Select therapeutic use:

Bacterial infections:

Indications for RIFADIN:

Asymptomatic carriers of Neisseria meningitidis to eliminate meningococci from nasopharynx. Not for treatment of meningococcal infection.

Adult:

Give 1hr before or 2hrs after meals with water. 600mg twice daily for 2 days.

Children:

Give 1hr before or 2hrs after meals with water. <1 month: 5mg/kg every 12hrs for 2 days. ≥1 month: 10mg/kg every 12hrs for 2 days; max 600mg per dose. Preparation of suspension: see full labeling.

Contraindications:

Concomitant ritonavir-boosted saquinavir (increased risk of severe hepatotoxicity). Concomitant atazanavir, darunavir, fosamprenavir, saquinavir, tipranavir. Concomitant praziquantel. Rifamycin hypersensitivity.

Warnings/Precautions:

Meningococcal: reserve rifampin for cases where high risk of meningococcal disease exists; confirm diagnosis. Not recommended for intermittent therapy (risk of rare renal hypersensitivity reactions). Monitor for hypersensitivity or severe cutaneous reactions (eg, SJS, TEN, DRESS); discontinue if occur. Monitor for signs of liver injury (esp. in prolonged treatment). If hepatic impaired: obtain LFTs at baseline, then every 2–4 weeks during therapy. Discontinue if signs of hepatic damage occur or worsen. Diabetes. May stain teeth, body secretions, contact lenses. IV: avoid extravasation. Elderly. Pregnancy. Nursing mothers: not recommended.

Pharmacologic Class:

Rifamycin.

Interactions:

See Contraindications. Discontinue rifampin 4 weeks before giving praziquantel; may be restarted one day after completing praziquantel treatment. Avoid concomitant zidovudine, indinavir, efavirenz, daclatasvir, simeprevir, sofosbuvir, telaprevir, halothane, quinine, and alcohol. Concomitant hepatotoxic agents: may cause fatal liver dysfunction. Antagonizes oral or other hormonal contraceptives (consider nonhormonal methods), phenytoin, antiarrhythmics, tamoxifen, toremifene, haloperidol, azole antifungals (avoid 2 weeks before and during itraconazole), β-blockers, diazepam, zopiclone, zolpidem, CCBs, prednisolone, moxifloxacin, sulfonylureas, cyclosporine, oxycodone, morphine, ondansetron, simvastatin, rosiglitazone, nortriptyline, enalapril, chloramphenicol, clarithromycin, dapsone, doxycycline, irinotecan, levothyroxine, losartan, methadone, telithromycin, theophylline. Monitor warfarin, digoxin, tacrolimus; adjust dose as needed. May be potentiated by probenecid, cotrimoxazole. Concomitant atovaquone: not recommended. Separate dosing of antacids by at least 1hr. May cause false (+) urine tests for opiates. May inhibit assays for serum folate and Vit. B12 (consider alternative methods). Perform LFTs and use contrast media prior to morning dose.

Adverse Reactions:

GI disturbances, jaundice, headache, fever, drowsiness, fatigue, ataxia, dizziness, inability to concentrate, mental confusion, muscular weakness, pain in extremities, generalized numbness, visual disturbances, elevated BUN and serum uric acid, menstrual disturbances, urticaria, rash, edema; hepatotoxicity, hepatitis, abnormal LFTs, cholestasis; rare: blood dyscrasias, anaphylaxis.

Generic Availability:

YES

How Supplied:

Caps 150mg—30; 300mg—60

Pricing for RIFADIN

300mg capsule (Qty: 60)
Appx. price $39
GoodRx

Tuberculosis:

Indications for RIFADIN:

Susceptible tuberculosis, in combination with other antituberculars.

