Rifampin
Mechanism :
This drug inhibits RNA synthesis of mycobacteria. It accomplishes this by inhibiting DNA dependent RNA polymerase. It spares the enzyme in human cells and is not toxic to humans. Inhibits DNA-dependent RNA polymerase by binding to beta subunit, which their blocks RNA transcription; potent enzyme inducer.
Indication :
- For the treatment of drug susceptible tuberculosis
- For the treatment of drug susceptible tuberculosis in persons living with HIV
- For the treatment of drug resistant tuberculosis
- For carriers of meningococcus in asymptomatic patients
- For prophylaxis of tuberculosis
- For hemophilus influenza type B prophylaxis
- For the treatment of leprosy
- For treatment of infective endocarditis.
- For treatment of CNS infections
Contraindications :
• Hypersensitivity reactions
• C. difficile associated diarrhea
• Contact lens wearers
• Hepatic disease
• Diabetes mellitus
• Serious rash
• Breastfeeding
Dosing :
For the treatment of drug susceptible tuberculosis:
Adolescents: 10-20 mg/kg/dose per oral once daily or 5 days/week.
Infants and children: 10-20 mg/kg/dose per oral once daily or 5 days/week.
For the treatment of drug susceptible tuberculosis in persons living with HIV:
Adolescents, infants and children: 10-20 mg/kg/dose per oral once daily or 5 days/week.
For the treatment of drug resistant tuberculosis:
Adolescents, infants and children: 10-20 mg/kg/dose per oral once daily.
For carriers of meningococcus in asymptomatic patients:
Infants, children and adolescents: 10 mg/kg/dose per oral every 12 hours for 2 days.
Neonates: 5 mg/kg/dose per oral every 12 hours for 2 days.
For prophylaxis of latent tuberculosis:
Infants, children and adolescents: 10-20 mg/kg/dose per oral once daily for 4-6 months.
For hemophilus influenza type B prophylaxis:
Adolescents and children: 20 mg/kg per oral once a day for 4 days.
Neonates: 10 mg/kg per oral daily for 4 days
.
For the treatment of leprosy:
Paucibacillary disease
:
Infants, children and adolescents: 10-20 mg/kg/dose per oral once a day with
dapsone for 1 year.
Multibacillary disease:
Infants, children, and adolescents: 10-20 mg/kg/dose per oral daily with
dapsone and
clofazimine for 2 years.
Adverse Effect :
vomiting, diarrhea, flushing, fever, rash, dizziness, weakness, fatigue, hepatitis, bleeding, anemia, hemolysis, dyspnea, conjunctivitis, palpitations etc
Interaction :
• Major reactions with NRTI’s
• Major reactions with afatinib
• Major reactions with amoxicillin, clarithromycin and omeprazole
• Major reaction with apixaban
• Major reaction with aprepitant
• Major reaction with aripripazole
• Major reaction with aspirin
• Major reaction with buspirone
• Major reaction with canagliflozin
• Major reaction with carbamazepine
• Major reaction with conjugated estrogens
• Major reaction with doxycycline
• Major reaction with NNRTI’s
• Major reactions with phenytoin
• Major reactions with lamotrigine
• Major reactions with olanzapine
• Major reactions with omeprazole
• Major reactions with risperidone
• Major reactions with sirolimus
Lactation :
Hepatic Dose :
Use only when benefit exceeds risk