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Rifampin

Rifampin is a common name for the drug Rifadine, an antibiotic used to treat bacterial infections.
It is approved for the treatment of all forms of tuberculosis, including latent tuberculosis infections.
Rifampin is also used to eliminate meningitis.
Rifampin is in a class of drugs called antimycobacteria. It kills bacteria, blocking the activity of the enzyme, which bacteria must reproduce and through which to survive.
The drug is also effective against most strains of various other bacteria, such as:

  • Staphylococcusaureus, including methicillin-resistant Staphaureus (MRSA)
  • Staphylococcusepidermidis, the most common cause of hospitalized staph infection
  • Hemophilus influenza, which causes an infection of the respiratory tract
  • Mycobacteriumleprae, which causes leprosy

Although studies do not show that rifampicin effectively and safely fights against these bacteria, doctors can prescribe a drug to treat the infections that they cause.
The FDA approved rifampicin in 1971. Pharmaceutical company Sanofi produces this drug.

Edit Warnings

You should not take rifampicin if you have hypersensitivity to it, any of its components or its associated antibiotics (rifamycins).
Some antiviral drugs reduce the effectiveness of rifampicin, including:

  • Darunavir (Presista)
  • Atazanavir (Reietetz)
  • Fosamprenavir (Lexiva)
  • Saquinavir (Invirase)
  • Tipranavir (Aptivus)

Taking rifampicin with activated ritonavir saquinavir (Invirase), an antiviral drug against HIV, can increase the risk of serious liver damage.
Your doctor will not prescribe rifampicin if you have symptoms of meningitis. This is because the drug increases the risk of rapid development of a resistant strain of bacteria that cause infection.
Before taking rifampin, tell your doctor if you have ever had liver problems.
Rifampin can repaint your urine, sweat, tears and mucus in a reddish color. This is a harmless side effect, but it can also permanently stain contact lenses.

Pregnancy and rifampin

Rifampin can harm a developing child.
It should be used during pregnancy only 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.
The drug can cause the formation of tumors, you should not take it when breastfeeding.
Rifampin can reduce the effectiveness and reliability of hormonal contraceptives, including birth control pills, patches, rings, implants and injections. Talk with your doctor about the most effective use of contraceptives during rifampicin intake.

Side effects of rifampin

  • Heartburn
  • An upset stomach and seizures
  • Gases
  • Diarrhea
  • Headache
  • Drowsiness
  • Fatigue
  • Dizziness
  • Inability to concentrate
  • Confusion and behavioral changes
  • Muscle weakness, pain in the hands or feet
  • Changes in vision
  • Painful or irregular menstruation
  • Itching
  • Lack of coordination

Severe side effects

Contact your doctor if you experience the following problems:

  • Fever
  • Loss of appetite
  • Malaise
  • Nausea and vomiting
  • Dark urine
  • Jaundice (yellowing of the skin and eyes)
  • Pain or swelling of the joints

Rare side effects:

The following side effects have been reported:

  • Myopathy (muscle disease)
  • Psychosis
  • Adrenal insufficiency
  • Kidney problems
  • Hepatitis

Interactions

You should always tell your doctor about any medications that you take, as rifampin can interact with a wide range of medicines, including the following types of medications:

  • Antacids
  • Anticonvulsant
  • Antiarrhythmic drugs
  • Anticoagulants
  • Antifungal
  • Barbiturates
  • Calcium channel blockers
  • Antibiotics
  • Corticosteroids
  • Cardiac glycosides
  • Hypoglycemic agents, including sulfonylureas
  • Narcotic painkillers
  • Progestins
  • Tricyclic antidepressants

Rifampin also interacts with the following drugs:

  • Atovaquone-Proguanil (Malarone)
  • Digitoxin (lanoxin)
  • Cyclosporin (Restasis) Clofibrate
  • Dapsone
  • Diazepam (Valium)
  • Haloperidol (Haldol)
  • Halothane (Fluuotan)
  • Isoniazid (Laniazid, Nydrazid and others, in Rifamate, IsonaRif and Rifater)
  • Levothyroxine (synthroid)
  • Methadone
  • Probenecid (Benimid and Probalan, in Proben-S and Kolbenemide)
  • Quinine
  • Sulfasalazine (Azulfidine)
  • Tacrolimus (Prograf, Advagraf)
  • Theophylline (Theo-24)
  • Zidovudine (Retrovir)

Rifampin and Alcohol

Drinking alcohol while taking rifampicin may increase the risk of liver damage.

Rifampin and other interactions

Rifampin can give false positive results in urinalysis. It can also interfere with other laboratory tests, including blood tests based on folate and vitamin B12, as well as liver and gallbladder function tests.

Dosage of rifampin

Rifampin is supplied in the form of oral capsules or in solution for intravenous use.
To treat adults with TB, rifampin should be taken once a day with a full glass of water, either one hour before meals or two hours after it.
The initial phase of treatment requires that it be taken with isoniazid and pyrazinamide for two months. It may also require a fourth drug – streptomycin or ethambutol.
After this initial course, doctors prescribe another four months of treatment with rifampin and isoniazid.
If you are taking rifampin, you should undergo a course of treatment, even if you get better. Completion of treatment ensures that the bacteria causing the infection are completely destroyed and do not become resistant.

Rifampin overdose

Symptoms of overdose include

  • Nausea and vomiting
  • Abdominal pain
  • Severe itching
  • Headache
  • Increased lethargy
  • Unconsciousness
  • Liver enlargement

Contact a toxicology center or an emergency department if you suspect that you have taken too much rifampicin.

Missed dose of Rifampin

The absence of a dose of rifampicin may increase the risk of developing low blood platelet counts and hypersensitivity to the drug in the kidneys.
Take the missed dose as soon as you remember. But if it’s time for the next dose, skip it and call your doctor.

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