Indications & Uses
Xefampin is indicated for:
Dosage Reference
Reference Information Only
Dosages shown are general references from official sources. Always consult your doctor or pharmacist for personalized dosing.
Adults:
Rifampin can be administered by the oral route or by IV infusion. IV doses are the same as those for oral.Tuberculosis: Adults: 10 mg/kg, in a single daily administration, not to exceed 600 mg/day, oral or IV Pediatric Patients: 10–20 mg/kg, not to exceed 600 mg/day, oral or IV It is recommended that oral rifampin be administered once daily, either 1 hour before or 2 hours after a meal with a full glass of water.Rifampin is indicated in the treatment of all forms of tuberculosis. A three-drug regimen consisting of rifampin, isoniazid, and pyrazinamide is recommended in the initial phase of shortcourse therapy which is usually continued for 2 months. The Advisory Council for the Elimination of Tuberculosis, the American Thoracic Society, and the Centers for Disease Control and Prevention recommend that either streptomycin or ethambutol be added as a fourth drug in a regimen containing isoniazid (INH), rifampin and pyrazinamide for initial treatment of tuberculosis unless the likelihood of INH resistance is very low. The need for a fourth drug should be reassessed when the results of susceptibility testing are known. If community rates of INH resistance are currently less than 4%, an initial treatment regimen with less than four drugs may be considered.Following the initial phase, treatment should be continued with rifampin and isoniazid for at least 4 months. Treatment should be continued for longer if the patient is still sputum or culture positive, if resistant organisms are present, or if the patient is HIV positive.
Side Effects
Facial flushing and itching, with or without a rash, flu-like syndrome characterised by episodes of fever, chills, headache, dizziness, bone pain, shortness of breath, and malaise; GI adverse effects (e.g. nausea, vomiting, anorexia, diarrhoea, epigastric distress), pseudomembranous colitis, eosinophilia, leucopenia, haemolytic anaemia; alterations in kidney function and renal failure, menstrual disturbances, oedema, myopathy, muscular weakness; orange-red discolouration of the urine, faeces, sweat, saliva, sputum, tears, and other body fluids; thrombophlebitis, local irritation and inflammation after prolonged IV infusion. Rarely, eye irritation and visual disturbances, anaphylaxis or shock.
Cautions & Contraindications
Warnings & Precautions
Rifampin has been shown to cause liver problems. Deaths related to jaundice have occurred in patients with liver disease and in those taking rifampin along with other drugs that can harm the liver. Patients with impaired liver function should be given rifampin only when truly necessary, and then only with caution and close medical supervision. In these patients, liver function, especially SGPT/ALT and SGOT/AST, should be checked carefully before starting treatment and every 2 to 4 weeks during treatment. If signs of liver cell damage appear, rifampin should be stopped. In some cases, a rise in bilirubin can occur in the early days of treatment because rifampin competes with bilirubin for the liver's excretory pathways at the cellular level. A single report of a moderate rise in bilirubin and/or transaminase levels is not, on its own, a reason to stop treatment; instead, the decision should be made after repeating the tests, tracking how the levels change over time, and weighing them alongside the patient's overall clinical condition. Rifampin has enzyme-inducing properties, including induction of delta amino levulinic acid synthetase. Isolated reports have linked rifampin use to flare-ups of porphyria.
Contraindications
Rifampicin should not be used in patients known to be hypersensitive to rifampin, to rifamycin-class drugs, or to any component of the formulation. It should also not be given together with ritonavir-boosted saquinavir, since this combination carries a heightened risk of severe liver cell toxicity. Similarly, rifampin should not be co-administered with atazanavir, darunavir, fosamprenavir, saquinavir, or tipranavir. Because rifampin can markedly lower the plasma levels of these antiretroviral drugs, combining them may cause the antivirals to lose effectiveness or allow the virus to develop resistance.