Drug Index


Mechanism :

Rifampin inhibits DNA-dependent RNA polymerase activity in susceptible cells. Specifically, it interacts with bacterial RNA polymerase but does not inhibit the mammalian enzyme. Rifampin at therapeutic levels has demonstrated bactericidal activity against both intracellular and extracellular Mycobacterium tuberculosis organisms.

Indication :

  • Tuberculosis
  • Staphylococcal infections
  • Meningococcal Infection prophylaxis
  • H influenza prophylaxis (off-label)
  • Cholestasis - pruritus

Contraindications :

Rifampin is contraindicated in patients with a history of hypersensitivity to any of the rifamycin’s.

Dosing :

Tuberculosis in combination with other drugs:
10-20 mg/kg PO as single morning dose. Max: 600 mg/day.
Meningococcal Infection prophylaxis:
≤1 month: 10 mg/kg/day PO in 12 hourly divided doses for two days.
>1 month; 20 mg/kg/day in in 12 hourly divided doses for two days.
Maximum dose:
600 mg/day.
H Influenza prophylaxis:
≤1 month: 10 mg/kg/day PO for four days.
>1 month: 20 mg/kg/day PO for four days: Maximum dose: 600 mg/day.
5-10 mg/kg (Max: 600 mg) once daily.

Adverse Effect :

Anorexia, nausea, vomiting, abdominal discomfort, diarrhea, pseudo-membranous colitis, flushing, urticaria, rash, red man syndrome, orange discoloration of urine and body fluids, discoloration of the contact lenses, thrombocytopenia with or without purpura, leukopenia, eosinophilia. Immunological reactions: flu-like symptoms, with chills, fever, dizziness, bone pain, shortness of breath and wheezing, acute hemolytic anemia, acute renal failure and thrombocytopenic purpura, alterations of liver function. Miscellaneous: edema, muscular weakness, and menstrual disturbances.

Interaction :

Anticonvulsants, Antiarrhythmics, Oral Anticoagulants, Antifungals, Itraconazole, Ketoconazole, Barbiturates, Beta-Blockers, Calcium Channel Blockers Diltiazem, Nifedipine, Verapamil, Chloramphenicol, Clarithromycin, Corticosteroids, Cyclosporine, Cardiac Glycoside Preparations, Clofibrate, Oral or other Systemic Hormone Contraceptives, Dapsone, Diazepam, Doxycycline, Fluoroquinolones, Haloperidol, Oral Hypoglycemic Agents (Sulfonylureas), Levothyroxine, Methadone, Narcotic Analgesics, Nortriptyline, Progestins, Quinine, Tacrolimus, Theophylline Tricyclic Antidepressants (e.g., Amitriptyline, Nortriptyline), and Zidovudine: Rifampin has been reported to accelerate the metabolism.
Oral or other Systemic Hormonal Contraceptives: Should be advised to change to nonhormonal methods of birth control during rifampin therapy.
Anticoagulant Drugs of the Coumarin Type: It is recommended that the prothrombin time be performed daily or as frequently as necessary to establish and maintain the required dose of anticoagulant.
Ketoconazole: Concurrent use of ketoconazole and rifampin has resulted in decreased serum concentrations of both drugs.
Enalapril: Concurrent use of rifampin and enalapril has resulted in decreased concentrations of enalaprilat, the active metabolite of enalapril.
Concomitant antacid administration may reduce the absorption of rifampin.
Probenecid and Cotrimoxazole: have been reported to increase the blood level of rifampin
Halothane or Isoniazid: The potential for hepatotoxicity is increased. The concomitant use of rifampin and halothane should be avoided. Patients receiving both rifampin and isoniazid should be monitored close for hepatotoxicity.
Sulfapyridine: Plasma concentrations of sulfapyridine may be reduced following the concomitant administration of sulfasalazine and rifampin.

Renal Dose :

Dose in Renal Impairment GFR (mL/min)
20-50Dose as in normal renal function
10-20Dose as in normal renal function
<1050% – 100% of normal dose

Dose in Patients undergoing Renal Replacement Therapies
CAPDNot dialysed. Dose as in GFR<10 mL/min
HDNot dialysed. Dose as in GFR<10 mL/min
HDF/High fluxNot dialysed. Dose as in GFR<10 mL/min
CAV/VVHDUnknown dialysability. Dose as in normal renal function

Hepatic Dose :

Patients with impaired liver function should only be given rifampicin if necessary under close medical supervision. If signs of hepatocellular damage occur, rifampicin should be withdrawn.
03/24/2024 10:46:51 Rifampicin
Disclaimer: The information given by www.pediatriconcall.com is provided by medical and paramedical & Health providers voluntarily for display & is meant only for informational purpose. The site does not guarantee the accuracy or authenticity of the information. Use of any information is solely at the user's own risk. The appearance of advertisement or product information in the various section in the website does not constitute an endorsement or approval by Pediatric Oncall of the quality or value of the said product or of claims made by its manufacturer.
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0