Names and pronunciation
(rif′am-pin) Rifadin, Rifampicin , Rofact
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Individual generic drug information
Extracted information for rifAMPin only.
(rif′am-pin) Rifadin, Rifampicin , Rofact
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Func. class.: Antitubercular
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Chem. class.: Rifamycin B derivative
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Do not confuse: rifAMPin/rifabutin/rifAXIMin
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ACTION: Inhibits DNA-dependent polymerase, decreases tubercle bacilli replication
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USES: Pulmonary TB, meningococcal carriers (prevention)
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Unlabeled uses: Endocarditis, Hae- mophilus influenzae type B prophy- laxis, Hansen’s disease, Mycobacterium avium complex (MAC), orthopedic device–related infection, pruritus, CNS infections
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Extracted information for rifAMPin only.
CONTRAINDICATIONS: Hyper sensitivity to this product, rifamycins; active Neisseria meningitidis infection Precautions: Pregnancy, breastfeeding, children <5 yr, hepatic disease, blood dyscrasias
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SIDE EFFECTS CNS: Headache, fatigue, anxiety, drowsi- ness, confusion EENT: Visual disturbances GI: Nausea, vomiting, anorexia, diar- rhea, CDAD, heartburn, sore mouth and tongue, pancreatitis, increased LFTs GU: Hematuria, acute renal failure, hemoglobinuria HEMA: Hemolytic anemia, eosinophilia, thrombocytopenia, leukopenia INTEG: Rash, pruritus, urticaria MISC: Flulike symptoms, menstrual disturbances, edema, SOB, Stevens-John- son syndrome, toxic epidermal necrolysis, angioedema, anaphylaxis, DRESS MS: Ataxia, weakness MISC: Staining of teeth, contact lens; coloring of urine, sweat, tears
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INTERACTIONS Do not use with protease inhibitors Increase: hepatotoxicity—isoniazid, alco- hol, ketoconazole, pyrazinamide Decrease: action of acetaminophen, alco- hol, anticoagulants, antidiabetics, β-blockers, barbiturates, benzodiazepines, chloramphenicol, clofibrate, cor ticosteroids, cycloSPORINE, dapsone, digox- in, doxycycline, haloperidol, hormones, imidazole antifungals, NIFEdipine, oral contraceptives, phenytoin, protease inhibi- tors, theophylline, verapamil, zidovudine Increase: LFTs Decrease: HB Drug/Lab Test Increase: alk phosphatase, ALT, AST, uric acid, bilirubin, eosinophils Interference: folate level, vit B12
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Extracted information for rifAMPin only.
DOSAGE AND ROUTES Tuberculosis • Adult: PO/IV Max 600 mg/day as sin- gle dose 1 hr before meals or 2 hr after meals or 10 mg/kg/day 5 days/wk or 2-3×/wk • Child >5 yr: PO/IV 10-20 mg/kg/day as single dose 1 hr before meals or 2 hr after meals, max 600 mg/day with other antituberculars • 6-mo regimen: 2 mo treatment of iso- niazid, rifAMPin, pyrazinamide, and pos- sibly streptomycin or ethambutol, then rifAMPin and isoniazid 3-4 mo • 9-mo regimen: rifAMPin and isoniazid supplemented with pyrazinamide, strep- tomycin, or ethambutol Meningococcal carriers • Adult: PO/IV 600 mg bid × 2 days, max 600 mg/dose • Child >5 yr: PO/IV 10-20 mg/kg × 2 days, max 600 mg/dose • Infant 3 mo-1 yr: PO 5 mg/kg bid × 2 days Prevention of H. influenzae type B infection (unlabeled) • Adult: PO 600 mg/day × 4 days • Child: PO 20 mg/kg/day × 4 days • Neonates: PO 10 mg/kg/day × 4 days MAC (unlabeled) • Adult: PO/IV 600 mg/day used with ≥3 other active microbials • Child: PO/IV 10-20 mg/kg/day used with ≥3 other active microbials Endocarditis with prosthetic valves (unlabeled) • Adult: PO 300 mg q8hr with gentami- cin and vancomycin • Child: PO 20 mg/kg/day in 2 divided doses with gentamicin and vancomycin, max 900 mg/day
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Available forms: Caps 150, 300 mg; powder for inj 600 mg/vial
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Administer: • After C&S completed; monthly to de- tect resistance • Do not give IM, SUBCUT PO route • On empty stomach, 1 hr before or 2 hr after meals with full glass of water; give with other products for TB • Antiemetic if vomiting occurs • Capsules may be opened, mixed with applesauce or jelly Intermittent IV INFUSION route • After diluting each 600 mg/10 mL of sterile water for inj (60 mg/mL), swirl, withdraw dose, and dilute in 100 mL or 500 mL of D5W given as infusion over 3 hr; if diluted in 100 mL, give over 1⁄2 hr; do not admix with other sol or products compatibilities: amiodarone, Y-site bumetanide, midazolam, pantoprazole, vancomycin
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Extracted information for rifAMPin only.
