Adult: In combination with at least 1 other anti-leprosy agent: 10 mg/kg once monthly. Max: 450 mg for patients weighing <50 kg; 600 mg for patients weighing ≥50 kg. Alternatively, 600 mg once monthly.
Intravenous Tuberculosis
Adult: In combination with other anti-tuberculosis drugs: 10 mg/kg once daily via infusion over 2-3 hours. Max: 600 mg daily. Child: In combination with other anti-tuberculosis drugs: 10-20 mg/kg once daily. Max: 600 mg daily.
Intravenous Brucellosis, Legionnaire's disease, Severe staphylococcal infections
Adult: In combination with other antibacterial agents: 600-1,200 mg daily in 2-4 divided doses.
Oral Brucellosis, Legionnaire's disease, Severe staphylococcal infections
Adult: In combination with other antibacterial agents: 600-1,200 mg daily in 2-4 divided doses.
Oral Prophylaxis against meningitis due to Haemophilus influenzae
Adult: 20 mg/kg (Max 600 mg) once daily for 4 days. Child: <1 month 10 mg/kg daily; ≤4 years Same as adult dose.
Oral Tuberculosis
Adult: In combination with other anti-tuberculosis agents: Recommended dose: 8-12 mg/kg once daily. Usual dose: <50 kg: 450 mg daily; ≥50 kg: 600 mg daily. Child: In combination with other anti-tuberculosis agents: 10-20 mg/kg daily. Max: 600 mg daily.
Oral Prophylaxis of meningococcal meningitis
Adult: 600 mg bid for 2 days. Child: <1 month 5 mg/kg bid; ≥1 month 10 mg/kg bid. Doses to be given for 2 days.
Oral Leprosy
Adult: In combination with at least 1 other anti-leprosy agent: 600 mg once monthly. Alternatively, 10 mg/kg once monthly. Max: 450 mg for patients weighing <50 kg; 600 mg for patients weighing ≥50 kg.
Suy gan
Max: 8 mg/kg daily.
Cách dùng
Should be taken on an empty stomach. Best taken on an empty stomach 1 hr before or 2 hr after meals.
Hướng dẫn pha thuốc
Reconstitute vial labelled as 600 mg with 10 mL sterile water for injection then dilute further with an appropriate volume of compatible solution (e.g. dextrose 5% in water) to a final concentration not exceeding 6 mg/mL.
Tương kỵ
Y-site: Diltiazem HCl.
Chống chỉ định
Hypersensitivity to rifampicin or other rifamycins. Jaundice. Concomitant use with saquinavir/ritonavir combination; atazanavir, darunavir, fosamprenavir, saquinavir, tipranavir.
Thận trọng
Patient with current or history of alcoholism, risk factors of vitamin K deficiency (e.g. chronic liver disease, poor nutritional status, receiving prolonged antibacterial or anticoagulant therapy), diabetes mellitus, porphyria. Renal (for doses >600 mg/day) and hepatic impairment. Children and elderly. Pregnancy and lactation.
Tác dụng không mong muốn
Significant: Hypersensitivity reactions (e.g. fever, rash, urticaria, angioedema, flu-like syndrome); superinfection (e.g. pseudomembranous colitis), anaemia, leucopenia, thrombocytopenia (with or without purpura), discolouration (yellow, orange, red, or brown) of teeth, urine, sweat sputum, tears; vitamin K-dependent coagulopathy, bleeding. Eye disorders: Visual disturbances. Gastrointestinal disorders: Nausea, vomiting. General disorders and administration site conditions: Chills, fatigue, pyrexia. Investigations: Increased blood bilirubin, AST, ALT. Metabolism and nutrition disorders: Facial or peripheral oedema. Musculoskeletal and connective tissue disorders: Muscle weakness, pain in extremities. Nervous system disorders: Headache, dizziness, drowsiness, generalised numbness. Psychiatric disorders: Mental confusion, behavioural changes, inability to concentrate. Reproductive system and breast disorders: Menstrual disturbances. Potentially Fatal: Hepatotoxicity (e.g. hyperbilirubinaemia, elevated liver enzymes, jaundice, hepatitis, fulminant liver failure) severe cutaneous reactions (e.g. Stevens-Johnson syndrome, toxic epidermal necrolysis, drug reaction with eosinophilia and systemic symptoms (DRESS), acute generalised exanthematous pustulosis).
This drug may cause permanent staining of soft contact lenses. Remove soft contact lenses during therapy.
Chỉ số theo dõi
Perform culture and susceptibility tests; consult local institutional recommendations before treatment initiation due to antibiotic resistance risks. Monitor LFTs (AST, ALT, bilirubin) at baseline and periodically (every 2-4 weeks) during therapy in patients with pre-existing hepatic impairment; serum creatinine and CBC at baseline and periodically in patients with baseline abnormalities; sputum culture, chest X-ray 2-3 months into treatment, coagulation tests during therapy in patient at risk of vitamin K deficiency.
