- What is rifampin?
- Important Information
- Before taking this medicine
- How should I use rifampin?
- What happens if I miss a dose?
- What happens if I overdose?
- What should I avoid while using rifampin?
- Rifampin side effects
- What other drugs will affect rifampin?
- Further information
- More about rifampin
- What is Rifampin?
- What is rifampicin?
- What infections does rifampicin treat?
- How is rifampicin prescribed?
- What are the side effects of rifampicin?
- Drug interactions with rifampicin
- Precautions that should be taken when on rifampicin
Brand Names: Rifadin, Rimactane
Generic Name: rifampin
- What is rifampin (Rifadin, Rimactane)?
- What are the possible side effects of rifampin (Rifadin, Rimactane)?
- What is the most important information I should know about rifampin (Rifadin, Rimactane)?
- What should I discuss with my healthcare provider before taking rifampin (Rifadin, Rimactane)?
- How should I take rifampin (Rifadin, Rimactane)?
- What happens if I miss a dose (Rifadin, Rimactane)?
- What happens if I overdose (Rifadin, Rimactane)?
- What should I avoid while taking rifampin (Rifadin, Rimactane)?
- What other drugs will affect rifampin (Rifadin, Rimactane)?
- Where can I get more information (Rifadin, Rimactane)?
What is rifampin (Rifadin, Rimactane)?
Rifampin is an antibiotic that fights bacteria and prevents it from spreading in your body.
Rifampin is used to treat or prevent tuberculosis (TB).
Rifampin may also be used to reduce certain bacteria in your nose and throat that could cause meningitis or other infections. Rifampin prevents you from spreading these bacteria to other people, but this medicine will not treat an active meningitis infection.
Rifampin may also be used for purposes not listed in this medication guide.
What are the possible side effects of rifampin (Rifadin, Rimactane)?
Get emergency medical help if you have signs of an allergic reaction (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning in your eyes, skin pain, red or purple skin rash that spreads and causes blistering and peeling).
Seek medical treatment if you have a serious drug reaction that can affect many parts of your body. Symptoms may include: skin rash, fever, swollen glands, flu-like symptoms, muscle aches, severe weakness, unusual bruising, or yellowing of your skin or eyes. This reaction may occur several weeks after you began using rifampin.
Call your doctor at once if you have:
- severe stomach pain, diarrhea that is watery or bloody;
- a light-headed feeling, like you might pass out;
- chest pain, cough, shortness of breath;
- pounding heartbeats or fluttering in your chest;
- easy bruising, unusual bleeding (nosebleeds, bleeding gums);
- little or no urinating;
- flu symptoms–fever, chills, body aches, headache, weakness, nausea, vomiting); or
- liver problems–upper stomach pain, tired feeling, loss of appetite, dark urine, jaundice (yellowing of the skin or eyes).
Common side effects may include:
- heartburn, gas, upset stomach, loss of appetite;
- nausea, vomiting, diarrhea, stomach cramps;
- headache, dizziness, drowsiness, weakness, tired feeling;
- muscle weakness, pain in your arms or legs;
- vision problems;
- flushing (warmth, redness, or tingly feeling); or
- confusion, changes in behavior, trouble concentrating.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
What is the most important information I should know about rifampin (Rifadin, Rimactane)?
Some medicines can interact with rifampin and should not be used at the same time. Your doctor may need to change your treatment plan if you take medicine to treat HIV or AIDS.
Generic Name: rifampin (oral/injection) (rif AM pin)
Brand Name: Rifadin, Rifadin IV, Rimactane
Medically reviewed by Drugs.com on Oct 3, 2019 – Written by Cerner Multum
- Side Effects
What is rifampin?
Rifampin is an antibiotic that is used to treat or prevent tuberculosis (TB).
Rifampin may also be used to reduce certain bacteria in your nose and throat that could cause meningitis or other infections. Rifampin prevents you from spreading these bacteria to other people, but rifampin will not treat an active meningitis infection.
