Rifampicin

Author: Prof. Dr. med. Peter Altmeyer

All authors of this article

Last updated on: 29.10.2020

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Synonym(s)

RMP

Definition
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Tuberculostatics, chemotherapy.

Half-life
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2–3 h

Spectrum of action
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Mycobacterium spp., Staphylococcus spp., Streptococcus spp., Enterococcus spp., Brucella spp., Chlamydia trachomatis, Coxiella burneti, Haemophilus influenzae, Legionella pneumophilia, Neisseria, Rochalimaea spp.

Indication
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Tuberculosis of all stages and leprosy in combination therapy.

Dosage and method of use
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  • Tuberculosis: Adults 10 mg/kg bw/day p.o. or i.v. (the daily dose is generally 600 mg; 450 mg should not be below and 750 mg should not be exceeded.
  • Children and adolescents: 10 mg/day/kg bw (not more than 450 mg/day). Infants > 3 months and toddlers: 15 mg/day kg bw.
  • Premature and newborn babies and infants < 3 months 10 mg/kg bw p.o. only under strictest indication.

Remember! Treatment of active tuberculosis during pregnancy in combination with ethambutol and isoniazid is generally possible (information about potential risk of malformation during early pregnancy). When used in late pregnancy: risk of postnatal bleeding in mother and newborn: substitution with vitamin K!

Undesirable effects
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  • Flu-like syndrome (skin reactions, upper abdominal pain, drug fever, chills, muscle and joint pain, rarely interstitial nephritis, haemolytic anaemia, anaphylactic reactions).
  • Cutaneous ADRs: pruritus, maculopapular exanthema, urticaria, Red Man syndrome, allergic reactions; pemphigus diseases.
  • Also: dyspnea, yellow discoloration of contact lenses, BB changes, menstrual disorders, gastrointestinal disorders, increase in transaminases, cholestasis, red color of urine, headache, dizziness.

Interactions
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See Table 1.

Contraindication
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First trimester pregnancy, lactation, severe liver dysfunction.

Preparations
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Rifa, Eremfat

Tables
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Main interactions of rifampicin

Antacids

Rifampicin absorption ↓

Azathioprine

Azathioprine effect ↓

Barbiturates

Barbiturate effect ↓

β -receptor blockers

Blood pressure lowering effect ↓

Quinidine

Quinidine effect ↓

Chloramphenicol

Chloramphenicol effect ↓

Dapson

Dapson effect ↓

Glucocorticoids

Glucocorticoid effect ↓

Ketoconazole

mutual effect ↓

Contraceptives, oral

contraceptive effect ↓

liver-damaging substances

Hepatotoxicity ↑

Methadone

Methadone effect ↓

Phenytoin

Phenytoin effect ↓

Sulfonylureas

Sulfonylurea effect ↓

Theophylline

Theophylline levels ↓

Authors

Last updated on: 29.10.2020