Drug reference

Rifabutin

BNF 80 (2020–2021)

Source: BNF 80 (2020–2021)
PDF pages: 630, 631

Review source pages for extracted sections and age labels. BNF dose snippets show only their first line.

Overview

Indications And Dose

Prophylaxis of Mycobacterium avium complex infections in immunosuppressed patients with low CD4 count ▶BY MOUTH ▶Adult: 300 mg once daily, also consult product literature Treatment of non-tuberculous mycobacterial disease, in combination with other drugs ▶BY MOUTH ▶Adult: 450–600 mg once daily for up to 6 months after cultures negative Treatment of pulmonary tuberculosis, in combination with other drugs ▶BY MOUTH ▶Adult: 150–450 mg once daily for at least 6 months Helicobacter pylori eradication [in combination with other drugs (see Helicobacter pylori infection p. 89)] ▶BY MOUTH ▶Adult: 150 mg twice daily for 10 days for third-line eradication therapy l UNLICENSED USE g Rifabutin is used for the eradication of Helicobacter pylori, h but is not licensed for this indication.

PDF page 630

Cautions

Acute porphyrias p. 1120. discolours soft contact lenses

PDF page 630

Allergy And Cross Sensitivity

Contra-indicated in patients with rifamycin hypersensitivity.

PDF page 630

Prescribing And Dispensing Information

If treatment interruption occurs, re-introduce with low dosage and increase gradually.

PDF page 631

Safety

Interactions

→Appendix 1: rifabutin

PDF page 630

Side Effects

Agranulocytosis. anaemia. arthralgia. bronchospasm. chest pain. corneal deposits. decreased leucocytes. dyspnoea. eosinophilia. fever. haemolysis. hepatic disorders. inﬂuenza like illness. myalgia. nausea. neutropenia. pancytopenia. skin reactions. thrombocytopenia. urine discolouration. uveitis (more common following high doses or concomitant use with drugs that increase plasma concentration). vomiting

PDF page 630

Conception And Contraception

Important Rifabutin induces hepatic enzymes and the effectiveness of hormonal contraceptives is reduced; alternative family planning advice should be offered.

PDF page 630

Pregnancy

Manufacturer advises avoid—no information available.

PDF page 630

Breast Feeding

Manufacturer advises avoid—no information available.

PDF page 630

Hepatic Impairment

Manufacturer advises caution in severe impairment.

PDF page 630

Renal Impairment

Dose adjustments Use half normal dose if eGFR less than 30 mL/minute/1.73 m2.

PDF page 630

Monitoring Requirements

▶Renal function should be checked before treatment. ▶Hepatic function should be checked before treatment. If there is no evidence of liver disease (and pre-treatment liver function is normal), further checks are only necessary if the patient develops fever, malaise, vomiting, jaundice or unexplained deterioration during treatment. However, hepatic function should be monitored on prolonged therapy. ▶Blood counts should be monitored on prolonged therapy. ▶Those with alcohol dependence should have frequent checks of hepatic function, particularly in the ﬁrst 2 months. Blood counts should also be monitored in these patients.

PDF page 631

Dose and formulations

Medicinal Forms

There can be variation in the licensing of different medicines containing the same drug. Forms available from special-order manufacturers include: oral suspension, oral solution Capsule CAUTIONARY AND ADVISORY LABELS 8, 14 ▶Mycobutin (Pfizer Ltd) Rifabutin 150 mg Mycobutin 150mg capsules | 30 capsule P £90.38 DT = £90.38

PDF page 631

Clinical care

Patient And Carer Advice

Soft contact lenses Patients or their carers should be advised that rifabutin discolours soft contact lenses. Hepatic disorders Patients or their carers should be told how to recognise signs of liver disorder, and advised to discontinue treatment and seek immediate medical attention if symptoms such as persistent nausea, vomiting, malaise or jaundice develop.

PDF page 631

Dose text by age group

Adult

300 mg once daily, also consult product

First-line fragment. Read the complete Indications and Dose section above.

PDF page 630

Adult

450–600 mg once daily for up to 6 months after

First-line fragment. Read the complete Indications and Dose section above.

PDF page 630

Adult

150–450 mg once daily for at least 6 months

First-line fragment. Read the complete Indications and Dose section above.

PDF page 630

Adult

150 mg twice daily for 10 days for third-line

First-line fragment. Read the complete Indications and Dose section above.

PDF page 630

Age labels are extracted for navigation. Check the complete source section and current local guidance before clinical use.

Drug reference

Rifabutin

BNF 80 (2020–2021)

Source: BNF 80 (2020–2021)
PDF pages: 630, 631

Review source pages for extracted sections and age labels. BNF dose snippets show only their first line.

Overview

Indications And Dose

PDF page 630

Cautions

Acute porphyrias p. 1120. discolours soft contact lenses

PDF page 630

Allergy And Cross Sensitivity

Contra-indicated in patients with rifamycin hypersensitivity.

PDF page 630

Prescribing And Dispensing Information

If treatment interruption occurs, re-introduce with low dosage and increase gradually.

PDF page 631

Safety

Interactions

→Appendix 1: rifabutin

PDF page 630

Side Effects

PDF page 630

Conception And Contraception

Important Rifabutin induces hepatic enzymes and the effectiveness of hormonal contraceptives is reduced; alternative family planning advice should be offered.

PDF page 630

Pregnancy

Manufacturer advises avoid—no information available.

PDF page 630

Breast Feeding

Manufacturer advises avoid—no information available.

PDF page 630

Hepatic Impairment

Manufacturer advises caution in severe impairment.

PDF page 630

Renal Impairment

Dose adjustments Use half normal dose if eGFR less than 30 mL/minute/1.73 m2.

PDF page 630

Monitoring Requirements

PDF page 631

Dose and formulations

Medicinal Forms

PDF page 631

Clinical care

Patient And Carer Advice

PDF page 631

Dose text by age group

Adult

300 mg once daily, also consult product

First-line fragment. Read the complete Indications and Dose section above.

PDF page 630

Adult

450–600 mg once daily for up to 6 months after

First-line fragment. Read the complete Indications and Dose section above.

PDF page 630

Adult

150–450 mg once daily for at least 6 months

First-line fragment. Read the complete Indications and Dose section above.

PDF page 630

Adult

150 mg twice daily for 10 days for third-line

First-line fragment. Read the complete Indications and Dose section above.

PDF page 630

Age labels are extracted for navigation. Check the complete source section and current local guidance before clinical use.