Rifampin may also be used for purposes not listed in this medication guide.
Tell your doctor about all your current medicines and any you start or stop using. Many drugs can interact, and some drugs should not be used together.
Before taking this medicine
You should not use rifampin if you are allergic to rifampin or similar medicines such as rifabutin, rifapentine, rifamycin, or rifaximin.
Many drugs can interact and cause dangerous effects. Some drugs should not be used together with rifampin. Your doctor may change your treatment plan if you also use: atazanavir, darunavir, fosamprenavir, praziquantel, ritonavir, saquinavir, or tipranavir.
Tell your doctor if you have ever had:
bleeding problems; or
porphyria (a genetic enzyme disorder that causes symptoms affecting the skin or nervous system).
It is not known whether this medicine will harm an unborn baby. However, using rifampin during the last few weeks of pregnancy may cause bleeding in the mother or the newborn baby. Tell your doctor if you are pregnant.
Rifampin can make hormonal birth control less effective, including birth control pills, injections, implants, skin patches, and vaginal rings. To prevent pregnancy while using rifampin, use a barrier form of birth control: condom, diaphragm, cervical cap, or contraceptive sponge.
You should not breastfeed while using this medicine.
How should I use rifampin?
Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.
Rifampin oral is taken by mouth. Rifampin injection is given as an infusion into a vein.
Take rifampin oral on an empty stomach, at least 1 hour before or 2 hours after a meal. Take each dose with a full glass of water.
A healthcare provider will give you rifampin injection. Tell your caregivers if you feel any burning, pain, or swelling around the IV needle when rifampin is injected.
Rifampin may cause temporary discoloration of your teeth, sweat, urine, saliva, and tears (a yellow, orange, red, or brown color). This side effect is usually not harmful. However, soft contact lenses may be permanently stained if you wear them while using rifampin.
Dark colored urine can be a sign of liver problems. Call your doctor if you have reddish-brown urine together with upper stomach pain, loss of appetite, and jaundice (yellowing of your skin or eyes).
Use this medicine for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Skipping doses may increase your risk of further infection that is resistant to antibiotics. Rifampin will not treat a viral infection such as the flu or a common cold.
You should not stop using rifampin without your doctor’s advice. Stopping the medicine suddenly and later starting again may cause kidney problems. Rifampin is usually given until lab tests show that the infection has cleared.
While using rifampin, you may need frequent blood tests.
This medicine may affect a drug-screening urine test and you may have false results. Tell the laboratory staff that you use rifampin.
Store at room temperature away from moisture and heat. Keep the bottle tightly closed when not in use.
What happens if I miss a dose?
Use the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not use two doses at one time.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
Overdose can cause worsening symptoms such as nausea, vomiting, stomach pain, itching, headache, lack of energy leading to loss of consciousness, and dark or discolored skin, saliva, tears, urine, or stools.
What should I avoid while using rifampin?
Avoid drinking alcohol. It may increase your risk of liver damage.
Avoid wearing contact lenses. Rifampin may discolor your tears, which could permanently stain soft contact lenses.
Rifampin side effects
Get emergency medical help if you have signs of an allergic reaction (hives, rash, feeling light-headed, wheezing, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning in your eyes, skin pain, red or purple skin rash that spreads and causes blistering and peeling).
Seek medical treatment if you have a serious drug reaction that can affect many parts of your body. Symptoms may include: skin rash, fever, swollen glands, muscle aches, severe weakness, unusual bruising, and joint pain or stiffness.
Call your doctor at once if you have:
severe stomach pain, diarrhea that is watery or bloody;
chest pain, cough, shortness of breath;
a light-headed feeling, like you might pass out;
easy bruising, unusual bleeding (nosebleeds, bleeding gums);
pounding heartbeats or fluttering in your chest;
flu symptoms–fever, chills, body aches, headache, weakness, nausea, vomiting; or
liver problems–upper stomach pain, tiredness, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).
