Generic
Rifampicin
8 brands available in the market
At a glance
Rifampicin is an antibiotic used for the treatment of tuberculosis and the meningococcal carrier state. It suppresses initiation of chain formation for RNA synthesis in susceptible bacteria by binding to the β subunit of DNA-dependent RNA polymerase, blocking RNA transcription.
Description
Rifampicin binds to the β subunit of DNA-dependent RNA polymerase, suppressing initiation of chain formation for RNA synthesis and blocking RNA transcription. It is used for all forms of tuberculosis and meningococcal carrier state.
Indications
- Tuberculosis (all forms)
- Meningococcal carrier state
Therapeutic class
Anti-tubercular antibiotics
Pharmacological class
Rifamycin (RNA Polymerase Inhibitor)
Pharmacology
Rifampicin binds to the β subunit of DNA-dependent RNA polymerase, suppressing chain formation for RNA synthesis and blocking RNA transcription. It exhibits bactericidal activity and is active against a broad range of bacteria including Mycobacterium tuberculosis.
Mechanism of action
Prevents bacterial RNA synthesis by inhibiting RNA polymerase.
Dosage
Adult Dose (Oral/IV):
- Tuberculosis: 10 mg/kg/day (max 600 mg/day) OR 2-3 times weekly
- Leprosy: 600 mg once monthly
- Meningococcal meningitis prophylaxis: 600 mg twice daily for 2 days
- Haemophilus influenzae meningitis prophylaxis: 600 mg/day for 4 days
- Hepatic impairment: Max 8 mg/kg/day
Pediatric Dose (Oral/IV):
- Tuberculosis: 10-20 mg/kg (max 600 mg/day)
- Twice weekly: 10-20 mg/kg/dose
Administration
- Take on an empty stomach (at least 1 hour before or 2 hours after meals)
- Take with a full glass of water
- Take at the same time each day
- IV: Dilute in 500 mL D5W or NS, infuse within 3 hours
Missed dose
If you miss a dose, take it as soon as possible; if almost time for next dose, skip it; do not double the dose.
Side effects
Side Effects:
- Orange-red discoloration of urine, sweat, saliva, feces (normal)
- Flushing and itching
- Flu-like syndrome (fever, chills, headache, bone pain)
- Nausea, vomiting, anorexia, diarrhea
- Elevated liver enzymes
- Thrombocytopenia
- Eosinophilia, leukopenia
- Hemolytic anemia
Precautions & warnings
- Liver dysfunction may occur; monitor LFT before and every 2-4 weeks during therapy
- Discontinue if signs of hepatocellular damage occur
- Enzyme-inducing properties; interactions with other drugs
- Avoid contact lenses (may cause discoloration)
- Use in last weeks of pregnancy may cause postnatal hemorrhage
Contraindications
- Hypersensitivity to rifampicin or other rifamycins
- Patients with jaundice
- Concurrent use with saquinavir/ritonavir therapy
Drug interactions
- Drugs metabolized by CYP450 (quinidine, phenytoin, theophylline): Increased metabolism and reduced effect
- Atovaquone: Decreased concentrations
- Ketoconazole: Decreased serum concentrations of both drugs
- Enalaprilat: Decreased serum concentrations
- Antacids: Reduced absorption
- Halothane or isoniazid: Increased risk of hepatotoxicity
- Potentially fatal: Increased risk of hepatotoxicity with saquinavir/ritonavir
Food interactions
Alcohol consumption with Rifampicin is unsafe.
Use in pregnancy
Use in Pregnancy: May be unsafe during pregnancy; animal studies have shown harmful effects; use in last weeks may cause postnatal hemorrhage; consult your doctor.
Pregnancy Category: C — always consult a doctor before taking during pregnancy.
Use in lactation
Use in Lactation: Safe during breastfeeding; human studies show insignificant transfer to breast milk.
Pediatric use
Pediatric dose based on weight; 10-20 mg/kg, max 600 mg/day.
Geriatric use
Caution required in elderly patients; sufficient numbers not studied.
Renal / hepatic impairment
Renal Impairment: Caution in kidney disease; dose adjustment may be needed; consult your doctor.
Hepatic Impairment: Caution in liver disease; monitor LFT; consult your doctor.
Overdose effects
Overdose: Nausea, vomiting, abdominal pain, pruritus, headache, lethargy; discoloration of skin, urine, etc.; liver enlargement, jaundice; treatment: gastric lavage, supportive care, monitoring.
Storage conditions
Store between 15-30°C; avoid excessive heat; protect from light.
Chemical structure
Rifampicin