ADAP drugs: rifampin

rifampin
(RIF, Rifampicin, Rifadin, Rimactane)

Drug description

Rifampin is a treatment for MAC and TB infections. Maintenance therapy after an episode of MAC is now routine, though it is not known which of the existing treatments is most effective. Multidrug therapy reduces mycobacterial colony counts in blood and leads to clinical improvement, especially the reduction of fevers.

Side effects
Chills, difficult breathing, dizziness, fever, headache, muscle and bone pain, rash, itching, sore throat, yellow eyes or skin, unusual bleeding or bruising, loss of appetite, nausea, vomiting, unusual tiredness or weakness, bloody or cloudy urine, stomach cramps, diarrhea, and sore mouth or tongue. Urine, feces, saliva, sputum, sweat or tears may become red-orange to red-brown in color. Soft contact lenses may become permanently discolored.

Dosage
Rifampin comes in pill and injectable forms. The drug is usually taken orally. Dosage is 600 mg per day or 450 mg per day for people weighing less than 50 kg. Rifampin interacts with ketoconazole in the body and can reduce the effectiveness of both drugs. Rifampin reduces the effectiveness of methadone and may lead to withdrawal symptoms. Rifampin lowers serum dapsone levels, so the two drugs should not be used together. Rifampin can decrease the effectiveness of oral contraceptives.

How long it may take to work
If you have latent but inactive TB and you are under 35 years old, you must be treated for at least one to two years with rifampin if you cannot tolerate standard treatment with isoniazid or other TB treatments. Ongoing maintenance treatment for MAC is necessary. Maintenance treatment means you keep taking the drug to control an infection so that you don't become ill. You should experience increased appetite, weight gain, reduced fatigue, and a sense of well-being with treatment.

Managing side effects
Take the drug on an empty stomach at least 1 hour before or 2 hours after meals. If GI irritation becomes a problem, rifampin can be taken with food. Antacids may also be taken 1 hour before taking drug. Capsules may be opened and contents mixed with applesauce or jelly for people who have difficulty swallowing. The pharmacist can make a syrup for people who are unable to swallow solids. Avoid alcohol during this therapy because alcohol increases the chance of damage to the liver.

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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