Common side effects may include:
red discoloration of your teeth, sweat, urine, saliva, and tears;
heartburn, gas, upset stomach, loss of appetite;
nausea, vomiting, diarrhea;
headache, dizziness, drowsiness, tiredness;
muscle weakness, pain in your arms or legs;
problems with balance or muscle movement;
confusion, changes in behavior, trouble concentrating.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
What other drugs will affect rifampin?
Sometimes it is not safe to use certain medications at the same time. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective.
Rifampin can harm your liver, especially if you also use certain medicines for infections, tuberculosis, depression, birth control, hormone replacement, high cholesterol, heart problems, high blood pressure, seizures, pain, or arthritis (including Tylenol, Advil, Motrin, or Aleve).
Many drugs can affect rifampin, and some drugs should not be used at the same time. Tell your doctor about all your current medicines and any medicine you start or stop using. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here.
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Copyright 1996-2018 Cerner Multum, Inc. Version: 6.01.
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PRECAUTIONS: Before taking rifampin, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: diabetes, liver problems (e.g., hepatitis), HIV infection, history of alcohol use/abuse.This drug may make you dizzy or drowsy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Limit alcoholic beverages.Before having surgery, tell your doctor or dentist that you are using this drug.During pregnancy, this medication should be used only when clearly needed. When this drug is taken during the last few weeks of pregnancy, the risk of bleeding in both mother and infant may be increased. Tell your doctor immediately if you notice any bleeding in your newborn. Discuss the risks and benefits with your doctor.Rifampin passes into breast milk but is unlikely to harm a nursing infant. Consult your doctor before breast-feeding.
DRUG INTERACTIONS: Your healthcare professionals (e.g., doctor or pharmacist) may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop or change the dosage of any medicine before checking with them first.This drug should not be used with the following medications because very serious interactions may occur: live bacterial vaccines (e.g., oral typhoid), certain non-nucleoside reverse transcriptase inhibitors (nevirapine, delavirdine, etravirine), voriconazole, HIV protease inhibitors (e.g., saquinavir, ritonavir, indinavir).If you are currently using any of these medications listed above, tell your doctor or pharmacist before starting rifampin.Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use.This drug can speed up the removal of other drugs from your body by affecting certain liver enzymes. These affected drugs include (not a complete list): antiarrhythmics (e.g., disopyramide, mexiletine, quinidine), certain anti-cancer drugs (e.g., erlotinib, exemestane, imatinib, irinotecan), anticoagulants (e.g., warfarin, dicumarol), certain anti-infectives (e.g., chloramphenicol, clarithromycin, dapsone, doxycycline, linezolid, telithromycin, zidovudine, quinolones such as ciprofloxacin), certain antimalarial drugs (e.g., atovaquone, quinine), anti-seizure drugs (e.g., phenytoin, phenobarbital, lamotrigine), aprepitant, azole antifungals (e.g., itraconazole, ketoconazole), benzodiazepines (e.g., diazepam, midazolam), certain drugs to lower blood pressure (e.g., enalapril, certain beta blockers such as metoprolol, calcium channel blockers such as verapamil), caspofungin, corticosteroids (e.g., prednisone), certain oral drugs for diabetes (e.g., repaglinide), digitoxin, certain hormone replacement drugs (e.g., estrogens such as conjugated estrogen, progestins such as medroxyprogesterone), certain drugs to suppress the immune system (e.g., cyclosporine, tacrolimus), certain drugs for mental/mood disorders (e.g., clozapine, haloperidol, tricyclic antidepressants such as amitriptyline), narcotic pain relievers (e.g., morphine, methadone), certain drugs for sleep (e.g., ramelteon, eszopiclone, zopiclone), certain statin drugs to lower cholesterol (e.g., atorvastatin, simvastatin), sulfasalazine, theophylline, thyroid medications (e.g., levothyroxine).This medication may decrease the effectiveness of hormonal birth control such as pills, patch, or ring. This could cause pregnancy. Discuss with your doctor or pharmacist if you should use additional reliable birth control methods while using this medication. Also tell your doctor if you have any new spotting or breakthrough bleeding, because these may be signs that your birth control is not working well.This medication may interfere with certain laboratory tests (urine screening for opiates, blood serum folate/vitamin B12), possibly causing false test results. Rifampin may also make it harder for your body to get rid of certain chemicals used in gallbladder tests. Make sure laboratory personnel and all your doctors know you use this drug.This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.
