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Rifampin (Oral route)

Pronunciation:

rif-AM-pin

Brand Names:

  • Rifadin
  • Rimactane

Dosage Forms:

  • Capsule
  • Tablet
  • Syrup

Classifications:

Therapeutic—

Antitubercular

Chemical—

Rifamycin

Uses of This Medicine:

Rifampin is used together with other medicines to treat tuberculosis (TB) in many different parts of the body. It is also used by patients who have a meningitis bacteria in their nose or throat to prevent the spread of the bacteria to other patients. Rifampin belongs to the class of medicines called antibiotics and works to kill or prevent the growth of bacteria. However, it will not work for colds, flu, or other virus infections.

This medicine is available only with your doctor's prescription.

Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although these uses are not included in product labeling, rifampin is used in certain patients with the following medical conditions:

  • Atypical mycobacterial infections, such as Mycobacterium avium complex (MAC).
  • Leprosy (Hansen's disease).
  • Prevention of Haemophilus influenzae infection.
  • Treatment of serious staphylococcal (bacterial) infections.

Before Using This Medicine:

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies—

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children—

Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of rifampin in children.

Older adults—

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of rifampin in the elderly.

Pregnancy—

Pregnancy CategoryExplanation
All TrimestersCAnimal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast-feeding—

Studies in women suggest that this medication poses minimal risk to the infant when used during breastfeeding.

Other medicines—

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Artemether
  • Atazanavir
  • Boceprevir
  • Cobicistat
  • Darunavir
  • Elvitegravir
  • Fosamprenavir
  • Lopinavir
  • Lurasidone
  • Maraviroc
  • Nelfinavir
  • Praziquantel
  • Ranolazine
  • Rilpivirine
  • Saquinavir
  • Telaprevir
  • Tipranavir
  • Voriconazole

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Abiraterone Acetate
  • Afatinib
  • Amiodarone
  • Amprenavir
  • Apixaban
  • Atovaquone
  • Axitinib
  • Bedaquiline
  • Bosutinib
  • Cabazitaxel
  • Cabozantinib
  • Canagliflozin
  • Clozapine
  • Crizotinib
  • Cyclosporine
  • Dabigatran Etexilate
  • Dabrafenib
  • Dasatinib
  • Delavirdine
  • Dolutegravir
  • Doxorubicin
  • Doxorubicin Hydrochloride Liposome
  • Dronedarone
  • Efavirenz
  • Enzalutamide
  • Erlotinib
  • Ethionamide
  • Etravirine
  • Everolimus
  • Fentanyl
  • Fosphenytoin
  • Hydrocodone
  • Ibrutinib
  • Ifosfamide
  • Imatinib
  • Indinavir
  • Irinotecan
  • Isoniazid
  • Itraconazole
  • Ivabradine
  • Ivacaftor
  • Ixabepilone
  • Ketoconazole
  • Lapatinib
  • Linagliptin
  • Lorcainide
  • Macitentan
  • Mifepristone
  • Mycophenolate Mofetil
  • Nevirapine
  • Nifedipine
  • Nilotinib
  • Nimodipine
  • Pazopanib
  • Perampanel
  • Phenytoin
  • Piperaquine
  • Pitavastatin
  • Pixantrone
  • Pomalidomide
  • Ponatinib
  • Posaconazole
  • Pyrazinamide
  • Quetiapine
  • Quinine
  • Regorafenib
  • Ritonavir
  • Rivaroxaban
  • Roflumilast
  • Romidepsin
  • Simeprevir
  • Sirolimus
  • Sofosbuvir
  • Sunitinib
  • Tacrolimus
  • Tasimelteon
  • Telithromycin
  • Temsirolimus
  • Ticagrelor
  • Tofacitinib
  • Tolvaptan
  • Trabectedin
  • Vandetanib
  • Vemurafenib
  • Vilazodone
  • Vincristine Sulfate
  • Vincristine Sulfate Liposome
  • Vinflunine
  • Vortioxetine

