Key takeaways
Pyrazinamide and Rifabutin (Mycobutin) are both antibiotics, but they belong to different medication classes and have different uses. Pyrazinamide is used to treat active tuberculosis (TB) and is taken with other TB medications like isoniazid and rifampin. Rifabutin, a rifamycin antibiotic, is used to prevent Mycobacterium avium complex (MAC) infection in people with advanced HIV. Both medications come as a lower-cost generic. Pyrazinamide is typically dosed based on body weight, while rifabutin is usually taken as a 300 mg capsule once daily. Pyrazinamide can cause side effects like muscle or joint pain and liver issues and may increase uric acid levels, raising the risk for gout. Rifabutin can change the color of your body fluids, including urine, and may cause low blood cell counts and serious allergic reactions. Pyrazinamide is not recommended for people with severe liver problems or recent gout flares, while rifabutin should not be used if you have active TB. Rifabutin interacts with many medications, so it's important to be sure your prescriber and pharmacist have a complete list of your medications.