Assess: • Infection: sputum culture, lung sounds, characteristics of sputum, sus- ceptibility tests baseline and periodi- cally to determine effectiveness and resistance • Signs of anemia: Hct, HB, fatigue • Hepatic function monthly: ALT, AST, bilirubin, decreased appetite, jaundice, dark urine, fatigue • Renal status before, each mo: BUN, cre- atinine, output, specific gravity, urinalysis • Serious skin reactions: fever, sore throat, fatigue, ulcers; lesions in mouth, lips, rash; can be fatal • CDAD: diarrhea, fever, abdominal pain/ cramping, bloody stools; product should be discontinued, prescriber notified • DRESS: Rash, fever, large lymph nodes, discontinue product if these occur • To take on an empty stomach 1 hr be- fore or 2 hr after food
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Evaluate: • Therapeutic response: decreased symptoms of TB, culture negative R
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CLINICAL CONSIDERATIONS
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Patient and caregiver information: • That compliance with dosage sched- ule, duration necessary • That scheduled appointments must be kept because relapse may occur • To avoid alcohol because hepatotoxic- ity may occur • That urine, feces, saliva, sputum, sweat, tears may be colored red-orange; that soft contact lenses may be perma- nently stained • To report flulike symptoms: excessive fatigue, anorexia, vomiting, sore throat; un- usual bleeding; yellowish discoloration of skin, eyes; diarrhea with pus, mucus, blood • To use nonhormonal form of birth con- trol; to notify prescriber if pregnancy is planned, suspected; not to breastfeed
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Extracted information for rifAMPin only.
PHARMACOKINETICS PO: Peak 1-4 hr, half-life 1-5 hr, metabo- lized in liver (active/inactive metabolites), excreted in urine as free product (30% crosses placenta) and in breast milk
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Filter the extracted dose blocks for this individual drug.
Tuberculosis
• Adult: PO/IV Max 600 mg/day as sin- gle dose 1 hr before meals or 2 hr after meals or 10 mg/kg/day 5 days/wk or 2-3×/wk
Candidate age grouping · source page 1154
Tuberculosis
• Child >5 yr: PO/IV 10-20 mg/kg/day as single dose 1 hr before meals or 2 hr after meals, max 600 mg/day with other antituberculars
Candidate age grouping · source page 1154
Tuberculosis
• 6-mo regimen: 2 mo treatment of iso- niazid, rifAMPin, pyrazinamide, and pos- sibly streptomycin or ethambutol, then rifAMPin and isoniazid 3-4 mo
Candidate age grouping · source page 1154
Tuberculosis
• 9-mo regimen: rifAMPin and isoniazid supplemented with pyrazinamide, strep- tomycin, or ethambutol Meningococcal carriers
Candidate age grouping · source page 1154
Tuberculosis
• Adult: PO/IV 600 mg bid × 2 days, max 600 mg/dose
Candidate age grouping · source page 1154
Tuberculosis
• Child >5 yr: PO/IV 10-20 mg/kg × 2 days, max 600 mg/dose
Candidate age grouping · source page 1154
Tuberculosis
• Infant 3 mo-1 yr: PO 5 mg/kg bid × 2 days Prevention of H. influenzae type B infection (unlabeled)
Candidate age grouping · source page 1154
Tuberculosis
• Adult: PO 600 mg/day × 4 days
Candidate age grouping · source page 1154
Tuberculosis
• Child: PO 20 mg/kg/day × 4 days
Candidate age grouping · source page 1154
Tuberculosis
• Neonates: PO 10 mg/kg/day × 4 days MAC (unlabeled)
Candidate age grouping · source page 1154
Tuberculosis
• Adult: PO/IV 600 mg/day used with ≥3 other active microbials
Candidate age grouping · source page 1154
Tuberculosis
• Child: PO/IV 10-20 mg/kg/day used with ≥3 other active microbials Endocarditis with prosthetic valves (unlabeled)
Candidate age grouping · source page 1154
Tuberculosis
• Adult: PO 300 mg q8hr with gentami- cin and vancomycin
Candidate age grouping · source page 1154
Tuberculosis
• Child: PO 20 mg/kg/day in 2 divided doses with gentamicin and vancomycin, max 900 mg/day
Candidate age grouping · source page 1154