Common use
Rifampin is an antibiotic used primarily to treat tuberculosis (TB) and eliminate meningococcal bacteria from the nose and throat. It works by inhibiting bacterial RNA synthesis, stopping bacteria from multiplying. Rifampin is often used in combination with other antibiotics to prevent drug resistance. It is also sometimes prescribed for off-label infections, such as prosthetic joint infections.
Dosage and direction
The usual adult dose for TB is 600 mg once daily, taken on an empty stomach, typically 1 hour before or 2 hours after meals. Dosage may vary based on the specific infection and patient weight. Rifampin should be taken at the same time every day for the full course prescribed, even if symptoms improve. Do not skip doses, as this increases the risk of resistance.
Precautions
Rifampin can cause liver damage, especially when used with other hepatotoxic drugs or in patients with pre-existing liver conditions. Regular liver function tests are recommended during treatment. It may cause red-orange discoloration of urine, sweat, tears, and saliva — this is harmless but can stain contact lenses or clothing. Tell your doctor if you are pregnant, breastfeeding, or taking birth control pills, as rifampin can reduce contraceptive effectiveness.
Contraindications
Rifampin is contraindicated in patients with a known hypersensitivity to rifampin or other rifamycins. It should not be used in severe liver disease without close monitoring. The drug may interact significantly with HIV protease inhibitors and some antiepileptics, and these combinations should be avoided unless supervised by a specialist. Rifampin is not recommended as a single-agent therapy due to rapid development of resistance.
Possible side effect
Common side effects include nausea, abdominal pain, rash, and fatigue. Some individuals may experience hepatitis, flu-like symptoms, or low platelet counts. Serious allergic reactions, including anaphylaxis, are rare but possible. Contact your doctor if you experience jaundice, dark urine, or unusual bleeding.
Drug interaction
Rifampin is a strong enzyme inducer and can lower the effectiveness of many drugs, including oral contraceptives, warfarin, antiretrovirals, and anticonvulsants. It speeds up drug metabolism in the liver, often requiring dose adjustments of other medications. Always inform your healthcare provider about all medicines, vitamins, or herbal supplements you take. Avoid alcohol to reduce the risk of liver toxicity.
Missed dose
If you miss a dose, take it as soon as you remember. If it’s nearly time for your next dose, skip the missed one and continue with your regular schedule. Do not take two doses at once to make up for the missed dose. Skipping doses can lead to treatment failure and antibiotic resistance.
Overdose
Symptoms of overdose include nausea, vomiting, confusion, seizures, or orange-red discoloration of skin and bodily fluids. In severe cases, overdose can lead to liver failure or coma. Immediate medical attention is required. Treatment is usually supportive and may include activated charcoal or hospital care.
Storage
Store rifampin capsules at room temperature (20°C to 25°C / 68°F to 77°F), away from moisture and light. Keep the medication in its original container with the lid tightly closed. Do not use past the expiration date. Keep out of reach of children and pets.
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