Adult:

10mg/kg once daily; max 600mg/day. Caps: give 1hr before or 2hrs after meals with water. IV: infuse over 30mins (100mL) or within 3hrs (500mL). Initial phase: treat for up to 2 months with isoniazid and pyrazinamide (streptomycin or ethambutol may be added as fourth drug if resistance to isoniazid exists). After initial phase, continue rifampin with isoniazid for at least 4 months; longer if sputum or culture remains (+), with resistant organisms, or HIV (+).

Children:

10–20mg/kg once daily; max 600mg/day. Caps: give 1hr before or 2hrs after meals with water. IV: infuse over 30mins (100mL) or within 3hrs (500mL). Initial phase: treat for up to 2 months with isoniazid and pyrazinamide (streptomycin or ethambutol may be added as fourth drug if resistance to isoniazid exists). After initial phase, continue rifampin with isoniazid for at least 4 months; longer if sputum or culture remains (+), with resistant organisms, or HIV (+). Preparation of suspension: see full labeling.

Contraindications:

Concomitant ritonavir-boosted saquinavir (increased risk of severe hepatotoxicity). Concomitant atazanavir, darunavir, fosamprenavir, saquinavir, tipranavir. Concomitant praziquantel. Rifamycin hypersensitivity.

Warnings/Precautions:

Meningococcal: reserve rifampin for cases where high risk of meningococcal disease exists; confirm diagnosis. Not recommended for intermittent therapy (risk of rare renal hypersensitivity reactions). Monitor for hypersensitivity or severe cutaneous reactions (eg, SJS, TEN, DRESS); discontinue if occur. Monitor for signs of liver injury (esp. in prolonged treatment). If hepatic impaired: obtain LFTs at baseline, then every 2–4 weeks during therapy. Discontinue if signs of hepatic damage occur or worsen. Diabetes. May stain teeth, body secretions, contact lenses. IV: avoid extravasation. Elderly. Pregnancy. Nursing mothers: not recommended.

See Also:

Pharmacologic Class:

Rifamycin.

Interactions:

See Contraindications. Discontinue rifampin 4 weeks before giving praziquantel; may be restarted one day after completing praziquantel treatment. Avoid concomitant zidovudine, indinavir, efavirenz, daclatasvir, simeprevir, sofosbuvir, telaprevir, halothane, quinine, and alcohol. Concomitant hepatotoxic agents: may cause fatal liver dysfunction. Antagonizes oral or other hormonal contraceptives (consider nonhormonal methods), phenytoin, antiarrhythmics, tamoxifen, toremifene, haloperidol, azole antifungals (avoid 2 weeks before and during itraconazole), β-blockers, diazepam, zopiclone, zolpidem, CCBs, prednisolone, moxifloxacin, sulfonylureas, cyclosporine, oxycodone, morphine, ondansetron, simvastatin, rosiglitazone, nortriptyline, enalapril, chloramphenicol, clarithromycin, dapsone, doxycycline, irinotecan, levothyroxine, losartan, methadone, telithromycin, theophylline. Monitor warfarin, digoxin, tacrolimus; adjust dose as needed. May be potentiated by probenecid, cotrimoxazole. Concomitant atovaquone: not recommended. Separate dosing of antacids by at least 1hr. May cause false (+) urine tests for opiates. May inhibit assays for serum folate and Vit. B12 (consider alternative methods). Perform LFTs and use contrast media prior to morning dose.

Adverse Reactions:

GI disturbances, jaundice, headache, fever, drowsiness, fatigue, ataxia, dizziness, inability to concentrate, mental confusion, muscular weakness, pain in extremities, generalized numbness, visual disturbances, elevated BUN and serum uric acid, menstrual disturbances, urticaria, rash, edema; hepatotoxicity, hepatitis, abnormal LFTs, cholestasis; rare: blood dyscrasias, anaphylaxis.

Generic Availability:

YES

How Supplied:

Caps 150mg—30; 300mg—60; Vials—1

Pricing for RIFADIN

300mg capsule (Qty: 60)
Appx. price $39
GoodRx