Which of the following is a major adverse effect of pyrazinamide?

• A. Hyperuricemia (gout) and hepatotoxicity
• B. Ototoxicity and nephrotoxicity
• C. Optic neuritis
• D. Severe myopathy

Answer: (A)

Pyrazinamide’s major adverse effects are hepatotoxicity and hyperuricemia, which can lead to gout. This drug is metabolized in the liver, so liver injury is a key risk and warrants monitoring liver enzymes during therapy. It also interferes with uric acid handling, causing elevated serum urate levels that may trigger gout, especially in patients with preexisting gout or kidney issues. So elevated liver enzymes and increased uric acid are the hallmark toxicities to watch for with this drug. Other listed adverse effects, like ototoxicity or nephrotoxicity, optic neuritis, or severe myopathy, are not characteristic major toxicities of pyrazinamide.