Rifampicin

Indications

Tuberculosis

In treating both tuberculosis and the meningococcal carrier state, the small number of resistant cells present within a large population of susceptible cells can quickly become the dominant type. Bacteriologic cultures should be taken before starting therapy to confirm that the organism is susceptible to rifampicin, and these cultures should be repeated throughout treatment to monitor the response. Because resistance can develop quickly, susceptibility testing should be carried out if cultures remain positive during the course of treatment. If test results show resistance to rifampicin and the patient is not responding to therapy, the treatment regimen should be modified.

⚠️ Always consult a registered physician before taking any medicine.

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.

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.

Dosage Reference

⚠️ Reference ranges from official sources only. Consult your doctor 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.

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Indications

Pharmacology

Pregnancy & Breastfeeding

Dosage Reference

Side Effects & Interactions

Side Effects

Key Interactions