COPD (chronic obstructive pulmonary disease) is the same as adult-onset asthma. See Answer
Rifampin is the generic name of the drug Rifadin, an antibiotic used to treat bacterial infections.
It’s approved to treat all forms of tuberculosis (TB) caused by Mycobacterium tuberculosis, including latent TB infections.
Rifampin is also used to eliminate meningitis-causing Neisseria meningitidis from the nose and throat of people who don’t have symptoms so they don’t spread the infection to others.
Rifampin is in a class of drugs called antimycobacterials. It kills bacteria by blocking the activity of an enzyme the bacteria need to reproduce and survive.
The drug is also effective against most strains of various other bacteria, such as:
- Staphylococcus aureus, including methicillin-resistant Staph aureus (MRSA)
- Staphylococcus epidermidis, the most frequent cause of hospital-acquired staph infection
- Haemophilus influenza, which causes respiratory tract infection
- Mycobacterium leprae, which causes leprosy
Although studies do not show rifampin effectively and safely combats these bacteria, doctors may prescribe the drug off-label to treat the infections they cause.
They may also prescribe it off-label to treat itching related to liver disease and Bartonella infections in people with infected with the human immunodeficiency virus (HIV).
The FDA approved rifampin in 1971. Sanofi pharmaceutical company manufactures the drug.
You shouldn’t take the rifampin if you are hypersensitive to it, any of its components, or related antibiotics (rifamycins).
Some antiviral medications reduce the effectiveness of rifampin, including:
- Darunavir (Prezista)
- Atazanavir (Reyataz)
- Fosamprenavir (Lexiva)
- Saquinavir (Invirase)
- Tipranavir (Aptivus)
Taking rifampin with ritonavir-boosted saquinavir (Invirase), an HIV-antiviral drug, could increase your risk of severe liver damage.
Your doctor will not prescribe rifampin if you have symptoms of meningitis. That’s because the medication increases your risk of rapidly developing a resistant strain of the bacteria causing the infection.
Before taking rifampin, tell your doctor if you have ever had liver problems or liver disease, any condition that affects your adrenal glands, porphyria (disorders that mainly cause nerve or skin problems), or diabetes.
Rifampin may cause your urine, sweat, tears, and mucus to turn reddish. This is a harmless side effect, but it can permanently stain rigid or extended-wear contact lenses.
Pregnancy and Rifampin
Rifampin is an FDA Pregnancy Category C Drug, meaning research in animals indicates it can be harmful to a developing baby, but human studies are lacking.
It should only be used during pregnancy if the potential benefits outweigh the risk to the fetus. You should tell your doctor if you are pregnant or plan to become pregnant while taking this medication.
Because rifampin is excreted in human breast milk and animal studies have shown that the drug has the potential to cause tumors to form, you shouldn’t take it if you are breastfeeding.
Rifampin can decrease the effectiveness and reliability of hormonal contraceptives, including birth control pills, patches, rings, implants, and injections. Talk to your doctor about the most effective contraceptive to use while you are taking rifampin.
Before taking rifampin,
- tell your doctor and pharmacist if you are allergic to rifampin, rifabutin (Mycobutin), rifapentine (Priftin), any other medications, or any of the ingredients in rifampin capsules. Ask your doctor or pharmacist for a list of the ingredients.
