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|Rifadin

RIFAMPIN (Systemic)

Some commonly used brand names are:

In the U.S.—

• Rifadin
• Rifadin IV
• Rimactane

In Canada—

• Rifadin
• Rimactane
• Rofact

Another commonly used name is rifampicin .

Category

• Antibacterial, antileprosy agent
• Antibacterial, antimycobacterial

Description

Rifampin (rif-AM-pin) is used to treat certain bacterial infections.

Rifampin is used with other medicines to treat tuberculosis (TB). Rifampin is also taken by itself by patients who may carry meningitis bacteria in their nose and throat (without feeling sick) and may spread these bacteria to others. This medicine may also be used for other problems as determined by your doctor. However, rifampin will not work for colds, flu, or other virus infections.

To help clear up your tuberculosis (TB) completely, you must keep taking this medicine for the full time of treatment, even if you begin to feel better. This is very important. It is also important that you do not miss any doses.

Rifampin is available only with your doctor"s prescription, in the following dosage forms:

• Oral
• Capsules (U.S. and Canada)
• Suspension (U.S. and Canada)

• Parenteral
• Injection (U.S.)

Before Using This Medicine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For rifampin, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to rifampin. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy—Pregnant women with tuberculosis (TB) should be treated with TB medicines, including rifampin. Rifampin can rarely cause bleeding in newborn babies and mothers when taken during the last weeks of pregnancy. Studies in rats and mice have shown that rifampin given in high doses causes birth defects, usually backbone problems (spina bifida) and cleft palate.

Breast-feeding—Rifampin passes into the breast milk. However, rifampin has not been reported to cause problems in nursing babies.

Children—This medicine has been tested in children and, in effective doses, has not been shown to cause different side effects or problems in children than it does in adults.

Older adults—Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults. Although there is no specific information comparing use of rifampin in the elderly with use in other age groups, this medicine is not expected to cause different side effects or problems in older people than it does in younger adults.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking rifampin, it is especially important that your health care professional know if you are taking any of the following:

• Acetaminophen (e.g., Tylenol) (with long-term, high-dose use) or
• Amiodarone (e.g., Cordarone) or
• Anabolic steroids (nandrolone [e.g., Anabolin], oxandrolone [e.g., Anavar], oxymetholone [e.g., Anadrol], stanozolol [e.g., Winstrol]) or
• Androgens (male hormones) or
• Antithyroid agents (medicine for overactive thyroid) or
• Carbamazepine (e.g., Tegretol) or
• Carmustine (e.g., BiCNU) or
• Chloroquine (e.g., Aralen) or
• Dantrolene (e.g., Dantrium) or
• Daunorubicin (e.g., Cerubidine) or
• Disulfiram (e.g., Antabuse) or
• Divalproex (e.g., Depakote) or
• Etretinate (e.g., Tegison) or
• Gold salts (medicine for arthritis) or
• Hydroxychloroquine (e.g., Plaquenil) or
• Isoniazid (e.g., INH, Nydrazid) or
• Mercaptopurine (e.g., Purinethol) or
• Methotrexate (e.g., Mexate) or
• Methyldopa (e.g., Aldomet) or
• Naltrexone (e.g., Trexan) (with long-term, high-dose use) or
• Phenothiazines (acetophenazine [e.g., Tindal], chlorpromazine [e.g., Thorazine], fluphenazine [e.g., Prolixin], mesoridazine [e.g., Serentil], perphenazine [e.g., Trilafon], prochlorperazine [e.g., Compazine], promazine [e.g., Sparine], promethazine [e.g., Phenergan], thioridazine [e.g., Mellaril], trifluoperazine [e.g., Stelazine], triflupromazine [e.g., Vesprin], trimeprazine [e.g., Temaril]) or
• Plicamycin (e.g., Mithracin) or
• Valproic acid (e.g., Depakene)—These medicines may increase the chance of liver damage if taken with rifampin

• Anticoagulants (blood thinners) or
• Aminophylline (e.g., Somophyllin) or
• Amprenavir (e.g. Agenerase) or
• Antidiabetics, oral (diabetes medicine you take by mouth), or
• Chloramphenicol or
• Corticosteroids (cortisone-like medicine) or
• Delavirdine (e.g., Rescriptor) or
• Digitalis glycosides (heart medicine) or
• Disopyramide (e.g., Norpace) or
• Efavirenz (e.g., Sustiva) or
• Fluconazole (e.g., Diflucan) or
• Indinavir (e.g., Crixivan) or
• Itraconazole (e.g., Sporanox) or
• Ketoconazole (e.g., Nizoral) or
• Methadone (e.g., Dolophine) or
• Mexiletine (e.g., Mexitil) or
• Nelfinavir (e.g., Viracept) or
• Nevirapine (e.g., Viramune) or
• Oxtriphylline (e.g., Choledyl) or
• Quinidine (e.g., Quinidex) or
• Ritonavir (e.g., Norvir) or
• Saquinavir (e.g., Fortovase, Invirase) or
• Theophylline (e.g., Theo-Dur, Somophyllin-T) or
• Tocainide (e.g., Tonocard) or
• Verapamil (e.g., Calan)—Rifampin may decrease the effects of these medicines

• Estramustine (e.g., EMCYT) or
• Estrogens (female hormones) or
• Oral contraceptives (birth control pills) containing estrogen or
• Phenytoin (e.g., Dilantin)—Rifampin may decrease the effects of these medicines. If you are taking oral contraceptives, this may increase the chance of pregnancy. These medicines may also increase the chance of liver damage if taken with rifampin

Other medical problems—The presence of other medical problems may affect the use of rifampin. Make sure you tell your doctor if you have any other medical problems, especially:

• Alcohol abuse (or history of) or
• Liver disease—There may be an increased chance of side effects affecting the liver in patients with a history of alcohol abuse or liver disease

Proper Use of This Medicine

Rifampin is best taken with a full glass (8 ounces) of water on an empty stomach (either 1 hour before or 2 hours after a meal). However, if this medicine upsets your stomach, your doctor may want you to take it with food.

