Rifampicin

Indications
 Oral
Tuberculosis
Adult: 10 mg/kg daily or 2-3 times wkly. Max: 600 mg/day.
Child: 10-20 mg/kg daily or 2-3 times wkly. Max: 600 mg/day.
Hepatic impairment: Dosage reduction may be necessary.
Oral
Leprosy
Adult: 600 mg once mthly.
Child: 10-14 yr: 450 mg once mthly; <10 yr: 300 mg once mthly.
Hepatic impairment: Dosage reduction may be necessary.
Oral
Prophylaxis against meningococcal meningitis
Adult: 600 mg bid for 2 days.
Child: 1-12 yr: 10 mg/kg; <12 mth: 5 mg/kg, doses to be given bid for 2 days.
Hepatic impairment: Dosage reduction may be necessary.
Oral
Prophylaxis against meningitis due to Haemophilus influenzae
Adult: 600 mg daily for 4 days.
Child: 1-3 mth: 10 mg/kg/day; >3 mth: 20 mg/kg/day. Doses to be taken once daily for 4 days. Max: 600 mg/day.
Hepatic impairment: Dosage reduction may be necessary.
Oral
Legionnaire's disease
Adult: 600-1200 mg daily, in divided doses. May also be given via IV infusion.
Child: ≤1 yr: 5-10 mg/kg bid; 1-18 yr: 10 mg/kg (max: 600 mg) bid. May be given via mouth or IV infusion.
Hepatic impairment: Dosage reduction may be necessary.
Oral
Brucellosis
Adult: 600-1200 mg daily, in divided doses. May also be given via IV infusion.
Child: ≤1 yr: 5-10 mg/kg bid; 1-18 yr: 10 mg/kg (max: 600 mg) bid. May be given via mouth or IV infusion.
Hepatic impairment: Dosage reduction may be necessary.
Oral
Staphylococcal infections
Adult: 600-1200 mg daily, in divided doses. May also be given via IV infusion.
Child: ≤1 yr: 5-10 mg/kg bid; 1-18 yr: 10 mg/kg (max: 600 mg) bid. May be given via mouth or IV infusion.
Hepatic impairment: Dosage reduction may be necessary.
Contraindications
 Hypersensitivity, jaundice, severe hepatic disease. IM/SC admin. Porphyria. Not to be used for treatment of meningococcal disease.
Warnings / Precautions
 Impaired hepatic or renal function. Elderly, malnourished or very young patients. Alcoholic patients. Monitor blood counts and liver function regularly. Body fluids may colour orange-red. Discontinue use if thrombocytopenia or purpura occurs. Pregnancy and lactation. Care should be taken during IV admin to prevent extravasation.
Adverse Reactions
 GI disturbances, pseudomembranous colitis (rare), abnormalities of liver function, fatalities in those with liver disorders, influenza-like symptoms, skin reactions, eosinophilia, transient leucopenia, thrombocytopenia, purpura, shock, drowsiness, headache, ataxia, visual disturbances, menstrual irregularities. Reddish coloured urine and tears. IV: Thrombophloebitis; extravasation following local irritation and inflammation.
Potentially Fatal: Hepatitis or shock-like syndrome with hepatic involvement.
Overdose Reactions
 May lead to nausea, vomiting, abdominal pain, pruritus, headache and lethargy. Hypotension, ventricular arrhythmias, seizures and cardiac arrest may occur in fatal cases.
Drug Interactions
 Increased metabolism of chloramphenicol, clofibrate, dapsone, digoxin, hexobarbitone, ketoconazole and quinidine. Absorption may be decreased when taken with antacids, anticholinergics, opioids and ketoconazole. Increased metabolism of losartan and its active metabolite, diazepam and nitrazepam. Reduces serum levels of aprepitant, atovaquone, bisoprolol, carvedilol, metoprolol, propanolol, buspirone, bunazosin, diltiazem, nifedipine and verapamil. Increased risk of transplant rejection when used with ciclosporin. Decreases effects of tolbutamide, clofibrate, coumarin anticoagulants, diazepam and oral contraceptives.
Potentially Fatal: May reduce efficacy of corticosteroids in Addison's disease and induce an addisonian crisis.
See Below for More rifampicin Drug Interactions
Lab Interactions
 Interferes with colorimetric tests, including bromsulphothalein tests of liver function and bilirubin assays. Erroneous low readings of vitamin B12 and folates may occur.
Mechanism of Actions
 Rifampicin has a broad-spectrum bactericidal action which inhibits bacterial RNA synthesis by binding to the β subunit of DNA-dependent RNA polymerase, thus blocking RNA transcription. It is commonly used in the treatment of tuberculosis, leprosy and opportunistic atypical mycobacterial infections.
Absorption: Readily absorbed from the GI tract (oral); peak plasma concentrations after 2-4 hr. May be reduced and delayed in the presence of food.
Distribution: Body tissues and fluids, CSF (increased during meningitis), crosses the placenta and enters into breast milk. Protein-binding: 84-91%
Metabolism: Hepatic; converted to 25-O-desacetylrifampicin.
Excretion: Via faeces (60% of the dose).
Administration
 Should be taken on an empty stomach. (Best taken on an empty stomach 1 hr before or 2 hr after meals.)
Storage Conditions
 Oral: Avoid excessive heat and protect from light.
ATC Classification
 J04AB02 - rifampicin ; Belongs to the class of antibiotics. Used in the systemic treatment of tuberculosis.
Storage
 Oral: Avoid excessive heat and protect from light.
Available As
  • Rifampicin 100 mg
  • Rifampicin 120 mg
  • Rifampicin 150 mg
  • Rifampicin 20 mg
  • Rifampicin 200 mg
  • Rifampicin 225 mg
  • Rifampicin 250 mg
  • Rifampicin 300 mg
  • Rifampicin 450 mg
  • Rifampicin 450 mg (4 tab)
  • Rifampicin 50 mg
  • Rifampicin 500 mg
  • Rifampicin 60 mg
  • Rifampicin 600 mg
  • Rifampicin 750 mg

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