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ANTIINFECTIVES FOR SYSTEMIC USE › ANTIMYCOBACTERIALS › DRUGS FOR TREATMENT OF TUBERCULOSIS › Antibiotics
rifampicin
J04AB02
Forms & Strengths
- Capsules: 150 mg, 300 mg
- IV Injection: 600 mg vial
Adult Dosing
- Tuberculosis: 10 mg/kg (max 600 mg) daily or 3 times weekly
- Meningococcal prophylaxis: 600 mg twice daily for 2 days
Pediatric Dosing
- Tuberculosis (neonates/infants/children): 10-20 mg/kg (max 600 mg) daily
- Meningococcal prophylaxis (>1 month): 10 mg/kg (max 600 mg) every 12 hours for 2 days
Indications
- Treatment of all forms of tuberculosis
- Elimination of Neisseria meningitidis carriage
- Treatment of serious staphylococcal infections in combination with other agents
Mechanism of Action
- Inhibits bacterial DNA-dependent RNA polymerase, blocking RNA transcription and leading to cell death
Contraindications
- Hypersensitivity to rifamycins
- Concomitant use with darunavir, atazanavir, and certain other direct-acting antivirals due to severe hepatotoxicity or loss of efficacy
- History of rifampin-induced hepatic disease
Adverse Reactions
- Red-orange discoloration of body fluids (urine, sweat, tears)
- Hepatotoxicity (elevated transaminases, jaundice, fatal hepatitis)
- Gastrointestinal upset (nausea, vomiting, diarrhea)
- Hypersensitivity reactions (fever, rash, thrombocytopenia, hemolytic anemia)
Drug Interactions
- Potent inducer of CYP3A4, CYP2C9, CYP2C19, and P-glycoprotein, significantly decreasing concentrations of many co-administered drugs
- Decreases efficacy of hormonal contraceptives
- Reduces serum concentrations of anticoagulants (warfarin), antiarrhythmics, azole antifungals, and immunosuppressants (cyclosporine)
Curated Content: Needs Vetting Before Put to Clinical Use