For patients unable to swallow capsules :

• Contents of the capsules may be mixed with applesauce or jelly. Be sure to take all the food to get the full dose of medicine.
• Your pharmacist can prepare an oral liquid form of this medicine if needed. The liquid form may be kept at room temperature or in the refrigerator. Follow the directions on the label. Shake the bottle well before using. Do not use after the expiration date on the label. The medicine may not work properly after that date. In addition, use a specially marked measuring spoon or other device to measure each dose accurately. The average household teaspoon may not hold the right amount of liquid.

To help clear up your tuberculosis (TB) infection completely, it is very important that you keep taking this medicine for the full time of treatment , even if you begin to feel better after a few weeks. You may have to take it every day for as long as 1 to 2 years or more. It is important that you do not miss any doses .

Dosing—The dose of rifampin will be different for different patients. Follow your doctor"s orders or the directions on the label . The following information includes only the average doses of rifampin. If your dose is different, do not change it unless your doctor tells you to do so.

The number of capsules that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are taking rifampin .

• For oral dosage form (capsules) and injection dosage form:
  • For the treatment of tuberculosis (TB):
    • Adults and older children—600 milligrams (mg) once a day. Your doctor may instruct you to take 600 mg two times a week or three times a week. Rifampin must be taken with other medicines to treat tuberculosis.
    • Infants and children—Dose is based on body weight and will be determined by your doctor. Rifampin is usually taken once a day. Your doctor may instruct you to take rifampin two times a week or three times a week. Rifampin must be taken with other medicines to treat tuberculosis.
  • For the treatment of patients in contact with the meningitis bacteria:
    • Adults and older children—600 mg once a day for four days.
    • Infants and children—Dose is based on body weight and will be determined by your doctor.

Missed dose—If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses. If this medicine is taken on an irregular schedule, side effects may occur more often and may be more serious than usual . If you have any questions about this, check with your health care professional.

Storage—To store the capsule form of this medicine:

• Keep out of the reach of children.
• Store away from heat and direct light.
• Do not store in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

Precautions While Using This Medicine

It is very important that your doctor check your progress at regular visits .

If your symptoms do not improve within 2 to 3 weeks, or if they become worse, check with your doctor.

Oral contraceptives (birth control pills) containing estrogen may not work properly if you take them while you are taking rifampin. Unplanned pregnancies may occur. You should use a different means of birth control while you are taking rifampin . If you have any questions about this, check with your health care professional.

Liver problems may be more likely to occur if you drink alcoholic beverages regularly while you are taking this medicine. Also, the regular use of alcohol may keep this medicine from working properly. Therefore, you should not drink alcoholic beverages while you are taking this medicine .

If this medicine causes you to feel very tired or very weak or causes a loss of appetite, nausea, or vomiting, stop taking it and check with your doctor immediately . These may be early warning signs of more serious problems that could develop later.

Rifampin will cause the urine, stool, saliva, sputum, sweat, and tears to turn reddish-orange to reddish-brown. This is to be expected while you are taking this medicine. This effect may cause soft contact lenses to become permanently discolored. Standard cleaning solutions may not take out all the discoloration. Therefore, it is best not to wear soft contact lenses while taking this medicine . This condition will return to normal once you stop taking this medicine. Hard contact lenses are not discolored by rifampin. If you have any questions about this, check with your doctor.

Rifampin can lower the number of white blood cells in your blood temporarily, increasing the chance of getting an infection. It can also lower the number of platelets, which are necessary for proper blood clotting. These problems may result in a greater chance of getting certain infections, slow healing, and bleeding of the gums. Be careful when using a regular toothbrush, dental floss, or a toothpick. Dental work should be delayed until your blood counts have returned to normal. Check with your medical doctor or dentist if you have any questions about proper oral hygiene (mouth care) during treatment.

Before you have any medical tests, tell the doctor in charge that you are taking this medicine. The results of some tests may be affected by this medicine.

Side Effects of This Medicine

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome:

This medicine commonly causes reddish-orange to reddish-brown discoloration of urine, stool, saliva, sputum, sweat, and tears. This side effect does not usually need medical attention.

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.

Additional Information

Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although these uses are not included in product labeling, rifampin is used in certain patients with the following medical conditions:

• Atypical mycobacterial infections, such as Mycobacterium avium complex (MAC)
• Leprosy (Hansen"s disease)
• Prevention of Haemophilus influenzae infection
• Treatment of serious staphylococcal (bacterial) infections

Other than the above information, there is no additional information relating to proper use, precautions, or side effects for these uses.

Revised: 11/10/2003

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