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RIFAMPICIN is a brand name for Rifampin (also known as Rifampicin). The medicine, its uses, side effects and dosage are the same regardless of brand.
Used for: Tuberculosis: Rifampicin, used in combination with other active anti-tuberculosis drugs, is indicated in the treatment of all forms of tuberculosis, including fresh, advanced, chronic and drug-resistant cases. Rifampicin is also effective against most atypical strains of mycobacteria. Prophylaxis of meningococcal…
Verbatim from this product's MHRA label. Tap a section to expand.
Posology Tuberculosis Rifampicin should be given with other effective anti-tuberculosis drugs to prevent the possible emergence of rifampicin resistant strains of mycobacteria.
Adults:
The recommended single daily dose in tuberculosis is 8-12mg/kg.
Usual daily dose:
Patients weighing less than 50kg – 450mg Patients weighing 50kg or more – 600mg Paediatric patients: Children above 3 months: Oral doses of 15 (10-20) mg/kg body weight daily are recommended, although a total daily dose should not usually exceed 600mg.
Prophylaxis of Meningococcal Meningitis Adults: 600mg twice daily for 2 days.
Paediatric patients:
Meningococcal Carriers: Dose must not exceed 600 mg/ dose. For children ≥1 month of age the recommended dose is 10 mg/kg every 12 hours for 2 days. For children <1 month of age, the recommended dose is 5 mg/kg every 12 hours for 2 days.
Leprosy Rifampicin should always be used in conjunction with at least one other anti-leprosy drug to treat the disease. Adults: 600mg of rifampicin should be given once per month. If a daily dose regime is indicated then the recommended single dose is 10mg/kg.
The usual daily dose for patients less than 50kg is 450mg and for patients 50kg or more, the usual daily dose is 600mg.
Paediatric patients:
Rifampicin should always be administered with dapsone in case of paucibacillary forms and with dapsone and clofazimine in case of multibacillary forms. For children over 10 years, the recommended dose for rifampicin is 450 mg once a month.
For children less than 10 years, the recommended dose for rifampicin is 10 to 20 mg/kg rifampicin once a month. The duration of treatment is 6 months for paucibacillary and 12 months multibacillary forms.
Prophylaxis of Haemophilus Influenzae Adults and children ≥1 month of age:
For members of a household exposed to H. Influenzae B disease when the household contains a child 4 years old or younger, it is recommended that all members (including the child) receive 20mg/kg once daily (maximum daily dose of 600mg) for 4 days.
The following CIOMS frequency rating is used, when applicable:
Very common (≥ 1/10); Common (≥ 1/100 to <1/10); Uncommon (≥ 1/1,000 to <1/100); Rare (≥ 1/10,000 to <1/1,000); Very rare (<1/10,000), Not known (cannot be estimated from available data).
Reactions occurring with either daily or intermittent dosage regiments include:
Infections and infestations Not known: Pseudomembranous colitis, Influenza Blood and lymphatic system disorders Common: Thrombocytopenia with or without purpura, usually associated with intermittent therapy, but is reversible if drug is discontinued as soon as purpura occurs.
Uncommon:
Leukopenia Not known: Thrombotic microangiopathy including thrombotic thrombocytopenic purpura/haemolytic uremic syndrome, Disseminated intravascular coagulation, Eosinophilia, Agranulocytosis, Haemolytic anaemia, Vitamin K dependent coagulation disorders Immune system disorders Not known: Anaphylactic reaction Endocrine disorders Not known: Adrenal insufficiency in patient with compromised adrenal function have been observed.
Metabolism and nutritional disorders Not known:
Decreased appetite Psychiatric disorders Not known: Psychotic disorder Nervous system disorders Common: Headache, Dizziness Not known: Cerebral haemorrhage and fatalities have been reported when rifampicin administration has been continued or resumed after the appearance of purpura.
4), Skin reaction, Pruritus, Rash pruritic, Urticaria, Dermatitis allergic, Pemphigoid, Sweat discoloration. 2% (53/573) (data between October 2007and March 2010) and higher frequency is reported as 25% (19/76) (data between 2000 and 2010).
Rifampicin should be given under the supervision of a respiratory or other suitably qualified physician. Cautions should be taken in case of renal impairment if dose > 600 mg/day. All tuberculosis patients should have pre-treatment measurements of liver function.
Adults treated for tuberculosis with rifampicin should have baseline measurements of hepatic enzymes, bilirubin, serum creatinine, a complete blood count, and a platelet count (or estimate). Baseline tests are unnecessary in children unless a complicating condition is known or clinically suspected.
All patients with abnormalities should have follow up examinations, including laboratory testing, if necessary. Patients with impaired liver function should only be given rifampicin in cases of necessity, and then with caution and under close medical supervision.
In these patients, lower doses of rifampicin are recommended and careful monitoring of liver function, especially serum alanine aminotransferase (ALT) and serum aspartate aminotransferase (AST) should initially be carried out prior to therapy, weekly for two weeks and then every two weeks for the next six weeks.
If signs of hepatocellular damage occur, rifampicin should be withdrawn. Rifampicin should also be withdrawn if clinically significant changes in hepatic function occur. The need for other forms of antituberculosis therapy and a different regimen should be considered.
