepatotoxicity.
What to do
Monitor liver enzymes at baseline and periodically. Stop or alter therapy if transaminases rise markedly or symptoms occur.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Pyrazinamide
- Pexidartinib + Pyrazinamide Major
- Pretomanid + Pyrazinamide Major
- Cyclosporine + Pyrazinamide Moderate
- Isoniazid + Pyrazinamide Moderate
- Mipomersen + Pyrazinamide Moderate
- Probenecid + Pyrazinamide Moderate
Frequently asked questions
Can I take Pyrazinamide with Rifampin?
MediHelp rates the interaction as moderate. Pyrazinamide and Rifampin can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Both drugs can cause hepatotoxicity and are used together in standard tuberculosis regimens. Their combination increases the risk of drug-induced liver injury, particularly with preexisting liver disease. Benefit usually outweighs risk with monitoring.
How serious is the interaction between Pyrazinamide and Rifampin?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor liver enzymes at baseline and periodically. Stop or alter therapy if transaminases rise markedly or symptoms occur.
What other medicines interact with Pyrazinamide?
MediHelp also lists interactions of Pyrazinamide with, for example, Pexidartinib, Pretomanid, Cyclosporine. The full list is on the Pyrazinamide page.
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