- tell your doctor if you are taking any of the following medications: atazanavir (Reyataz), darunavir (Prezista), fosamprenavir (Lexiva), praziquantel (Biltricide), saquinavir (Invirase), tipranavir (Aptivus), or ritonavir (Norvir) and saquinavir (Invirase) taken together. Your doctor will probably tell you not to take rifampin if you are taking any of these medications. If you are taking rifampin and need to take praziquantal (Biltricide), you should wait at least 4 weeks after you stop taking rifampin before you begin to take praziquantel.
- tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: anticoagulants (‘blood thinners’) such as warfarin (Coumadin, Jantoven); antifungals such as fluconazole (Diflucan), itraconazole (Onmel, Sporanox), and ketoconazole; atovaquone (Mepron, in Malarone); barbiturates such as phenobarbital; beta blockers such as atenolol (Tenormin), labetalol (Trandate), metoprolol (Lopressor, Toprol XL), nadolol (Corgard), and propranolol (Inderal, Innopran); calcium channel blockers such as diltiazem (Cardizem, Cartia, Tiazac), nifedipine (Adalat, Procardia), and verapamil (Calan, Verelan); chloramphenicol; clarithromycin (Biaxin); cyclosporine (Gengraf, Neoral, Sandimmune); daclatasvir (Daklinza); dapsone; diazepam (Valium); doxycycline (Monodox, Oracea, Vibramycin); efavirenz (Sustiva); enalapril (Vaseretic); fluoroquinolone antibiotics such as ciprofloxacin (Cipro) and moxifloxacin (Avelox); gemfibrozil (Lopid); haloperidol (Haldol); hormonal contraceptives (birth control pills, patches, rings, or injections); hormone replacement therapy (HRT); indinavir (Crixivan); irinotecan (Camptosar); isoniazid (in Rifater, Rifamate); levothyroxine (Levoxyl, Synthroid, Tirosint); losartan (Cozaar); medications for irregular heartbeat such as digoxin (Lanoxin), disopyramide (Norpace), mexiletine, propafenone (Rythmol), and quinidine (in Nuedexta); medications for seizures such as phenytoin (Dilantin, Phenytek); methadone (Dolophine, Methadose); narcotic medications for pain such as oxycodone (Oxaydo, Xtampza) and morphine (Kadian); ondansetron (Zofran, Zuplenz); oral medications for diabetes such as glipizide (Glucotrol), glyburide (Diabeta), and rosiglitazone (Avandia); probenecid (Probalan); quinine (Qualquin); simvastatin (Flolipid, Zocor), steroids such as dexamethasone (Decadron), methylprednisolone (Medrol), and prednisone; sofosbuvir (Sovaldi); tamoxifen (Soltamox); toremifene (Fareston); trimethoprim and sulfamethoxazole (Bactrim, Septra); tacrolimus(Prograf); theophylline (Elixophyllin, Theo-24); tricyclic antidepressants such as amitriptyline and nortriptyline (Pamelor); zidovudine (Retrovir, in Trizivir), and zolpidem (Ambien). Many other medications may interact with rifampin, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
- if you are taking antacids, take rifampin at least 1 hour before you take the antacids.
- tell your doctor if you are taking or using hormonal contraceptives (birth control pills, patches, rings, implants, and injections). Rifampin can decrease the effectiveness of hormonal contraceptives. You should use another method of birth control while taking this medication. Talk to your doctor about birth control while taking rifampin.
- tell your doctor if you have or have ever had diabetes, porphyria (condition in which certain natural substances build up in the body and may cause stomach pain, changes in thinking and behavior, or other symptoms), any condition that affects your adrenal gland (small gland next to the kidney that produces important natural substances) or liver disease.
- tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while taking rifampin, call your doctor.
- tell your doctor if you wear soft contact lenses. Rifampin may cause permanent red stains on your contact lenses if you wear them during your treatment with rifampin.