Quá liều
Symptoms: Nausea, vomiting, abdominal pain, pruritus, headache, lethargy; unconsciousness (in presence of severe hepatic disease); transient increases in liver enzymes and bilirubin; brownish-red or orange discolouration of the skin, urine, sweat, saliva, tears, faeces; facial or periorbital oedema (particularly in children); liver enlargement, hypotension, sinus tachycardia, ventricular arrhythmias, seizures, cardiac arrest. Management: Supportive and symptomatic treatment. Secure airway and establish an adequate respiratory exchange. Perform gastric lavage within 2-3 hours of ingestion to induce emesis followed by instillation of activated charcoal into the stomach. May administer antiemetic agents to control severe nausea and vomiting. May consider active diuresis, with measured intake and output, to promote excretion. For severe cases, haemodialysis may also be considered.
Tương tác
May increase the risk of hepatotoxicity when given with halothane or isoniazid. May decrease the serum concentrations, thus reducing the efficacy of praziquantel. May enhance the adverse effect, particularly bleeding, when given concomitantly with cefazolin and other cephalosporins containing N-methylthiotetrazole side chain. May increase metabolism and decrease serum concentrations and effects of antiarrhythmics (e.g. disopyramide, quinidine), antiepileptics (e.g. phenytoin,), barbiturates, hormone antagonist (e.g. tamoxifen, toremifene), antipsychotics (e.g. haloperidol, aripiprazole), anticoagulants (e.g. warfarin), antifungals (e.g. fluconazole, ketoconazole), other antiretrovirals (e.g. zidovudine, indinavir, efavirenz), hepatitis C antiviral drugs (e.g. daclatasvir), beta-blockers (e.g. bisoprolol), Ca channel blocker (e.g. diltiazem), anxiolytics and hypnotics (e.g. diazepam), certain antibacterials (e.g. chloramphenicol, clarithromycin), corticosteroids, cardiac glycosides, hormonal contraceptives (e.g. oestrogens, progestogens), antidiabetic agents (e.g. glipizide, rosiglitazone), immunosuppressants (e.g. ciclosporin, tacrolimus), thyroid hormone (e.g. levothyroxine), analgesics (e.g. methadone, morphine), selective 5-HT3 receptor antagonists (e.g. ondansetron), statins that are metabolised by CYP3A4 (e.g. simvastatin), TCAs (e.g. amitriptyline, nortriptyline), cytotoxics (e.g. imatinib), enalapril, losartan, irinotecan, theophylline, quinine, riluzole. Absorption may be reduced by antacids. Concomitant use with atovaquone increased plasma concentrations of rifampicin and decreased plasma concentrations of atovaquone. Increased plasma concentrations with probenecid and trimethoprim-sulfamethoxazole. Potentially Fatal: Increased risk of severe hepatotoxicity with saquinavir/ritonavir combination. May substantially decrease the plasma concentrations and efficacy of atazanavir, darunavir, fosamprenavir, saquinavir, tipranavir which may result in the development of viral resistance.
Tương tác với thức ăn
Delayed and reduced absorption with food.
Ảnh hưởng đến kết quả xét nghiệm
Interferes with standard microbiological assays for serum folate and vitamin B12. Cross-reactivity and false-positive urine screening tests for opiates using the Kinetic Interaction of Microparticles in Solution (KIMS) method (e.g. Roche diagnostic systems, Abuscreen online opiates assay). Interferes with the biliary excretion of contrast media used for visualisation of the gallbladder.
Tác dụng
Description: Mechanism of Action: Rifampicin binds to the β subunit of DNA-dependent RNA polymerase leading to inhibition of bacterial RNA synthesis.
Synonym: rifampin. Duration: ≤24 hours. Pharmacokinetics: Absorption: Readily and well absorbed from the gastrointestinal tract. Reduced and delayed absorption with food. Time to peak plasma concentrations: 2-4 hours. Distribution: Widely distributed in most body tissues and fluids, including CSF. Crosses the placenta and blood-brain barrier; enters breast milk. Plasma protein binding: Approx 80%. Metabolism: Rapidly metabolised in the liver mainly to active 25-O-deacetylrifampicin; undergoes enterohepatic recirculation. Excretion: Via faeces (60-65%); urine (approx 30%, with approx 50% as unchanged drug). Elimination half-life: 3-4 hours.
Đặc tính
Rifampicin Source: National Center for Biotechnology Information. PubChem Database. Rifampicin, CID=135398735, https://pubchem.ncbi.nlm.nih.gov/compound/Rifampicin (accessed on Jan. 22, 2020)
Bảo quản
Store between 15-30°C. Protect from light and excessive heat.
Đăng xuất
