RIFAMPICIN = R oral

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    Last updated: June 2021

     

     

    Prescription under medical supervision

     

    Therapeutic action

    • Antibacterial, first line antituberculosis antibacterial (sterilising and bactericidal activity), antileprotic antibacterial (bactericidal activity)

    Indications

    • Tuberculosis, in combination with other antituberculosis antibacterials
    • Paucibacillary and multibacillary leprosy, in combination with dapsone and clofazimine
    • Brucellosis, in combination with another antibacterial
    • Latent tuberculosis, as monotherapy or in combination with isoniazid 

    Forms and strengths

    • 150 mg tablet and 300 mg capsule

    Dosage

    Tuberculosis, latent tuberculosis, as monotherapy or in combination with isoniazid

    • Child under 30 kg: 15 mg/kg once daily, on an empty stomach
    • Child 30 kg and over and adult: 10 mg/kg once daily, on an empty stomach

     

    Do not exceed 600 mg daily.

     

    Paucibacillary and multibacillary leprosy

    • Child under 10 years: 10 mg/kg once monthly, on an empty stomach
    • Child from 10 to 14 years: 450 mg once monthly, on an empty stomach
    • Child 15 years and over and adult: 600 mg once monthly, on an empty stomach

     

    Brucellosis

    • Child: 15 to 20 mg/kg once daily, on an empty stomach (max. 600 mg daily)
    • Adult: 600 to 900 mg once daily, on an empty stomach

     

    In patients with hepatic impairment: do not exceed 8 mg/kg/day when treatment is administered daily.

    Duration

    • Tuberculosis: according to protocol
    • Latent tuberculosis as monotherapy: 4 months
    • Latent tuberculosis in combination with isoniazid: 3 months
    • Paucibacillary leprosy: 6 months
    • Multibacillary leprosy: 12 months
    • Brucellosis: 6 weeks

    Contra-indications, adverse effects, precautions

    • Do not administer to patients with jaundice, hypersensitivity to rifamycins or history of severe haematological disorders (thrombocytopenia, purpura) during a previous treatment with rifamycins.
    • Avoid or administer with caution to patients with hepatic disorders.
    • May cause:
      • harmless orange-red discoloration of body secretions (urine, tears, saliva, sputum, sweat, etc.);
      • gastrointestinal disturbances (can be taken with a small amount of food to increase gastrointestinal tolerance); headache, drowsiness, hepatotoxicity;
      • influenza-like symptoms;
      • thrombocytopenia, hypersensitivity reactions.
    • If signs of hepatotoxicity (e.g. jaundice) develop, rifampicin should be discontinued until symptoms resolve.
    • Rifampicin reduces the effect of many drugs (antimicrobials, some antiretrovirals, some hormones, antidiabetics, corticosteroids, phenytoin, direct-acting antivirals for chronic hepatitis C, warfarin, etc.):
      • in patients taking nevirapine, lopinavir/ritonavir, atazanavir/ritonavir, use rifabutin in place of rifampicin;
      • in women using contraception, use injectable medroxyprogesterone or an intrauterine device;
      • in the event of concomitant fluconazole administration, administer each drug 12 hours apart (rifampicin in the morning, fluconazole in the evening);
      • for the other drugs, adjust dosage if necessary.
    • Pregnancy: no contra-indication. Risk of maternal and neonatal bleeding disorders when the mother receives rifampicin in late pregnancy: administer phytomenadione (vitamin K) to the mother and the neonate to reduce the risk.
    • Breast-feeding: no contra-indication

    Remarks

    • For patients sensitive to first-line antituberculosis treatment, rifampicin is given as part of a fixed dose combination.

    Storage

     
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    Below 25 °C 
    Path