Dosing & Uses
Dosage Forms & Strengths
- May be given in conjunction with isoniazid or with isoniazid and pyrazinamide
- Rifampin dosage not to exceed 600 mg/day
Neisseria Meningitidis Carrier
600 mg q12hr for 2 days
Haemophilus Influenzae Type B Infection
600 mg/day PO/IV for 4 days
Dosage Forms & Strengths
Neisseria Meningitidis Infection
>1 month: 20 mg/kg/day PO divided q12hr for 2 days; not to exceed 600 mg/day
Serious - Use Alternative
Significant - Monitor Closely
Elevated liver function test (LFT) results (up to 14%)
Epigastric distress (1-2%)
Pseudomembranous colitis (1-2%)
Frequency Not Defined
Hypersensitivity to rifamycins
Concomitant administration of live bacterial vaccines
Contraindicated in patients receiving ritonavir-boosted saquinavir, because of increased risk of severe hepatocellular toxicity
Contraindicated in patients receiving atazanavir, darunavir, fosamprenavir, saquinavir, or tipranavir, because rifampin may cause substantial decreases in plasma concentrations of these antiviral drugs, which may result in loss of antiviral efficacy or development of viral resistance
May decrease the effectiveness of oral contraceptive pills (OCPs)
Do not administer parenteral preparation IM or SC
Patients on regimens of >600 mg once or twice weekly may experience adverse reactions, including flulike syndrome
History of diabetes mellitus (rifampin may make diabetes management more difficult)
Regimens of >600 mg once or twice weekly may cause leukemia, anemia, or thrombocytopenia
Discontinue therapy if patient develops any signs of hepatocellular damage, including hyperbilirubinemia
Prolonged use may result in bacterial or fungal superinfection
Use with caution in patients with liver impairment and porphyria
Not for use in meningococcal disease; may be suitable for short-term use in asymptomatic carriers
Use with caution in patients with history of alcoholism and patients receiving additional medications that may cause hepatotoxicity
Rifampin is not recommended for intermittent therapy; caution patient against intentional or accidental interruption of daily dosage regimen; rare renal hypersensitivity reactions have been reported when therapy was resumed in such cases
Rifampin has enzyme-inducing properties that can enhance metabolism of endogenous substrates, including adrenal hormones, thyroid hormones, and vitamin D
Pregnancy & Lactation
Pregnancy category: C
Effects unknown; reported to cross placental barrier and appear in cord blood; increased congenital malformations, primarily spina bifida and cleft palate reported in offspring of rodents given oral doses of 150-250 mg/kg/day during pregnancy; case reports of postnatal hemorrhage in mother and infant when administered during last few weeks of pregnancy
Lactation: Drug enters breast milk
A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA:Information not available.
Mechanism of Action
Inhibits DNA-dependent RNA polymerase by binding to beta subunit, which in turn blocks RNA transcription; potent enzyme inducer
PO well absorbed; food may delay or slightly reduce peak
Peak plasma time: PO, 2-4 hr
Highly lipophilic; crosses blood-brain barrier well, and relative diffusion from blood into CSF is adequate, with or without inflammation (exceeds usual MICs)
Protein bound: 80%
Metabolized by liver; undergoes enterohepatic recirculation
Half-life: 3-4 hr (prolonged in hepatic impairment); in end-stage renal disease, 1.8-11 hr
Excretion: Feces (60-65%) and urine (~30%) as unchanged drug
Take on empty stomach
Solution: D5W (at 1.2 g/L within 4 hours)
Solution: NS (may be used within 24 hours)
Add 10 mL of SWI to 600 mg of rifampin in vial
Before administration, solution may be added to 500 mL of D5W or 100 mL of D5W
Prepare and administer within 4 hours
In 500 mL of D5W: Infuse within 3 hours
In 100 mL of D5W: Infuse within 30 minutes
Adding plans allows you to compare formulary status to other drugs in the same class.
To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.
Adding plans allows you to:
- View the formulary and any restrictions for each plan.
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The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.
|1||This drug is available at the lowest co-pay. Most commonly, these are generic drugs.|
|2||This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.|
|3||This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.|
|4||This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.|
|5||This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.|
|6||This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.|
|NC||NOT COVERED – Drugs that are not covered by the plan.|
Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.