Rifampin

Dosing

Usual dose10 mg/kg PO q24h (max 600 mg)

  • BW <50 kg: 450 mg PO q24h

  • BW ≥50 kg: 600 mg PO q24hNo renal dose adjustment

10-20 mg/kg PO div q12-24hNo renal dose adjustment

Hepatic impairmentUse with caution

General Information

  • Tuberculosis

  • Tuberculosis - HIV infection

  • Meningococcal infectious disease, carrier

Rifampin is used clinically in the management of infections due to mycobacteria.

Perform liver function tests (ALT and AST levels) at baseline.

Perform bilirubin level, serum creatinine level, and CBC panel (including platelets) at baseline and continue follow-up monitoring in patients who have abnormalities.

Obtain acid-fast bacilli smear and culture from sputum until 2 consecutive culture specimens are negative.

Perform chest x-rays after 2-3 months of treatment and at end of treatment.

Monitor coagulation tests in patients at risk of vitamin K deficiency.

Serious

  • Hepatotoxicity

  • Hypersensitivity reaction

  • Anaphylaxis

  • Nephrotoxicity

  • Renal failure

  • Agranulocytosis

  • Disseminated intravascular coagulation

Multiple drug-drug interactions

CYP450, transporter interactions:

  • Substrate of: OATP1B1, PGP

  • Induces: 1A2, 2B6, 2C8/9, 2C19, 2D6, 3A4, PGP

  • Inhibits: OAT, OATP1B1

Antimicrobial class: Antitubercular, Rifamycin

Pregnancy category: C

Average serum half life: 1.5-5 hours

CSF penetration: Therapeutic

Precautions:

  • Doses greater than 600 mg 1-2 times weekly increase risk of serious adverse effects (shortness of breath, shock, anaphylaxis, and renal failure).

  • Severe hepatic dysfunction have been reported in patients with liver dysfunction and concomitant hepatotoxic agents; monitoring is recommended and discontinuation may be necessary.

  • Discontinue use if systematic hypersensitivity reactions are suspected.

  • Monitoring recommended in patients at risk of vitamin K deficiency and consider discontinuation if abnormal coagulation tests and/or bleeding occurs.

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