Indications & Uses
Rifajap is indicated for:
Pharmacology
Rifampicin binds to the β subunit of DNA-dependent RNA polymerase in susceptible bacteria, blocking chain initiation for RNA synthesis and thereby inhibiting transcription.
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 given by mouth or by IV infusion. The IV dose is the same as the oral dose.
Tuberculosis: Adults: 10 mg/kg as a single daily dose, not to exceed 600 mg/day, oral or IV. Pediatric patients: 10 to 20 mg/kg, not to exceed 600 mg/day, oral or IV.
Oral rifampin is best taken once daily, either 1 hour before or 2 hours after a meal, with a full glass of water.
Rifampin is indicated for all forms of tuberculosis. In the initial phase of short-course therapy, a three-drug regimen of rifampin, isoniazid and pyrazinamide is recommended, and this phase usually runs for 2 months. The Advisory Council for the Elimination of Tuberculosis, the American Thoracic Society and the Centers for Disease Control and Prevention also recommend adding either streptomycin or ethambutol as a fourth drug to the regimen of isoniazid (INH), rifampin and pyrazinamide for initial treatment, unless the likelihood of INH resistance is very low. Once the results of susceptibility testing are known, the need for that fourth drug should be reassessed. If community rates of INH resistance are currently less than 4%, an initial regimen with fewer than four drugs may be considered.
Following the initial phase, treatment should continue with rifampin and isoniazid for at least 4 months. It should go on longer if the patient is still sputum or culture positive, if resistant organisms are present, or if the patient is HIV positive.
Side Effects
Rifampicin can cause facial flushing and itching, with or without a rash. Some people develop a flu-like syndrome, which comes as episodes of fever, chills, headache, dizziness, bone pain, shortness of breath and malaise. GI adverse effects include nausea, vomiting, anorexia, diarrhoea and epigastric distress. Pseudomembranous colitis can also occur, along with eosinophilia, leucopenia and haemolytic anaemia. Other effects are alterations in kidney function and renal failure, menstrual disturbances, oedema, myopathy and muscular weakness. Rifampicin turns the urine, faeces, sweat, saliva, sputum, tears and other body fluids an orange-red colour. After prolonged IV infusion, thrombophlebitis can develop, with local irritation and inflammation. Rarely, people report eye irritation and visual disturbances, and anaphylaxis or shock can occur.
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.
Pregnancy & Breastfeeding
Pregnancy: If rifampicin is given during the final weeks of pregnancy, it can cause post-natal hemorrhage in both the mother and the newborn, and treatment with vitamin K may be needed as a result.
Nursing Mothers: Animal studies have shown a potential for tumorigenicity with rifampicin, so nursing mothers and their doctors should weigh how important the drug is to the mother against this risk when deciding whether to stop breastfeeding or stop the medicine.
⚠️ Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
Use in Special Populations
Geriatric Use: Rifampicin has not been studied in enough people aged 65 and over to show whether they respond differently from younger people. Other clinical experience that has been reported hasn't found any difference in response between elderly and younger patients either. Even so, take care when using rifampin in elderly patients.
Overdose
After rifampicin overdose, nausea, vomiting, abdominal pain, itching, headache and growing drowsiness will probably start within a short time of swallowing it. If the person already has severe liver disease, they may lose consciousness. Liver enzymes and/or bilirubin may rise for a short while. The skin, urine, sweat, saliva, tears and faeces turn brownish-red or orange, and the deeper the colour, the more was taken.
Within a few hours of a severe overdose the liver can become enlarged, sometimes tender, and bilirubin may go up and jaundice can appear quickly. The liver is likely to be affected more in patients whose liver function was already impaired. Other physical findings stay essentially normal. A direct effect on the blood-forming system, electrolyte levels or acid-base balance is unlikely.
Facial or periorbital oedema has also been reported in children. In some fatal cases, low blood pressure, sinus tachycardia, ventricular arrhythmias, seizures and cardiac arrest were reported.
⚠️ In an emergency call 999 or go to the nearest hospital emergency department.
Storage
Keep Rifampicin between 15 and 30° C, away from excessive heat and protected from light.
Drug Interactions
Common questions about Rifajap 450 mg
What is Rifajap 450 mg Capsule?
Rifajap 450 mg Capsule is a medicine that contains Rifampicin. It is made by Jalalabad Pharmaceuticals Ltd. It belongs to the Anti-tubercular antibiotics group of medicines.
What is Rifajap used for?
Rifajap is used for: Tuberculosis.
What are the side effects of Rifajap?
Rifampicin can cause facial flushing and itching, with or without a rash. Some people develop a flu-like syndrome, which comes as episodes of fever, chills, headache, dizziness, bone pain, shortness of breath and malaise.
Can I take Rifajap during pregnancy or while breastfeeding?
Pregnancy: If rifampicin is given during the final weeks of pregnancy, it can cause post-natal hemorrhage in both the mother and the newborn, and treatment with vitamin K may be needed as a result. Nursing Mothers: Animal studies have shown a potential for tumorigenicity with rifampicin, so nursing mothers and their doctors should weigh how important the drug is to the mother against this risk when deciding whether to stop breastfeeding or stop the medicine. Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
What happens if I take too much Rifajap?
After rifampicin overdose, nausea, vomiting, abdominal pain, itching, headache and growing drowsiness will probably start within a short time of swallowing it. If the person already has severe liver disease, they may lose consciousness. In an emergency call 999 or go to the nearest hospital emergency department.
How should I store Rifajap?
Keep Rifampicin between 15 and 30° C, away from excessive heat and protected from light.
Can I take other medicines with Rifajap?
Some medicines can interact with Rifampicin, for example: Lercanidipine Hydrochloride, Rivaroxaban, Paclitaxel, Osimertinib, Istradefylline, Ledipasvir + Sofosbuvir. Tell your doctor or pharmacist about every medicine you take.
Do I need a prescription for Rifajap?
Rifajap is a prescription (Rx) medicine. Take it as your doctor advises.