RIFAPENTINE = P oral

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    Last updated: September 2023

     

    Prescription under medical supervision

     

    Therapeutic action

    • Antituberculosis antibacterial (bactericidal activity) 

    Indications

    •  Latent tuberculosis, in combination with isoniazid  

    Forms and strengths

    • 150 mg and 300 mg tablets

    Dosage and duration

    Weekly regimen for 3 months, in combination with isoniazid  

    • Child 2 years and over and adult:

     

    Weight

    Weekly dosage

    150 mg tablet

    		 300 mg tablet

    10 to 14 kg 

    300 mg 

    2 tab once weekly 

    		 1 tab once weekly 

    14.1 to 25 kg 

    450 mg 

    3 tab once weekly 

    		 _

    25.1 to 32 kg 

    600 mg 

    4 tab once weekly 

    		 2 tab once weekly 

    32.1 to 49 kg 

    750 mg 

    5 tab once weekly 

    		 _

    ≥ 50 kg 

    900 mg 

    6 tab once weekly 

    		 3 tab once weekly 

     

    Daily regimen for 1 month, in combination with isoniazid 

    • Child 13 years and over and adult: 600 mg once daily 

    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. 
    • Do not administer the weekly regimen to children under 2 years or the daily regimen to children under 13 years. 
    • 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; rarely, hepatotoxicity; 
      • headache, influenza-like symptoms; 
      • haematological disorders, cutaneous reactions (rash, pruritus) and hypersensitivity reactions (approximately 4% of patients).
    • If signs of hepatotoxicity develop (e.g. jaundice), rifapentine should be discontinued until symptoms resolve. 
    • Rifapentine reduces the effect of many drugs (antimicrobials, anticonvulsants, some antiretrovirals, some hormones, antidiabetics, corticosteroids, direct-acting antivirals for chronic hepatitis C, warfarin, etc.): 
      • do not administer in patients on protease inhibitors or nevirapine; 
      • in women using contraceptive, use medroxyprogesterone or an intrauterine device; 
      • in the event of concomitant fluconazole administration, administer each drug 12 hours apart (rifapentine in the morning, fluconazole in the evening); 
      • for the other drugs, adjust dosage if necessary. 
    • Pregnancy and breast-feeding: not recommended (safety not established) 

    Remarks

    • Tablets can be crushed and mixed into a spoon with a small amount of food. 
    • Also comes in fixed dose combination containing 300 mg of rifapentine/300 mg of isoniazid. Prefer this formulation for weekly regimens to reduce the pill burden (3 tablets once weekly). This formulation is only recommended for children over 14 years and adults.  
    • Rifapentine and rifampicin are not interchangeable in regimens for latent tuberculosis. 

    Storage

     
    –  
     
    –  Below 25 °C
    Path