What are the potential side effects of rifampin and pyrazinamide?

• A. Hepatotoxicity requiring regular monitoring of liver function.
• B. Nephrotoxicity.
• C. Cardiac arrhythmias.
• D. Hypoglycemia.

Answer: (A)

Hepatotoxicity requiring regular liver function monitoring is the main risk with rifampin and pyrazinamide. Both drugs can injure the liver, so baseline liver tests should be done before starting therapy and repeated periodically during treatment to catch early signs of liver injury. Watch for symptoms such as fatigue, loss of appetite, nausea, right upper quadrant pain, dark urine, or jaundice, and interpret any rising transaminases or bilirubin in the context of these drugs. If liver function worsens or symptoms appear, therapy should be reassessed per protocol to prevent more serious damage. Nephrotoxicity, cardiac arrhythmias, and hypoglycemia are not typical primary adverse effects of these medications, though rifampin can cause other issues like orange-red body fluids and drug interactions, and pyrazinamide can raise uric acid levels.