RIFAMPICIN

 

Indication

- In associationb with other anti TB drug to treat TB... See protocol TB

Dose

patient weight	30-39 kg	40-49 kg	>50 kg
R= Rifampicin (rif)	300 mg	450 mg	600 mg

 

 

- Since bacterial resistance may develop rapidly when rifampin is administered alone in the treatment of tuberculosis,Rifampin is indicated in combination with other antituberculosis medications in the treatment of all forms of tuberculosis, including tuberculous meningitis.
The duration of treatment with an antituberculosis regimen is at least 6 months and may be continued for to 2 years...

- Rifampin does not accumulate in patients with impaired renal function

- Rifampin preferably should be taken with a full glass (240 mL) of water on an empty stomach (either 1 hour before or 2 hours after a meal) to obtain optimum absorption. However, it may be taken with food if gastrointestinal irritation occurs.

- Clinical effects of rifampin overdose : Mental obtundation (mental changes); periorbital or facial edema (swelling around the eyes or the whole face); pruritus, generalized (itching over the whole body); Redman syndrome (red-orange discoloration of skin, mucous membranes, and sclera)

 

Possible side/adverse effect

- Gastrointestinal disturbances (diarrhea; stomach cramps)

- yellow eyes or skin... do not need care if no other hepatic signs... ictere will go down after a few weeks.

- Reddish-orange to reddish-brown discoloration of urine, feces, saliva, sputum, sweat, and tears Nothing to do.Tears discolored by rifampin may also discolor soft contact lenses.

-"Flu-like" syndrome (chills; difficult breathing; dizziness; fever; headache; muscle and bone pain; shivering)

- hypersensitivity (itching; redness; skin rash)

- Incidence rare

+Blood dyscrasias (sore throat; unusual bleeding or bruising)

+ hepatitis prodromal symptoms (loss of appetite; nausea or vomiting; unusual tiredness or weakness)

+ interstitial nephritis (bloody or cloudy urine, greatly decreased frequency of urination or amount of urine)
Those indicating need for medical attention only if they continue or are bothersome

+ Fungal overgrowth (sore mouth or tongue)
Those not indicating need for medical attention

Attention! It is rare that we must discontinue rifampicin treatment. Mild side effect (icteric, prurit...) are better than TB treatment without rifampicin!

 

Drug interactions and/or related problems

Alcohol concurrent daily consumption of alcohol may increase the risk of rifampin-induced hepatotoxicity and increased metabolism of rifampin; dosage adjustments of rifampin may be necessary, and patients should be monitored closely for signs of hepatotoxicity)

Aminophylline or theophylline rifampin may decrease theophylline, and aminophylline concentration

Azole antifungals concurrent use may lowering the azole antifungals plasma concentrations; depending on the clinical situation, the dose of an azole antifungal may need to be increased during concurrent use with rifampin

Barbiturates concurrent use with rifampin may ower serum concentrations; there are conflicting data on rifampin's effect on phenobarbital; dosage adjustment may be required

Chloramphenicol concurrent use with rifampin may lower serum chloramphenicol concentrations; dosage adjustment may be necessary

Corticosteroids, glucocorticoid and mineralocorticoid concurrent use with rifampin mayresulting in a considerable decrease in corticosteroid plasma concentrations; dosage adjustment may be required

Dapsone concurrent use with rifampin may decrease dapsone concentrations

Diazepam concurrent use with rifampin may decreased plasma concentrations of diazepam, dosage adjustment may be necessary

Digitalis glycosides concurrent use with rifampin may resulting in significantly lower serum digoxin or digitoxin concentrations; dosage adjustment may be necessary

Phenytoin concurrent use with rifampin may decrease phenytoin level and dosage adjustments of phenitoin may be necessary

Trimethoprim concurrent use with rifampin may significantly decrease the trimethoprim concentration

Other informations

- Store below 40 °C.

- Store in a tight, light-resistant container.