Rifampin is a potent antibiotic primarily used to treat tuberculosis (TB) and prevent meningococcal infections. It works by inhibiting bacterial RNA synthesis, effectively stopping bacterial growth. This medication is often combined with other drugs to prevent resistance.
Rifampin binds to bacterial DNA-dependent RNA polymerase, blocking transcription. This unique action makes it bactericidal against slow-growing organisms like Mycobacterium tuberculosis and Neisseria meningitidis.
Besides TB, rifampin treats leprosy and staph infections. It's also used prophylactically for close contacts of meningococcal disease patients and in prosthetic joint infections.
For TB, adults typically take 600mg daily or twice weekly. Pediatric doses are weight-based. Always take on an empty stomach to maximize absorption.
Orange discoloration of body fluids is harmless but expected. More serious effects include hepatotoxicity, flu-like symptoms, and thrombocytopenia requiring monitoring.
Rifampin induces liver enzymes, affecting many medications. Regular liver function tests are essential. Contraindicated in patients with jaundice or severe liver disease.
Single-drug therapy rapidly causes resistance. TB treatment always combines rifampin with isoniazid, pyrazinamide, and ethambutol for the first two months.
Capsules should be swallowed whole. For patients unable to swallow, contents can be mixed with applesauce or jelly but never chewed.
Rifampin significantly reduces effectiveness of oral contraceptives, warfarin, and many HIV medications. Dose adjustments or alternatives are often necessary.
Baseline and periodic LFTs, CBC, and renal function tests are recommended. Patients should report dark urine, abdominal pain, or unexplained bruising immediately.
Rifampin penetrates well into tissues and cavities, including cerebrospinal fluid, making it effective for TB meningitis and abscesses.
Store at room temperature away from moisture. Unused medication should be returned to take-back programs to prevent environmental contamination.
This harmless effect occurs because rifampin and its metabolites are red-orange compounds excreted in urine, sweat, and tears. It's not a cause for concern but may stain contact lenses.
While symptoms may improve within weeks, complete TB treatment typically takes 6-9 months. Stopping early can lead to relapse or drug-resistant TB.
High-fat meals reduce absorption by 30%. Take rifampin 1 hour before or 2 hours after meals, unless specifically instructed otherwise for tolerance reasons.
Take it as soon as remembered unless close to the next dose. Never double doses. For weekly therapy, contact your healthcare provider for guidance.
Yes, it dramatically reduces their effectiveness. Use non-hormonal contraception (condoms) during and for one month after rifampin treatment.
Generally considered safe for TB treatment in pregnancy, but benefits must outweigh risks. Vitamin K supplementation is recommended for newborns due to rifampin's effect on clotting factors.
Rifampin can cause hepatitis, especially when combined with other hepatotoxic drugs like isoniazid. Baseline and regular liver enzyme checks detect early damage.
Alcohol increases hepatotoxicity risk. Complete abstinence is advised, especially for patients with existing liver conditions or those taking other liver-metabolized drugs.
It reduces levels of most protease inhibitors and some NNRTIs. HIV patients need carefully adjusted regimens, often using rifabutin instead.
Rifabutin causes fewer drug interactions and is preferred for HIV patients, but is more expensive. Both are rifamycin antibiotics with similar mechanisms.