Urgent advice should be obtained from a specialist in the management of tuberculosis. If rifampicin is re- introduced after liver function has returned to normal, liver function should be monitored daily. In patients with impaired liver function, elderly patients, malnourished patients, and possibly, children under two years of age, caution is particularly recommended when instituting therapeutic regimens in which isoniazid is to be used concurrently with rifampicin.
1. 5). 5).
Not medical advice. Always read the patient information leaflet and follow your prescriber or pharmacist.
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Index cases should be treated prior to discharge from hospital. For children <1 month of age: 10mg/kg once daily for 4 days Brucellosis, Legionnaires Disease or Serious Staphylococcal Infections Adults: The recommended daily dose is 600mg to 1200mg given in 2 to 4 divided doses, together with another appropriate antibiotic to prevent the emergence of resistant strains of the infecting organism.
Patients with impaired liver function A daily dose of 8mg/kg should not be exceeded in patients with impaired liver function. Use in the Elderly In elderly patients, the renal excretion of rifampicin is decreased proportionally with physiological decrease of renal function; due to compensatory increase of liver excretion, the serum terminal half- life is similar to that of younger patients.
However, as increased blood levels have been noted in one study of rifampicin in elderly patients, caution should be exercised in using rifampicin in such patients, especially if there is evidence of liver function impairment. Method of administration For oral administration only.
The daily dose of rifampicin, calculated from the patient’s body weight, should preferably be taken on an empty stomach or at least 30 minutes before a meal or 2 hours after a meal to ensure rapid and complete absorption.
Not known:
Oedema Investigations Common: Blood bilirubin increased, Aspartate aminotransferase increased, Alanine aminotransferase increased Not known: Blood pressure decreased, Blood creatinine increased, Hepatic enzyme increased. Reporting of suspected adverse reactions Reporting suspected adverse reactions after authorisation of the medicinal product is important.
It allows continued monitoring of the benefit/risk balance of the medicinal product. uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store.
It is rarely necessary, in the absence of clinical findings, to increase the frequency of performing routine liver function tests in patients with normal pretreatment liver unless fever, vomiting, jaundice or other deterioration in the patients condition occur.
Patients should be seen at least monthly during therapy and should be specifically questioned concerning symptoms associated with adverse reactions. In some patients, hyperbilirubinaemia resulting from competition between rifampicin and bilirubin for excretory pathways of the liver at the cell level, can occur in early days of treatment.
An isolated report showing a moderate rise in bilirubin and/or transaminase level is not in itself an indication for interrupting treatment; rather the decision should be made after repeating the tests, noting trends in the levels and considering them in conjunction with the patient’s clinical condition.
Cases of drug-induced liver injury, including fatal cases (especially when used in combination with other anti-tuberculosis drugs), have been reported in patients treated with rifampicin with an onset of a few days to a few months following treatment initiation.
Signs and symptoms include elevated serum hepatic enzymes, cholestatic jaundice, hepatitis, hepatotoxicity, hepatocellular injury, and mixed liver injury. Most patients recovered on discontinuation of rifampicin treatment; nevertheless, progression to acute liver failure requiring liver transplantation can occur.
The mechanism of rifampicin-induced liver injury is not clearly elucidated, but data indicate either an immuno-allergic mechanism or direct toxicity of metabolic products. Patients should be instructed to contact their physician in case symptoms suggestive of liver injury occur.
In such patients rifampicin should be discontinued and liver function should be assessed. Rifampicin should not be re-introduced in patients with an episode of hepatic injury during treatment with rifampicin for which no other cause of liver injury has been determined.
8) occurring with intermittent therapy (less than 2 to 3 times per week) patients should be closely monitored. Patients should be cautioned against interruption of dosage regimens since these reactions may occur. Rifampicin has enzyme induction properties that can enhance the metabolism of endogenous substrates including adrenal hormones, thyroid hormones and vitamin D.
Isolated reports have associated porphyria exacerbation with rifampicin administration. Cases of thrombotic microangiopathy (TMA), manifested as thrombotic thrombocytopenic purpura (TTP) or haemolytic uremic syndrome (HUS), including fatal cases, have been reported with Rifampicin capsules use.
If laboratory or clinical findings associated with TMA occur in a patient receiving Rifampicin capsules, treatment should be discontinued and thorough evaluation for TMA performed, including platelet levels, renal function, serum lactate dehydrogenase (LDH) and a blood film for schistocytes (erythrocyte fragmentation).
ADAMTS13 activity and anti-ADAMTS13- antibody determination should be completed. If anti-DAMTS13-antibody is elevated in conjunction with low ADAMTS13 activity, treatment with Rifampicin capsules should not be resumed and patients should be treated accordingly (consider plasma exchange).
8). It is important to note that early manifestations of hypersensitivity, such as fever, lymphadenopathy or biological abnormalities (including eosinophilia, liver abnormalities) may be present even though rash is not evident. If such signs or symptoms are present, the patient should be advised to consult immediately their physician.
Rifampicin capsules should be discontinued if an alternative etiology for the signs and symptoms cannot be established. Paradoxical drug reaction […]