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Acetyldigoxin
  • Aliskiren
  • Anisindione
  • Aprepitant
  • Atorvastatin
  • Betamethasone
  • Bexarotene
  • Bosentan
  • Buprenorphine
  • Buspirone
  • Carbamazepine
  • Carvedilol
  • Caspofungin
  • Chloramphenicol
  • Chlorpropamide
  • Citalopram
  • Clarithromycin
  • Clofibrate
  • Cortisone
  • Deferasirox
  • Desogestrel
  • Dexamethasone
  • Dicumarol
  • Dienogest
  • Digoxin
  • Diltiazem
  • Disopyramide
  • Doxycycline
  • Drospirenone
  • Eltrombopag
  • Enalaprilat
  • Enalapril Maleate
  • Estradiol Cypionate
  • Estradiol Valerate
  • Ethinyl Estradiol
  • Ethynodiol Diacetate
  • Etonogestrel
  • Etoricoxib
  • Fesoterodine
  • Fluconazole
  • Fludrocortisone
  • Fosaprepitant
  • Gefitinib
  • Gliclazide
  • Glyburide
  • Haloperidol
  • Isradipine
  • Lamotrigine
  • Leflunomide
  • Levomethadyl
  • Levonorgestrel
  • Levothyroxine
  • Linezolid
  • Losartan
  • Medroxyprogesterone Acetate
  • Mefloquine
  • Mestranol
  • Metformin
  • Methadone
  • Methylprednisolone
  • Metoprolol
  • Morphine
  • Morphine Sulfate Liposome
  • Moxifloxacin
  • Nisoldipine
  • Norelgestromin
  • Norethindrone
  • Norgestimate
  • Norgestrel
  • Ospemifene
  • Oxycodone
  • Phenprocoumon
  • Pioglitazone
  • Pirmenol
  • Prednisolone
  • Prednisone
  • Propafenone
  • Raltegravir
  • Repaglinide
  • Rofecoxib
  • Rosiglitazone
  • Ruxolitinib
  • Sertraline
  • Simvastatin
  • Tadalafil
  • Tamoxifen
  • Theophylline
  • Tocainide
  • Triazolam
  • Trimetrexate
  • Valproic Acid
  • Warfarin
  • Zaleplon
  • Zidovudine
  • Zolpidem

Other interactions—

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Other medical problems—

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Alcohol abuse, or history of—Use with caution. May cause side effects to become worse.
  • Diabetes, history of or
  • Liver disease or
  • Porphyria (an enzyme problem)—Use with caution. May make these conditions worse.

Proper Use of This Medicine:

Take this medicine exactly as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. To do so may increase the chance for side effects.

To help clear up your infection completely, it is very important that you keep using this medicine for the full time of treatment, even if you begin to feel better after a few weeks. If you have TB, you might have to take rifampin every day for several months. It is important that you not miss any doses.

Take the capsule on an empty stomach, 1 hour before or 2 hours after a meal, with a full of glass water. If you take this medicine on a regular schedule it will help prevent side effects.

If you or your child use antacids (e.g., Maalox®, Mylanta®), do not take rifampin with the antacids. Take the capsule 1 hour before you use the antacid.

For patients unable to swallow the capsule:

  • A special liquid form of the medicine can be prepared by a pharmacist.
  • Shake the bottle well before each dose.
  • Measure the liquid with a marked measuring spoon, oral syringe, or medicine cup. The average household teaspoon may not hold the right amount of liquid.

Dosing—

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (capsules):
    • For the treatment of meningitis bacteria in the nose or throat:
      • Adults—600 milligrams (mg) two times per day for 2 days.
      • Children and infants 1 month of age and older—Dose is based on body weight and must be determined by your doctor. The dose is 10 mg per kilogram (kg) of body weight every 12 hours for 2 days.
      • Infants younger than 1 month of age—Dose is based on body weight and must be determined by your doctor. The dose is 5 mg per kg of body weight every 12 hours for 2 days.
    • For the treatment of tuberculosis:
      • Adults—Dose is based on body weight and must be determined by your doctor. The dose is 10 milligrams (mg) per kilogram (kg) of body weight once a day. Your doctor may increase your dose as needed. However, the dose is usually not more than 600 mg per day.
      • Children—Dose is based on body weight and must be determined by your doctor. The dose is 10 to 20 mg per kg of body weight once a day. Your doctor may increase your dose as needed. However, the dose is usually not more than 600 mg per day.

Missed dose—

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage—

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

The specially prepared liquid form may be kept at room temperature or in a refrigerator for 4 weeks. Do not use the liquid after the expiration date on the label.

