Comparative Pharmacology
Head-to-head clinical analysis: ARIKAYCE KIT versus PYRAZINAMIDE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ARIKAYCE KIT versus PYRAZINAMIDE.
ARIKAYCE KIT vs PYRAZINAMIDE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Amikacin is an aminoglycoside antibiotic that binds to the 30S ribosomal subunit of susceptible bacteria, causing misreading of mRNA and inhibiting protein synthesis.
Converted to pyrazinoic acid, which disrupts membrane potential and inhibits mycobacterial fatty acid synthase (FAS-1).
590 mg (contents of one kit) administered as inhalation via the Lamira Nebulizer System once daily.
15-30 mg/kg orally once daily (max 2 g/day) for initial phase of tuberculosis treatment.
None Documented
None Documented
The terminal elimination half-life of amikacin from plasma is approximately 2-3 hours in patients with normal renal function. In the liposomal formulation (ARIKAYCE), after inhalation, the half-life in epithelial lining fluid is prolonged, with a terminal half-life of approximately 23 hours. Clinical context: accumulation may occur with renal impairment.
Clinical Note
moderatePyrazinamide + Tenofovir disoproxil
"The metabolism of Tenofovir disoproxil can be decreased when combined with Pyrazinamide."
Clinical Note
moderatePyrazinamide + Sulfisoxazole
"The metabolism of Sulfisoxazole can be decreased when combined with Pyrazinamide."
Clinical Note
moderatePyrazinamide + Erythromycin
"The metabolism of Erythromycin can be decreased when combined with Pyrazinamide."
Clinical Note
moderatePyrazinamide + Fluconazole
9–10 hours in patients with normal renal function; prolonged to 15–20 hours in renal impairment; requires dose adjustment in renal failure
Amikacin is primarily eliminated unchanged by glomerular filtration; renal excretion accounts for approximately 94-98% of the dose within 24 hours. Biliary/fecal elimination is minimal (<1%).
Renal: approximately 70% (40% unchanged, 30% as metabolites); biliary/fecal: minimal (less than 10%)
Category C
Category A/B
Antimycobacterial
Antimycobacterial
"The metabolism of Fluconazole can be decreased when combined with Pyrazinamide."