Rifampin

Indications

  • Staphylococcus Aureus (see Staphylococcus Aureus, [[Staphylococcus Aureus]])
  • Leprosy (Hansen’s Disease) (see Leprosy, [[Leprosy]])
  • Tuberculosis (see Tuberculosis, [[Tuberculosis]])
    • Active Tuberculosis
    • Latent Tuberculosis (Positive PPD)

Pharmacology

  • Rifamycin Group Antibiotic: inhibits bacterial DNA-dependent RNA polymerase -> inhibits bacterial RNA synthesis
    • Rifamycins (a subclass of the ansamycins) are produced by the bacterium Amycolatopsis Rifamycinica (originally named Streptomyces Mediterranei when it was first isolated in 1957) or synthesized
    • Rifamycins were originally named after the French crime story Rififi (which was favored by the researchers who discovered these agents)
    • Members of Rifamycin Group
      • Rifamycins
      • Rifabutin (see Rifabutin, [[Rifabutin]])
      • Rifalazil
      • Rifampin (Rifampicin)
      • Rifapentine

Metabolism

  • xxx

Administration

  • PO: xxx
  • IV: xxx

Dose Adjustment

  • Hepatic
  • Renal

Breast Feeding

  • Rifampin is Excreted in Breast Milk: breast feeding should be avoided during rifampin administration

Drug Interactions

  • Upregulation of Hepatic Cytochrome P450 Enzymes (CYP2C9, CYP3A4)
    • Increased Coumadin Metabolism (see Coumadin, [[Coumadin]]): decreasing efficacy of coumadin anticoagulation
    • Increased Oral Contraceptive Hormonal Metabolism (see Oral Contraceptives, [[Oral Contraceptives]]): decreasing efficacy

Adverse Effects

Constitutional Adverse Effects

  • Flu-Like Symptoms: may be due to excellent penetration of drug into the brain
    • Fever/Chills (see Fever, [[Fever]])
    • Headache (see Headache, [[Headache]])
    • Arthralgias (see Arthralgias, [[Arthralgias]])
    • Malaise

Dermatologic Adverse Effects

  • Flushing (see Flushing, [[Flushing]])
  • Pruritus (see Pruritus, [[Pruritus]])
  • Rash

Gastrointestinal Adverse Effects

Hepatotoxicity

Other Gastrointetsinal Manifestations

Pulmonary Adverse Effects

Drug-Induced Pulmonary Eosinophilia (see Drug-Induced Pulmonary Eosinophilia, [[Drug-Induced Pulmonary Eosinophilia]])

  • Epidemiology
  • Clinical

Dyspnea (see Dyspnea, [[Dyspnea]])

  • xxx

Other Adverse Effects

  • Orange-Red Secretions/Tears: may stain contact lenses
  • Orange-Red Urine (see Urine Discoloration, [[Urine Discoloration]])

References

  • xxx