What is Rifampin?
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Tenofovir Alafenamide
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Abiraterone Acetate
- Cholera Vaccine, Live
- Dabigatran Etexilate
- Doxorubicin Hydrochloride Liposome
- Ethinyl Estradiol
- Irinotecan Liposome
- Mycophenolate Mofetil
- Mycophenolic Acid
- Vincristine Sulfate Liposome
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Aripiprazole Lauroxil
- Enalapril Maleate
- Morphine Sulfate Liposome
- Valproic Acid
What is rifampicin?
Rifampicin is an antibiotic used to treat serious bacterial infections. It may be prescribed by dermatologists for the treatment of:
- Recurrent boils
- Folliculitis decalvans
- Hidradenitis suppurativa
What infections does rifampicin treat?
It is also used to treat brucellosis, for serious staphylococcal infections, and to clear asymptomatic carriers of Neisseria meningiditis (which can cause meningococcal disease).
Rifampicin is active against a variety of organisms including Staphylococcus aureus, coagulase negative staphylococcus, Mycobacterium tuberculosis, Mycobacterium leprae, Neisseria meningiditis and Brucella species.
How is rifampicin prescribed?
In New Zealand rifampicin is available as:
- Rifadin™ tablets, suspension and intravenous infusion
- Rifinah™ tablets, where it is combined with isoniazid for the treatment of tuberculosis and leprosy
Rifampicin is often prescribed with another antibiotic in order to prevent bacterial resistance, which can develop rapidly if it is used alone.
It should be taken on an empty stomach at least 30 minutes before a meal or 2 hours after a meal. Antacids should be given at least 1 hour after rifampicin.
What are the side effects of rifampicin?
Rifampicin is usually well-tolerated and rarely causes serious toxicity. The commonest side effects involve the skin and the gastrointestinal system.
Discoloured urine while on rifampicin
Effects of bodily fluids
Tears, sweat and urine may become orange coloured by oral rifampicin. Contact lenses may be permanently stained. This effect is usually mild and self-limiting.
Cutaneous adverse reactions
Rifampicin may cause flushing and itching, with or without rash. Other cutaneous reactions reported are:
- Drug-induced urticaria
- Erythema multiforme
- Toxic epidermal necrolysis (rare).
Rifampicin may cause loss of appetite, vomiting, abdominal pain and diarrhoea.
Hepatitis can be caused by rifampicin, particularly if rifampicin is given with isoniazid.
Serious haematological disorders have been reported in patients taking rifampicin, including:
- Thrombocytopenia (low platelet count), which may potentially result in bruising and bleeding
- Low white blood cell count; very rarely, agranulocytosis (severely decreased white blood cell counts)
- Disseminated intravascular coagulation (also very rare).
Muscle weakness and myopathy are uncommon side effects of rifampicin.
Rifampicin is sometimes used intermittently (less than 2 to 3 doses per week) for the treatment of tuberculosis and leprosy. When rifampicin is used in this way, it may be associated with a ‘flu-like syndrome, shortness of breath, low blood pressure, acute renal failure and shock.
Drug interactions with rifampicin
Rifampicin is a P-glycoprotein inducer and may increase the breakdown of other medications, making them less effective. The dosage of these drugs may need adjustment if they are taken together with rifampicin:
- Anticoagulants (warfarin, dabigatran)
- Anticonvulsants (phenytoin)
- Antiarrhythmics (disopyramide, mexiletine)
- Antipsychotics (eg, haloperidol)
- Antifungals (eg, itraconazole)
- Antiretroviral drugs (eg, zidovudine)
- Calcium channel blockers (eg, diltiazem, verapamil)
- Hormonal contraceptives
- Benzodiazepines (eg, diazepam).
Precautions that should be taken when on rifampicin
- Non-hormonal contraceptive methods may be necessary for women of childbearing age when taking rifampicin, due to its effects on oral contraceptives, injected contraceptives, and implanted contraceptives.
