Adult Dosing
Active/Latent Tuberculosis
- 10 mg/kg PO daily x 4-6 months
- Max: 600 mg/day
- Note: Administer either 1 hour before or 2 hours after a meal with a full glass of water
Meningococcal Carriers
Leprosy/Hansen's Disease [Not FDA approved]
- Multibacillary leprosy
- 600 mg PO q1 month x 12 months
- Paucibacillary Leprosy
- 600 mg PO q1 month x 6 months
- Single-lesion Paucibacillary Leprosy
Endocarditis, prosthetic valve
- 300 mg PO q8 h for 6 weeks
Epiglottitis [Non-FDA Approved]
- 600 mg PO once daily x 4 days
Pediatric Dosing
Tuberculosis
- <15 yo: 10-20 mg/kg PO daily x 4-6 months
- >15 yo: 10 mg/kg PO daily x 4-6 months
- Max: 600 mg/day
Note: Administer either 1 hour before or 2 hours after a meal with a full glass of water
H. influenzae prophylaxis
- <1 mo: 10 mg/kg PO q24h x 4 days
- >1 mo: 20 mg/kg PO q24h x 4 days
- Max: 600 mg/day
Meningococcal Prophylaxis
1 month: 10 mg/kg PO bid x 2 days; Max: 600 mg/dose- <1 month: 5 mg/kg PO bid x 2 days
Leprosy [Not FDA approved]
- Multibacillary leprosy
- Children <10 yrs: 300 mg PO q 1 month x 12 months
- Children 10-14 yrs: 450 mg PO q 1 month x 12 months
- Paucibacillary Leprosy
- Children <10 yrs: 300 mg PO q 1 month x 6 months
- Children 10-14 yrs: 450 mg PO q 1 month x 6 months
- Single-lesion Paucibacillary Leprosy
- Children 5-14 yrs: 300 mg PO x 1
Epiglottitis [Non-FDA Approved]
- 20 mg/kg PO once daily x 4 days (max 600 mg dose)
[Outline]
See Supplemental Patient Information
- Rifampin is known to cause fatalities associated with jaundice in patients with liver disease and in patients taking rifampin with other hepatotoxic agents, so should be given only in cases of necessity with caution and under strict medical supervision
- Monitor liver function especially SGPT and SGOT prior to therapy and then every 2-4 wks during therapy. Discontinue the drug if there are signs of hepatocellular damage
- Exacerbation of porphyria has been reported following administration of rifampin. Rifampin has enzyme-inducing properties, including induction of delta amino levulinic acid synthetase
- It is not indicated for the treatment of meningococcal infection. Because of the possibility of the rapid emergence of resistant organisms, restrict its use for short-term treatment of the asymptomatic carrier state
- To reduce the development of drug-resistant bacteria and maintain the effectiveness of therapy, rifampin should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria
- Rifampin dose greater than 600 mg given once or twice weekly can cause flu syndrome (fever, chills and malaise), hematopoietic reactions (leukopenia, thrombocytopenia, or acute hemolytic anemia), cutaneous, gastrointestinal, and hepatic reactions, shortness of breath, shock, anaphylaxis, and renal failure. Twice weekly dose of rifampin 600 mg plus isoniazid 15 mg/kg are much better tolerated
- Intermittent therapy is not recommended as it can cause rare renal hypersensitivity reactions when therapy is resumed in such cases
- Enzyme induction properties of rifampin have been reported to alter vitamin D metabolism, also reduce levels of circulating 25-hydroxy vitamin D and 1,25-dihydroxy vitamin D, reduced serum calcium and phosphate, and elevated parathyroid hormone
- Hepatic enzymes, bilirubin, serum creatinine, a complete blood count, and a platelet count measurement should be done at the base line
Cautions: Use cautiously in
- Hepatic impairment
- History of diabetes mellitus
- Concurrent use of other hepatotoxic agents
- Porphyria
- Elderly patients
Supplemental Patient Information
- Patients are warned against Skipping doses or not completing the full course of therapy as it may lead to decrease in the effectiveness of the immediate treatment and will also increase the likelihood that bacteria to develop resistance and will not be treatable by rifampin or other antibacterial drugs in the future
- Rifampin may produce a reddish coloration of the urine, sweat, sputum, and tears
- Patient are advised to use alternative contraceptive measures as the reliability of oral or other systemic hormonal contraceptives may be affected
- Patients are advised to take drug either 1 hour before or 2 hours after a meal with a full glass of water
- Patients should immediately contact their physicians if they experience fever, loss of appetite, malaise, nausea and vomiting, darkened urine, yellowish discoloration of the skin and eyes, and pain or swelling of the joints
Pregnancy Category:C
Breastfeeding: The centers for disease control and Prevention state that breastfeeding should not be discouraged in women taking rifampin. Limited information indicates that rifampin is excreted in breastmilk in low levels and thus would not be expected to adversely affect the breastfed infant. The amount of rifampin in milk is insufficient to treat tuberculosis in the breastfed infant. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT). This drug is compatible and considered safe with breastfeeding based upon data from AAP Policy Guidelines (available at http://aappolicy.aappublications.org/cgi/content/full/pediatrics;108/3/776 last accessed 10 June 2011). Because of the potential for tumorigenicity, manufacturer recommends discontinuation of breastfeeding or discontinuation of drug taking into account the importance of the drug to the mother.
Pricing data from www.DrugStore.com in U.S.A.
- Rifampin 300 MG CAPS [Bottle] (LANNETT)
30 mg = $64.99
90 mg = $175.97 - Rifadin 150 MG CAPS [Bottle] (SANOFI-AVENTIS U.S.)
60 mg = $166.32
180 mg = $475.2
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
