Rifadin

1 What is Rifadin?

Brand: Rifadin, Rimactane

Generic: Rifampin

Rifadin is a prescription-only antibiotic used in combination with other medicines to treat tuberculosis (TB) affecting the lungs and other body parts. It can also be prescribed for bacterial meningitis (inflammation of coverings of the brain).

Your doctor based on his/her experience may also prescribe Rifadin in:

  • Atypical mycobacterial infections, such as Mycobacterium avium complex (MAC)
  • Leprosy
  • Prevention of H. influenza infection
  • Treatment of serious bacterial infections

It is available as:

  • Capsule
  • Tablet
  • Syrup

2 What to Know Before Using

Before using Rifadin, you must know all about the risks and complications associated with it. Together with your doctor, you can decide whether the medication will do you more goods than the harms.

Here are some factors to be considered before deciding to use this medicine:

Allergies

Inform your doctor about the allergies you have, such as to this medication, other medications, or to foods, dyes, or preservatives. 

Pediatric

It may be used in children after assessing risks and benefits of the use.

Geriatric

It may be used in elderly after assessing risks and benefits of the use.

Pregnancy

It falls under pregnancy category C for all trimesters, meaning that due to lack of sufficient studies, it’s not clear if this medication is safe for use in pregnancy.

Breastfeeding

It may be used in a nursing mother after assessing risks and benefits of the use.

Drug Interactions

Taking two medicines together can be harmful due to possible interactions. In other cases, even if there is a possible interaction between two medicines your doctor may advise you to take them together after adjusting the dose or issuing precautions. Here is a list of the medicines which in general are not recommended to be used with rifampin. Inform your doctor if you are using any of these medicines:

  • Atazanavir
  • Darunavir
  • Fosamprenavir
  • Ritonavir
  • Saquinavir
  • Tipranavir.

Though usually not recommended, your doctor may decide, after adjusting dose or frequency of one or both medicines, to use this medicine with any of the following medicines:

  • Abiraterone
  • Afatinib
  • Amprenavir
  • Atovaquone
  • Axitinib
  • Canagliflozin
  • Clozapine
  • Cyclosporine
  • Deferasirox
  • Delavirdine
  • Dolutegravir
  • Doxorubicin
  • Enzalutamide
  • Etravirine
  • Fentanyl
  • Fosphenytoin
  • Idelalisib
  • Ifosfamide
  • Indinavir
  • Itraconazole
  • Ixabepilone
  • Ketoconazole
  • Ledipasvir
  • Linagliptin
  • Mycophenolate Mofetil
  • Mycophenolic Acid
  • Nevirapine
  • Nifedipine
  • Nimodipine
  • Olaparib
  • Palbociclib
  • Panobinostat
  • Phenytoin
  • Pitavastatin
  • Posaconazole
  • Quinine
  • Romidepsin
  • Simeprevir
  • Sirolimus
  • Sofosbuvir
  • Tacrolimus
  • Telithromycin
  • Temsirolimus
  • Tolvaptan
  • Vilazodone
  • Vincristine
  • Vortioxetine

Rarely and only when absolutely needed, this medicine may be used with the following medicines even if using them together may put you at risk of certain side effects. In such cases, you may have to take the adjusted dose or change the frequency of intake.

  • Acetyldigoxin
  • Atorvastatin
  • Betamethasone
  • Buspirone
  • Carbamazepine
  • Carvedilol
  • Chloramphenicol
  • Chlorpropamide
  • Citalopram
  • Clarithromycin
  • Clofibrate
  • Dicumarol
  • Digoxin
  • Diltiazem
  • Disopyramide
  • Doxycycline
  • Enalapril Maleate
  • Estradiol Cypionate
  • Ethinyl Estradiol
  • Ethynodiol Diacetate
  • Etonogestrel
  • Fluconazole
  • Gliclazide
  • Haloperidol
  • Levonorgestrel
  • Levothyroxine
  • Linezolid
  • Losartan
  • Mefloquine
  • Mestranol
  • Metformin
  • Methadone
  • Morphine
  • Norelgestromin
  • Norethindrone
  • Oxycodone
  • Propafenone
  • Raltegravir
  • Rofecoxib
  • Tamoxifen
  • Theophylline
  • Triazolam
  • Trimetrexate
  • Valproic Acid
  • Zidovudine
  • Zolpidem

Other Interactions

Taking your medicine together with certain foods or items such as alcohol or tobacco may cause undesirable interactions. Talk to your doctor to know if using this medicine with food, alcohol, or tobacco is safe. AVOID high-tyramine foods such as beer, aged cheese, smoked meats, fermented pickles, sauces, and soybeans.

Medical Problems

Inform your doctor about the following conditions, if any:

  • Alcohol abuse in the past: Use cautiously.
  • History of diabetes
  • Liver problems
  • Porphyria: Use cautiously.