- If used in pregnancy, rifampicin may be harmful to the fetus without causing malformations. It appears in breast milk.
- Baseline blood tests should be done in adults, including a blood count, renal function tests, and liver function tests. If there are significant abnormalities, these should be repeated during treatment. Caution should be taken when there is a pre-existing liver disease or liver function abnormalities.
New Zealand approved datasheets are the official source of information for these prescription medicines, including approved uses and risk information. Check the individual New Zealand datasheet on the Medsafe website.
Heartburn, epigastric distress, anorexia, nausea, vomiting, jaundice, flatulence, cramps, and diarrhea have been noted in some patients. Although Clostridium difficile has been shown in vitro to be sensitive to rifampin, pseudomembranous colitis has been reported with the use of rifampin (and other broad spectrum antibiotics). Therefore, it is important to consider this diagnosis in patients who develop diarrhea in association with antibiotic use. Tooth discoloration (which may be permanent) may occur.
Transient abnormalities in liver function tests (e.g., elevations in serum bilirubin, alkaline phosphatase, serum transaminases) have been observed. Rarely, hepatitis or a shock-like syndrome with hepatic involvement and abnormal liver function tests has been reported.
Thrombocytopenia has occurred primarily with high dose intermittent therapy, but has also been noted after resumption of interrupted treatment. It rarely occurs during well-supervised daily therapy. This effect is reversible if the drug is discontinued as soon as purpura occurs. Cerebral hemorrhage and fatalities have been reported when rifampin administration has been continued or resumed after the appearance of purpura.
Rare reports of disseminated intravascular coagulation have been observed.
Leukopenia, hemolytic anemia, decreased hemoglobin, bleeding, and vitamin K-dependent coagulation disorders (abnormal prolongation of prothrombin time or low vitamin K-dependent coagulation factors) have been observed.
Agranulocytosis has been reported very rarely.
Central Nervous System
Headache, fever, drowsiness, fatigue, ataxia, dizziness, inability to concentrate, mental confusion, behavioral changes, muscular weakness, pains in extremities, and generalized numbness have been observed.
Psychoses have been rarely reported.
Rare reports of myopathy have also been observed.
Visual disturbances have been observed.
Menstrual disturbances have been observed.
Rare reports of adrenal insufficiency in patients with compromised adrenal function have been observed.
Elevations in BUN and serum uric acid have been reported. Rarely, hemolysis, hemoglobinuria, hematuria, interstitial nephritis, acute tubular necrosis, renal insufficiency, and acute renal failure have been noted. These are generally considered to be hypersensitivity reactions. They usually occur during intermittent therapy or when treatment is resumed following intentional or accidental interruption of a daily dosage regimen, and are reversible when rifampin is discontinued and appropriate therapy instituted.
Cutaneous reactions are mild and self-limiting and do not appear to be hypersensitivity reactions. Typically, they consist of flushing and itching with or without a rash. More serious cutaneous reactions which may be due to hypersensitivity occur but are uncommon.
Occasionally, pruritus, urticaria, rash, pemphigoid reaction, erythema multiforme, acute generalized exanthematous pustulosis, Stevens-Johnson syndrome, toxic epidermal necrolysis, Drug Reaction with Eosinophilia and Systemic Symptoms syndrome (see WARNINGS), vasculitis, eosinophilia, sore mouth, sore tongue, and conjunctivitis have been observed.
Anaphylaxis has been reported rarely.
Edema of the face and extremities has been reported. Other reactions which have occurred with intermittent dosage regimens include “flu syndrome” (such as episodes of fever, chills, headache, dizziness, and bone pain), shortness of breath, wheezing, decrease in blood pressure and shock. The “flu syndrome” may also appear if rifampin is taken irregularly by the patient or if daily administration is resumed after a drug-free interval.
Read the entire FDA prescribing information for Rifadin (Rifampin)