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Pyrazinamide (Z)
Pyrazinamide is converted to pyrazinoic acid inside Mycobacterium tuberculosis cells, where it disrupts bacterial energy metabolism and nucleic acid synthesis.
Pyrazinamide is converted to pyrazinoic acid inside Mycobacterium tuberculosis cells, where it disrupts bacterial energy metabolism and nucleic acid synthesis. Used for Tuberculosis (TB), including drug-susceptible and multidrug-resistant TB as part of combination therapy.
At a glance
| Generic name | Pyrazinamide (Z) |
|---|---|
| Sponsor | Global Alliance for TB Drug Development |
| Drug class | Nicotinamide analog; antituberculous agent |
| Target | Pantothenate synthetase (PanC); pyrazinamidase activation |
| Modality | Small molecule |
| Therapeutic area | Infectious Disease |
| Phase | Phase 3 |
Mechanism of action
Pyrazinamide is a prodrug that requires activation by the bacterial enzyme pyrazinamidase to form pyrazinoic acid. Once activated, pyrazinoic acid accumulates in the mycobacterial cell and inhibits the enzyme pantothenate synthetase, disrupting the synthesis of coenzyme A and ultimately impairing bacterial energy production and nucleic acid synthesis. This mechanism is particularly effective against intracellular and slowly replicating tubercle bacilli.
Approved indications
- Tuberculosis (TB), including drug-susceptible and multidrug-resistant TB as part of combination therapy
Common side effects
- Hyperuricemia
- Gout
- Hepatotoxicity
- Nausea
- Arthralgias
Key clinical trials
- Shortened Regimen for Drug-susceptible TB in Children (PHASE3)
- Treatment of Tuberculosis Multidrug Resistance Treatment of Tuberculosis Multidrug Resistance
- AIPH-TB: AI-Optimised Pyrazinamide-Hydroxychloroquine vs Standard RIPE for Drug-Sensitive Pulmonary Tuberculosis - A Phase II RCT (PHASE2)
- Digitally Facilitated, Integrated Community and Facility-Based Interventions: The HEART-TB Trial Protocol (NA)
- Asymptomatic TB With Innovative Modified Short-course Regimens (PHASE4)
- ATORvastatin in Pulmonary TUBerculosis: a POPulation PharmacoKinetics -PharmacoDynamics Sub-study (ATORTUB popPK-PD) (PHASE2)
- Phase 2 Trial to Evaluate the Safety and Tolerability and Early Bactericidal Activity of RESP30TB in Tuberculosis (PHASE2)
- Determination of Adequate Tuberculosis Regimen in Patients Hospitalized With HIV-associated Severe Immune Suppression (PHASE3)
Primary sources
Every claim on this page is sourced from regulatory or scientific primary sources. See our editorial policy for full methodology.
| Source | Used for |
|---|---|
| ClinicalTrials.gov | Trial enrolment, design, endpoints, results |
Competitive intelligence
For the full competitive landscape — auto-detected comparators, recent regulatory actions across the set, upcoming PDUFA, patent timeline, sponsor landscape:
- Pyrazinamide (Z) CI brief — competitive landscape report
- Pyrazinamide (Z) updates RSS · CI watch RSS
- Global Alliance for TB Drug Development portfolio CI