Rifampin

Brand names

• Rifadin
• Rifadin IV
• Rifamate [CD]
• Rifater [CD]
• Rimactane
• Rofact

Usage

To treat all forms of tuberculosis (TB); must be used in conjunction with other antitubercular agents. Also to prevent the spread of TB by people who are carriers of it but who do not have active disease, and to treat other bacterial infections and persons who have been exposed to certain types of meningitis causing bacteria.

How it works

Rifampin interferes with the activity of enzymes needed for the replication of RNA (ribonucleic acid) in bacterial cells, preventing the bacteria from reproducing.

Side effects

Serious

Difficulty breathing, chills, pain in muscles and bones, dizziness, headache, itching, fever, shivering, skin rash and redness, nausea and vomiting, diarrhea, yellow discoloration of the skin or eyes.

Common

Reddish-orange or brown discoloration of urine, saliva, phlegm, stools, sweat, skin, and tears; stomach cramps.

Less common

There are no less-common side effects associated with the use of rifampin.

Possible interactions

Other medicaments:

Rifampin taken concurrently with:

• halothane anesthesia may result in serious liver damage.

Rifampin may decrease the effects of:



• amiodarone (Cordarone).
• amprenavir (Agenerase).
• antianxiety agents such as diazepam and perhaps other benzodiazepines.
• anticoagulants such as warfarin (Coumadin).
• anticonvulsant medicaments such as phenytoin (Dilantin).
• barbiturates.
• BCG live-attenuated vaccine.
• beta blockers such as metoprolol or propranolol.
• birth control pills (oral contraceptives).
• buspirone (Buspar).
• some calcium channel blockers.
• carbamazepine (Tegretol)-may lead to carbamazepine toxicity.
• carvedilol (Coreg).
• chloramphenicol (Chloromycetin).
• clofibrate (Atromid-S).
• clozapine (Clozaril).
• cortisone like medicaments.
• cyclosporine (Sandimmune).
• dapsone.
• delavirdine (Rescriptor).
• digitalis preparations (Lanoxin, others).
• disopyramide (Norpace).
• donepezil (Aricept).
• doxycycline (various).
• enalapril (Vasotec).
• fluconazole (Diflucan).
• fosphenytoin (Cerebyx).
• some HMG-CoA reductase inhibitors (fluvastatin).
• indinavir (Crixivan) and nelfinavir (Viracept).
• itraconazole (Sporanox).
• leflunomide (Arava).
• losartan (Cozaar).
• ketoconazole (Nizoral).
• methadone (Dolophine).
• metoprolol (Lopressor).
• montelukast (Singulair).
• mexiletine (Mexitil).
• narcotics such as methadone.
• nicardipine (Cardene).
• nifedipine (Adalat).
• olanzapine (Zyprexa).
• oral hypoglycemic agents (sulfonylureas such as tolbutamide).
• phenytoin (Dilantin).
• progestins.
• propafenone (Rythmol).
• quinidine (Quinaglute, others).
• repaglinide (Prandin).
• ritonavir (Norvir}-this combination may also lead to rifampin toxicity.
• rofecoxib (VIOXX).
• sildenafil (Viagra).
• sirolimus (Rapamune) or tacrolimus (Prograf).
• theophylline (Theo-Dur, others).
• tricyclic antidepressants.
• trimexate (Neutrexin).
• verapamil (Verelan).
• warfarin (Coumadin); increased INR testing is needed.
• zaleplon (Sonata).
• zidovudine (AZT); the therapeutic effect will be lessened by a decreased medicament level.
• zolpidem (Ambien).

The following medicament may decrease the effects of rifampin:



• para-aminosalicylic acid (PAS) and reduce its antitubercular effectiveness.

Herbal medicines or minerals:

Some patients use Echinacea to attempt to boost their immune systems. Unfortunately, use of Echinacea is not recommended in people with damaged immune systems. This herb may also actually weaken any immune system if it is used too often or for too long a time. Do not take mistletoe herb, oak bark or marshmallow root, woody nightshade stem or licorice.

Alcohol:

It is best to avoid alcohol completely to reduce the risk of liver toxicity.

Discontinuation:

It is advisable not to interrupt or stop this medicament without consulting your physician. Intermittent use can increase risk of developing allergic reactions.