Precautions While Using This Medicine:

It is very important that your doctor check the progress of you or your child at regular visits. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to take it. Blood tests may be needed to check for unwanted effects.

You should not use this medicine if you or your child are also receiving atazanavir, darunavir, fosamprenavir, ritonavir, saquinavir, tipranavir, Aptivus®, Fortovase®, Invirase®, Lexiva®, Norvir®, Prezista®, or Reyataz®. These medicines are used to treat human immunodeficiency virus (HIV) infections.

Liver problems may occur with this medicine. The risk for liver problems is increased if you drink alcoholic beverages on a regular basis. You should limit the amount of alcoholic beverages you drink while you are receiving this medicine. If you have any concerns about this, talk to your doctor.

Stop using this medicine and check with your doctor right away if you or your child have pain or tenderness in the upper stomach; pale stools; dark urine; loss of appetite; nausea; unusual tiredness or weakness; or yellow eyes or skin. These could be symptoms of a serious liver problem.

Rifampin will cause urine, stool, saliva, sputum, sweat, and tears to turn a reddish-orange to reddish-brown color. This is to be expected while you are using this medicine, and everything will return to normal once you stop using it. This effect may cause soft contact lenses to become permanently discolored, so it is best not to wear soft contact lenses while you are using this medicine. If you or your child have any questions about this, check with your doctor.

Birth control pills may not work properly while you are taking this medicine. To keep from getting pregnant, use another form of birth control together with your birth control pills. Other forms include condoms, diaphragms, or contraceptive foams or jellies.

Before you have any medical tests, tell the doctor in charge that you or your child are taking this medicine. The results of some tests may be affected by this medicine.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Side Effects of This Medicine:

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Rare
Abdominal or stomach pain
agitation
back pain
bleeding gums
blood in the urine or stools
bruising
confusion
cough or hoarseness
coughing or vomiting blood
dark urine
darkening of the skin
decreased frequency or amount of urine
difficulty with swallowing
dizziness
fainting
fast heartbeat
fever with or without chills
general feeling of tiredness or weakness
headache
hives
hostility
increased blood pressure
increased thirst
irritability
lethargy
light-colored stools
loss of appetite
lower back or side pain
mental depression
nausea and vomiting
painful or difficult urination
persistent bleeding or oozing from puncture sites, mouth, or nose
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
shortness of breath
skin itching, rash, or redness
sores, ulcers, or white spots on the lips or in the mouth
swelling of the face, ankles, fingers, hands, or lower legs
tightness in the chest
tiredness
troubled breathing
unusual bleeding or bruising
unusual tiredness or weakness
weight gain
wheezing
yellow eyes or skin
Incidence not known
Blistering, peeling, or loosening of the skin
bloating
bone pain
chest pain
chills
cold, clammy skin
diarrhea, watery and severe, which may also be bloody
difficulty with speaking
double vision
fast heartbeat
fast, weak pulse
inability to move the arms, legs, or facial muscles
inability to speak
joint or muscle pain
lightheadedness
pale skin
pinpoint red spots on the skin
red skin lesions, often with a purple center
red, irritated eyes
redness, soreness, or itching skin
slow speech
sores, welting, or blisters
sweating
swollen glands
unpleasant breath odor
unusual weight loss

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose
Blurred vision
convulsions (seizures)
dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
fast, pounding, or irregular heartbeat or pulse
full feeling in the upper abdomen or stomach
itching
low blood pressure or slow pulse
nausea or vomiting
pain in the upper abdomen or stomach
reddish-orange to reddish-brown color of the urine, stool, saliva, sputum, sweat, and tears
swelling around the eyes or face
unconsciousness
unusual tiredness or weakness
yellow eyes or skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Rare
Feeling that others are watching you or controlling your behavior
feeling that others can hear your thoughts
feeling, seeing, or hearing things that are not there
muscular pain, tenderness, wasting, or weakness
severe mood or mental changes
unusual behavior
Incidence not known
Belching
bloated or full feeling
drowsiness
excess air or gas in the stomach or intestines
indigestion
not able to concentrate
pain or discomfort in the chest, upper stomach, or throat
weight loss

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.


Last Updated: 4/4/2014

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