3 Proper Usage

To use Rifadin properly, you must follow all instructions given by your doctor. Here are some points to consider:

  • Follow your doctor’s instructions about the use of any medicine.
  • Never discontinue or skip the dose of any antitubercular medicines without consulting your doctor. Doing so can make the TB microorganism resistant to treatment. Remember that TB treatments last for months.
  • Take rifampin on an empty stomach.
  • Do not take rifampin and antacid together. Take the antacid at least one hour after taking rifampin.
  • You can also ask for rifampin syrup if you cannot take the capsule. Shake well before use and use medicine cup to measure the recommended dose.

Dosing

For best results, follow your doctor to know what amount of medicine you should take in a single dose. The doses of a medicine can differ according to the conditions for which it is being prescribed. Remember your doses can differ.

Consult your doctor if you have anything to ask.

The doses for capsule are:

For the treatment of bacterial meningitis 

  • Adults: 600 milligrams (mg) 2 times a day for 2 days.
  • Children and infants 1 month and older: 10 mg per kilogram (kg) body weight 2 times a day for 2 days. Your doctor will decide what dose is to be taken based on the body weight.
  • Infants below 1 month: 5 mg per kg body weight 2 times a day for 2 days. Your doctor will decide what dose is to be taken based on the body weight.

For the treatment of tuberculosis

  • Adults: 10 mg per kg body weight once a day. Then the dose may be increased but do not take more than 600 mg per day. Your doctor will decide what dose is to be taken based on the body weight.
  • Children: 10 to 20 mg per kg of body weight once a day. Then the dose may be increased but do not take more than 600 mg per day. Your doctor will decide what dose is to be taken based on the body weight.

Missed Dose

Take your missed dose once you remember but avoid it if it’s time to take your next dose, and follow your normal dosing schedule. Avoid taking double doses to make up for the missed dose.

Storage:

  • Store in a closed container at room temperature.
  • Keep away from heat, moisture, and direct light.
  • Do not freeze.
  • Keep away from children.
  • Discard any unused or expired medicines.
  • The syrup is effective for 4 weeks if stored under proper conditions.

4 Precautions to Take

Before using Rifadin, there are some precautions you must take. Your progress should be regularly monitored to determine if you are responding to the treatment. You may also need blood tests to detect any undesirable effects. Remember:

  • Do not take rifampin if you are taking atazanavir, darunavir, fosamprenavir, ritonavir, saquinavir, tipranavir and other similar medicines. Talk to your doctor if you are using any of these medicines.
  • If you develop symptoms indicative of serious liver damage, such as the tender upper stomach, pale stools, dark urine, decreased appetite, or yellowish eyes or skin, see your doctor immediately. AVOID alcohol while taking rifampin as alcohol can further damage your liver and make the medicine less effective.
  • You may have reddish-orange colored urine, stools, saliva, sputum, sweat, and tears while taking rifampin. Do not panic as it is normal. Colored tears can affect your soft contact lenses if you're wearing them. Therefore, during the treatment with rifampin, do not wear soft contact lenses.
  • Rifampin can interfere with the action of some contraceptive pills. Therefore, use other contraceptive measures to avoid pregnancy.
  • Rifampin can also affect results of some medical tests. Inform the concerned doctor about your intake of rifampin.
  • Consult your doctor before taking any prescription or nonprescription medicines and herbal or vitamin supplements.

5 Potential Side Effects

As with many medications, there are several potential side effects associated with Rifadin.

Consult your doctor immediately if you experience any of the following side effects:

Rare:

  • Pain in stomach or back
  • Bleeding from gums or site of injection
  • Bloody urine or stools
  • Bruising
  • Confusion
  • A cough or hoarseness
  • Little or dark urine
  • Painful urination
  • Coughing or vomiting blood
  • Swallowing or breathing difficulties
  • Dizziness
  • Fainting
  • Rapid heartbeat
  • Fever
  • Headache
  • Welts
  • Elevated blood pressure
  • Unusual thirst
  • Restlessness and irritability
  • Excessive tiredness
  • Clay-colored stools
  • Decreased appetite
  • Depression
  • Nausea and vomiting
  • Swollen eyelids or areas around the eyes, face, lips, or tongue
  • Red, itchy rashes
  • Swollen face, ankles, fingers, hands, or lower legs
  • Abnormal bleeding or bruising
  • Yellowish eyes or skin

Seek emergency medical help if you experience any of these symptoms of overdose:

  • Blurred vision
  • Seizures
  • Dizziness
  • Fainting
  • Rapid and abnormal heartbeat or pulse
  • Bloated upper abdomen
  • Reduced blood pressure
  • Feeble pulse
  • Nausea or vomiting
  • Upper abdominal pain
  • Swollen eyes or face
  • Excessive tiredness
  • Yellowish eyes or skin

Mild and non-serious side effects usually go away on their own without requiring medical intervention. You may also ask your doctor to learn more about how you may prevent or reduce the side effects.

Talk to your doctor if the side effects persist or worry you, including:

Rare:

  • Paranoia
  • Hallucinations
  • Muscle pain
  • Severe mood or behavioral changes

The side effects of the medicine are not limited to the ones listed above. Call your doctor immediately if you experience any side effects that are uncommon or worry you. To report side effects to the FDA, contact at 1-800-FDA-1088.

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