Rifabutin

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 07.10.2021

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Definition
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Tuberculostatics, chemotherapy.

Indication
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Tuberculosis, infections by atypical mycobacteria (MAI), prophylaxis of MAI infection in HIV patients with < 200 CD4 cells/μl.

Limited indication
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Pregnancy, lactation, children < 14 years, severe liver and kidney failure.

Dosage and method of use
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Tuberculosis (combination therapy): 150 mg/day p.o., in case of immunosuppression 300 mg/day p.o.

MAI: 300 mg/day p.o. for up to 6 months after achieving negative cultures; in combination with clarithromycin, other macrolides or triazole antifungals 300 mg/day. In combination with indinavir: 150 mg/day p.o.

MAI prophylaxis: 300 mg/day p.o.

Reminder. Patients with soft contact lenses must be informed about the possibility of permanent discolouration of the lenses!

Undesirable effects
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Allergic reactions, skin discoloration and discoloration of body excretions after red-orange, headaches, sleep disorders, uveitis, chest pain, anemia, eosinophilia, leukopenia, neutropenia, thrombopenia, abdominal pain, myalgias.

Interactions
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See Table 1.

Contraindication
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Rifamycin hypersensitivity, acute hepatitis or cirrhosis of the liver, occlusive scterus, thrombocytopenia.

Preparations
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Mycobutin

Tables
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Major interactions of rifabutin

Quinidine

Quinidine effect ↓

Clarithromycin

Rifabutin toxicity (plasma levels around 80% ↑, possibly dose reduction).

Cotrimoxazole

Cotrimoxazole effect ↓

Coumarins

Coumarin effect ↓

Dapsone

Dapsone effect ↓

Didanosine

Palpitations, tachycardia

Fluconazole

Rifabutin levels around 80% ↑, possible dose adjustment.

Glucocorticoids

Glucocorticoid effect ↓

Cardiac glycosides

Cardiac glycoside effect ↓

Contraceptives, oral

contraceptive effect ↓

L-methadone

L-methadone effect ↓

Opioids

Opioid effect ↓

Phenytoin

Phenytoin effect ↓

Sulfonylureas

Sulfonylurea effect ↓

Incoming links (2)

Isavuconazole; Neutropenia;

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Last updated on: 07.10.2021