Rifampicin (R)

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    Update: January 2022

     

    Forms and strengths

    • 300 mg capsule and 150 mg tablet

    Dosage

    • Child under 30 kg: 15 mg/kg (10 to 20 mg/kg) once daily 
    • Child 30 kg and over and adult: 10 mg/kg  (8 to 12 mg/kg) once daily
    • Maximum dose: 600 mg daily
    • Hepatic impairment: 8 mg/kg once daily max.

     

    Weight
    (kg)

    Daily dose
    (mg)

    300 mg
     capsule

    150 mg
    tablet

    5

    50-100

    ½ tab

    6

    60-120

    ½ tab

    7

    70-140

    ½ tab

    8

    80-160

    1 tab

    9

    90-180

    1 tab

    10

    100-200

    1 tab

    11

    110-220

    1 tab

    12

    120-240

    1 tab

    13

    130-260

    1½ tab

    14

    140-280

    1½ tab

    15

    150-300

    1½ tab

    16

    160-320

    1 tab

    17

    170-340

    1 tab

    18

    180-360

    1 tab

    19

    190-380

    1 tab

    20

    200-400

    1 tab

    21

    210-420

    1 tab

    22

    220-440

    1 tab

    23

    230-460

    1 tab

    24

    240-480

    1 tab

    25

    250-500

    1 tab

    26

    260-520

    1 tab

    27

    270-540

    1 tab

    28

    280-560

    1 tab

    29

    290-580

    1 tab

     

    30-35

    300

    1 tab

    36-45

    450

    1½ tab

    46-55

    450

    1½ tab

    56-70

    600

    2 tab

    > 70

    600

    2 tab

     

    Contra-indications, adverse effects, precautions

    • Do not administer to patients with hypersensitivity to rifamycins or history of severe haematological disorders (thrombocytopenia, purpura) during a previous treatment with a rifamycin.
    • Avoid or administer with caution to patients with hepatic disorders.
    • May cause:
      • hepatotoxicity;
      • influenza-like symptoms, thrombocytopenia, hypersensitivity reactions.
    • For the management of adverse effects, see Appendix 17.
    • 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 antiretrovirals, see Appendix 19
      • 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 and breastfeeding: no contra-indication. If used in late pregnancy, administer phytomenadione (vitamin K1) to the mother and the neonate.

    Monitoring

    • Symptomatic monitoring.
    • Liver function in patients with hepatic disease.

    Patient instructions

    • Take without food (or with a small amount of food to increase gastrointestinal tolerance).
    • Harmless orange-red discoloration of the urine, faeces, sweat, saliva, sputum, tears and other body fluids.

    Remarks

    • For patients on drug-susceptible TB treatment, rifampicin is given as part of a fixed-dose combination.
    • For the 6HRZ-Eto regimen for drug-susceptible TB meningitis, the dose of rifampicin is 20 mg/kg once daily (max. 600 mg daily).
    • Rifampicin is also used in the treatment of latent TB infection.

    Storage

     
    – 
     
    – 
    Below 25 °C