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Rifampicin

    Brands

    DEA Class; Rx

    Common Brand Names; Rifadin, Rimactane

    • Antitubercular Agents

    Semisynthetic rifamycin antibiotic
    Primarily used as part of first-line, combination therapy for the treatment of tuberculosis and also used to treat asymptomatic carriers of Neisseria meningitidis
    Potent inducer of hepatic microsomal enzymes and associated with many significant drug interactions

    Indicated for Tuberculosis.
    Indicated for treatment of asymptomatic carriers of Neisseria meningitidis to eliminate meningococci from the nasopharynx
    For Haemophilus Influenzae Type B Infection (Off-label)

    Hypersensitivity to rifamycins or excipients

    Coadministration with atazanavir, darunavir, fosamprenavir, ritonavir/saquinavir, sazuinavir, or tipranavir

    • Elevated liver function test (LFT) results (up to 14%)
    • Rash (1-5%)
    • Epigastric distress (1-2%)
    • Anorexia (1-2%)
    • Nausea (1-2%)
    • Vomiting (1-2%)
    • Diarrhea (1-2%)
    • Cramps (1-2%)
    • Pseudomembranous colitis (1-2%)
    • Pancreatitis (1-2%)
    • Muscular weakness
    • Edema
    • Flushing
    • Ataxia
    • Impaired concentration
    • Fever
    • Fatigue
    • Headache
    • Numbness
    • Behavioral changes
    • Dizziness

    May decrease the effectiveness of oral contraceptive pills (OCPs)

    Do not administer parenteral preparation IM or SC

    Patients on regimens of >600 mg once or twice weekly may experience adverse reactions, including flulike syndrome

    History of diabetes mellitus (rifampin may make diabetes management more difficult)

    Regimens of >600 mg once or twice weekly may cause leukemia, anemia, or thrombocytopenia

    Discontinue therapy if patient develops any signs of hepatocellular damage, including hyperbilirubinemia

    Prolonged use may result in bacterial or fungal superinfection

    Use with caution in patients with liver impairment and porphyria

    Not for use in meningococcal disease; may be suitable for short-term use in asymptomatic carriers

    Mild to severe cholestasis reported; discontinue therapy if confirmed

    Use with caution in patients with history of alcoholism and patients receiving additional medications that may cause hepatotoxicity; advise patients to abstain from alcohol, hepatotoxic medications or herbal products while taking drug

    Rifampin is not recommended for intermittent therapy; caution patient against intentional or accidental interruption of daily dosage regimen; rare renal hypersensitivity reactions have been reported when therapy was resumed in such cases

    Rifampin has enzyme-inducing properties that can enhance metabolism of endogenous substrates, including adrenal hormones, thyroid hormones, and vitamin D

    No adequate and well-controlled studies have been performed in pregnant women; has been shown to be teratogenic in rodents

    Rifampin has been reported to cross the placental barrier and appear in cord blood

    Because of potential for tumorigenicity shown for rifampin in animal studies, a decision should be made whether to discontinue nursing or discontinue drug, taking into account importance of drug to mother

    Adults

    10 mg/kg/day (Max: 600 mg/day) PO/IV for tuberculosis treatment; 1,200 mg/day PO/IV for meningococcal prophylaxis.

    Geriatric

    10 mg/kg/day (Max: 600 mg/day) PO/IV for tuberculosis treatment; 1,200 mg/day PO/IV for meningococcal prophylaxis.

    Adolescents

    20 mg/kg/day PO/IV (Max: 600 mg/day PO/IV for tuberculosis treatment; 1,200 mg/day PO/IV for meningococcal prophylaxis).

    Children

    20 mg/kg/day PO/IV (Max: 600 mg/day PO/IV for tuberculosis treatment; 1,200 mg/day PO/IV for meningococcal prophylaxis).

    Infants

    20 mg/kg/day PO/IV.

    Neonates

    20 mg/kg/day PO/IV for tuberculosis treatment has been used off-label; 10 mg/kg/day PO/IV for meningococcal prophylaxis.

    Rifampin

    capsule

    • 150mg
    • 300mg

    injectable powder

    • 600mg