ADAP drugs: rifabutin

rifabutin (Ansamycin, Mycobutin)

Drug description

Rifabutin is used in combination with other drugs for prevention and treatment of MAC. A number of different drugs are being tried for prevention and maintenance treatment of MAC. MAC is related to tuberculosis (TB), but no one anti-TB drug works against MAC. Maintenance therapy after an episode of MAC is now routine, though it is not known which of the existing treatments is most effective. Recent Public Health Service recommendations suggest either clarithromycin or azithromycin as the first line treatment for MAC, along with at least one other drug, usually ethambutol and one of the following: ciprofloxacin or rifabutin. Multidrug therapy reduces mycobacterial colony counts in blood and leads to clinical improvement, especially the reduction of fever. Preventive treatment for MAC is recommended in people with less than 75 T4 cells.

Side effects
Possible kidney and liver effects, bone marrow suppression, rash, fever, gastrointestinal distress, uveitis (a swelling of the eye). Rifabutin can also cause an orange discoloration of the urine, sweat and tears. Soft contact lenses can become permanently discolored. Taking rifabutin and clarithromycin together raises the level of rifabutin in the body which increases the risk of side effects.

Dosage
Rifabutin comes in 150 mg capsules. Dosage for preventive treatment is 300 mg daily. Rifabutin is likely to have similar drug interactions to rifampin which interacts with ketoconazole and reduces the effectiveness of both drugs to subtherapeutic doses.

How long it may take to work
The drug usually helps with symptoms in two to four weeks. Ongoing maintenance treatment is necessary. Maintenance treatment means you keep taking the drug to control an infection so that you don't become ill.

Managing side effects
Drugs that can help reduce the symptoms of nausea include Compazine, Phenergan, and Reglan. Nutrition strategies such as eating dry salted crackers and not lying down right after you eat can help with stomach upset and nausea. Early warning signs of kidney problems are decreased urination, increased thirst, or light-headedness after you stand up. Kidney problems can generally be treated. One of the purposes of frequent and repeated blood tests when you are severely ill is to make sure that your kidneys are working well. If blood tests show signs of any potential problems, treatment can begin promptly. Treatment often requires adjusting doses of certain drugs, decreasing your fluid intake, and following a special diet for kidney failure. When taking rifabutin, be sure to notify immediately of any eye problems or changes in vision.

This information is specific to the use of this medication for HIV-related conditions. For additional information about this drug for other conditions, refer to: www.nursespdr.com/ and www.healthanswers.com/Library/library_fset.asp

The drug descriptions on these pages are intended for informational purposes only. The Network does not promote or endorse the use of any specific treatment for any health-related condition. The medications described here can only be dispensed by a licensed health care professional. The information may have changed since these pages were updated, though every effort is made to keep these pages current. Please contact The Network at (800) 734-7104 to make sure you have the most up-to-date information

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