Uses of Rifambin: - Tuberculosis (TB) Tuberculosis, Leprosy, Brucellosis, Meningitis , Legionnaire's disease; Staphylococcal infections Hypersensitivity to rifampicin or other rifamycins. Patient w/ jaundice. Concurrent use w/ saquinavir/ritonavir therapy.

Anti-Tubercular Antibiotics

Rifampicin suppresses initiation of chain formation for RNA synthesis in susceptible bacteria by binding to the β subunit of DNA-dependent RNA polymerase, thus blocking RNA transcription.

How to use Rifampicin: Take this medicine in the dose and duration as advised by your doctor. Do not chew, crush or break it. Rifampicin is to be taken empty stomach. Administration: Should be taken on an empty stomach. Best taken on an empty stomach 1 hr before or 2 hr after meals. Adult Dose: Oral Tuberculosis Adult: 10 mg/kg/day or 2-3 times/wk. Max: 600 mg/day. <50 kg: 450 mg daily; >50 kg: 600 mg daily. Leprosy 600 mg once mthly. Prophylaxis against meningococcal meningitis 600 mg twice daily for 2 days. Prophylaxis against meningitis due to Haemophilus influenzae 600 mg/day for 4 days. Hepatic impairment: Max: 8 mg/kg/day. Child Dose: Oral Tuberculosis 10–20 mg/kg, max 600 mg for TB q24h With directly observed biweekly therapy, dosage is still 10–20 mg/kg/dose (max 600 mg) twice weekly 20 mg/kg/day for 2 days for meningococcus prophylaxis, q12h

May accelerate the metabolism and reduce the effect of drugs that are metabolised by CYP450 enzymes (e.g. quinidine, phenytoin, theophylline). Decreased concentrations of atovaquone and increased concentrations of rifampicin when taken concomitantly. Concurrent use of ketoconazole and rifampicin may result in decreased serum concentrations of both drugs. May decrease serum concentrations of enalaprilat. Reduced absorption by antacids. Increased risk of hepatotoxicity w/ halothane or isoniazid. Potentially Fatal: Increased potential for hepatotoxicity when taken concomitantly w/ saquinavir/ritonavir combination.

Hypersensitivity to rifampicin or other rifamycins. Patient w/ jaundice. Concurrent use w/ saquinavir/ritonavir therapy.

Common - Low blood platelets - Headache - Dizziness - Vomiting - Abnormal liver function tests - Nausea - Fever - Chills Facial flushing and itching, w/ or w/o a rash, flu-like syndrome characterised by episodes of fever, chills, headache, dizziness, bone pain, shortness of breath, and malaise; GI adverse effects (e.g. nausea, vomiting, anorexia, diarrhoea, epigastric distress), pseudomembranous colitis, eosinophilia, leucopenia, haemolytic anaemia; alterations in kidney function and renal failure, menstrual disturbances, oedema, myopathy, muscular weakness; orange-red discolouration of the urine, faeces, sweat, saliva, sputum, tears, and other body fluids; Rarely, eye irritation and visual disturbances, anaphylaxis or shock. Potentially Fatal: Hepatotoxicity, hypotension, sinus tachycardia, ventricular arrhythmias, seizures and cardiac arrest, thrombocytopenia and purpura.

Pregnancy: When administered during the last few weeks of pregnancy, rifampin can cause post natal hemorrhages in the mother and infant for which treatment with vitamin K may be indicated.Nursing Mothers: Because of the potential for tumorigenicity shown for rifampin in animal studies, a decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.

Precaution: Patient w/ history of alcoholism. Hepatic and renal impairment. Elderly, malnourished patients, childn <2 yr. Pregnancy and lactation. Patient Counselling May permanently stain soft contact lenses. Monitoring Parameters Monitor liver function (AST, ALT, bilirubin), CBC, mental status, sputum culture; chest x-ray 2-3 mth into treatment.

Nausea, vomiting, abdominal pain, pruritus, headache, and increasing lethargy will probably occur within a short time after ingestion; unconsciousness may occur when there is severe hepatic disease. Transient increases in liver enzymes and/or bilirubin may occur. Brownish-red or orange discoloration of the skin, urine, sweat, saliva, tears, and feces will occur, and its intensity is proportional to the amount ingested.Liver enlargement, possibly with tenderness, can develop within a few hours after severe overdosage; bilirubin levels may increase and jaundice may develop rapidly. Hepatic involvement may be more marked in patients with prior impairment of hepatic function. Other physical findings remain essentially normal. A direct effect upon the hematopoietic system, electrolyte levels, or acid-base balance is unlikely.Facial or periorbital edema has also been reported in pediatric patients. Hypotension, sinus tachycardia, ventricular arrhythmias, seizures and cardiac arrest were reported in some fatal cases.

Store between 15-30° C. Avoid excessive heat and protect from light.

Anti-Tubercular Antibiotics

Rifampicin suppresses initiation of chain formation for RNA synthesis in susceptible bacteria by binding to the beta subunit of DNA-dependent RNA polymerase, thus blocking RNA transcription.

Pregnancy: When administered during the last few weeks of pregnancy, rifampin can cause post natal hemorrhages in the mother and infant for which treatment with vitamin K may be indicated.Nursing Mothers: Because of the potential for tumorigenicity shown for rifampin in animal studies, a decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.