Rifampicin


Generic Medicine Info
Administration
Should be taken on an empty stomach. Best taken on an empty stomach 1 hr before or 2 hr after meals.
Contraindications
Hypersensitivity to rifampicin or other rifamycins. Jaundice. Concomitant use with saquinavir/ritonavir combination; atazanavir, darunavir, fosamprenavir, saquinavir, tipranavir.
Special Precautions
Patient with current or history of alcoholism, risk factors of vitamin K deficiency (e.g. chronic liver disease, poor nutritional status, receiving prolonged antibacterial or anticoagulant therapy), diabetes mellitus, porphyria. Renal (for doses >600 mg/day) and hepatic impairment. Children. Pregnancy and lactation. Patient Counselling This drug may cause permanent staining of soft contact lenses. Remove soft contact lenses during therapy. Monitoring Parameters Perform culture and susceptibility tests; consult local institutional recommendations before treatment initiation due to antibiotic resistance risks. Monitor LFTs (AST, ALT, bilirubin) at baseline and periodically (every 2-4 weeks) during therapy in patients with pre-existing hepatic impairment; serum creatinine and CBC at baseline and periodically in patients with baseline abnormalities; sputum culture, chest X-ray 2-3 months into treatment, coagulation tests during therapy in patient at risk of vitamin K deficiency.
Adverse Reactions
Significant: Hypersensitivity reactions (e.g. fever, rash, urticaria, angioedema, flu-like syndrome); superinfection (e.g. pseudomembranous colitis), anaemia, leucopenia, thrombocytopenia (with or without purpura), discolouration (yellow, orange, red, or brown) of teeth, urine, sweat sputum, tears; vitamin K-dependent coagulopathy, bleeding. Eye disorders: Visual disturbances. Gastrointestinal disorders: Nausea, vomiting. General disorders and administration site conditions: Chills, fatigue, pyrexia. Investigations: Increased blood bilirubin, AST, ALT. Metabolism and nutrition disorders: Facial or peripheral oedema. Musculoskeletal and connective tissue disorders: Muscle weakness, pain in extremities. Nervous system disorders: Headache, dizziness, drowsiness, generalised numbness. Psychiatric disorders: Mental confusion, behavioural changes, inability to concentrate. Reproductive system and breast disorders: Menstrual disturbances.
Potentially Fatal: Hepatotoxicity (e.g. hyperbilirubinaemia, elevated liver enzymes, jaundice, hepatitis, fulminant liver failure) severe cutaneous reactions (e.g. Stevens-Johnson syndrome, toxic epidermal necrolysis, drug reaction with eosinophilia and systemic symptoms (DRESS), acute generalised exanthematous pustulosis).
Drug Interactions
May increase the risk of hepatotoxicity when given with halothane or isoniazid. May decrease the serum concentrations, thus reducing the efficacy of praziquantel. May enhance the adverse effect, particularly bleeding, when given concomitantly with cefazolin and other cephalosporins containing N-methylthiotetrazole side chain. May increase metabolism and decrease serum concentrations and effects of antiarrhythmics (e.g. disopyramide, quinidine), antiepileptics (e.g. phenytoin,), barbiturates, hormone antagonist (e.g. tamoxifen, toremifene), antipsychotics (e.g. haloperidol, aripiprazole), anticoagulants (e.g. warfarin), antifungals (e.g. fluconazole, ketoconazole), other antiretrovirals (e.g. zidovudine, indinavir, efavirenz), hepatitis C antiviral drugs (e.g. daclatasvir), beta-blockers (e.g. bisoprolol), Ca channel blocker (e.g. diltiazem), anxiolytics and hypnotics (e.g. diazepam), certain antibacterials (e.g. chloramphenicol, clarithromycin), corticosteroids, cardiac glycosides, hormonal contraceptives (e.g. oestrogens, progestogens), antidiabetic agents (e.g. glipizide, rosiglitazone), immunosuppressants (e.g. ciclosporin, tacrolimus), thyroid hormone (e.g. levothyroxine), analgesics (e.g. methadone, morphine), selective 5-HT3 receptor antagonists (e.g. ondansetron), statins that are metabolised by CYP3A4 (e.g. simvastatin), TCAs (e.g. amitriptyline, nortriptyline), cytotoxics (e.g. imatinib), enalapril, losartan, irinotecan, theophylline, quinine, riluzole. Absorption may be reduced by antacids. Concomitant use with atovaquone increased plasma concentrations of rifampicin and decreased plasma concentrations of atovaquone. Increased plasma concentrations with probenecid and trimethoprim-sulfamethoxazole.
CIMS Class
ATC Classification
J04AB02 - rifampicin ; Belongs to the class of antibiotics. Used in the systemic treatment of tuberculosis.
Disclaimer: This information is independently developed by CIMS based on rifampicin from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to CIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, CIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2021 CIMS. All rights reserved. Powered by CIMSAsia.com
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