Last updated: June 2021
- Antibacterial, first line antituberculosis antibacterial (sterilising and bactericidal activity), antileprotic antibacterial (bactericidal activity)
- 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
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
- 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.
- 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
- For patients sensitive to first-line antituberculosis treatment, rifampicin is given as part of a fixed dose combination.