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ANTIINFECTIVES FOR SYSTEMIC USE › ANTIMYCOBACTERIALS › DRUGS FOR TREATMENT OF TUBERCULOSIS › Antibiotics
rifapentine
J04AB05
Adult Dosing
- Latent tuberculosis infection (LTBI): 900 mg (six 150 mg tablets) once weekly for 3 months (12 doses) administered with isoniazid
- Active pulmonary tuberculosis: 600 mg twice weekly during the intensive phase (with other anti-TB drugs) or 600 mg once weekly in the continuation phase
Pediatric Dosing
- Ages 2 years and older for LTBI (isoniazid-rifapentine regimen): Dosed by weight, 900 mg max once weekly for 12 weeks
- Safety and efficacy in children under 2 years of age have not been established
Indications
- Treatment of pulmonary tuberculosis (in combination with other antituberculosis agents)
- Treatment of latent Mycobacterium tuberculosis infection in patients at high risk for disease progression
Mechanism of Action
- Inhibits DNA-dependent RNA polymerase in susceptible strains of Mycobacterium tuberculosis, leading to suppression of RNA synthesis and cell death
Contraindications
- Known hypersensitivity to rifamycins (e.g., rifampin, rifabutin)
- Patients with active tuberculosis with HIV infection receiving certain antiretroviral therapy regimens affected by CYP induction
Adverse Reactions
- Red-orange discoloration of body fluids (urine, sweat, tears, saliva)
- Hepatotoxicity (elevated transaminases, jaundice, hepatitis)
- Hypersensitivity reactions (flu-like syndrome, rash, thrombocytopenia, anemia)
- Gastrointestinal upset (nausea, vomiting, dyspepsia)
Drug Interactions
- Potent inducer of CYP3A4 and CYP2C8/9; may significantly decrease serum concentrations of antiretrovirals, hormonal contraceptives, anticoagulants, and corticosteroids
- Concurrent use with PZA and isoniazid increases risk of hepatotoxicity
- May reduce efficacy of systemic hormonal contraceptives; alternative non-hormonal birth control is recommended
Curated Content: Needs Vetting Before Put to Clinical Use