Rifampin | 300mg capsule uses, side effects, how to take
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Rifampin | 300mg capsule uses side effects, how to take | pharmacyteach.com |
Introduction
Welcome to this article well talk about rifampin before we start let's talk about the objectives for the article at the end of this article you should know
- the uses of rifampin
- mechanism of action
- know what the deal is with rifampin and the resistance
- deal with rifampin and drug-drug interactions when we think about rifampin
Most of us think it's that drug that treats TB but it's actually a lot more versatile than you might think it's used for other micro bacterial infections like leprosy but more commonly it's actually used to treat staph infections, especially device-related infections like prosthetic valves infected with staph aureus or staph epidermidis why does it work against them well we'll get to that but during this article just keep in mind that rifampin is not just a TB drug.
Mechanism of action of Rifampin
let's talk about how it works here's an abacterial cell and we know that most antibiotics work by messing with some of the processes here so they can either mess with DNA synthesis mRNA synthesis protein translation folate metabolism potentially the cell wall so which of these things does rifampin target what happens to inhibit RNA polymerase so in the presence of rifampin this bacterial cell can't make mRNA and thus can't make proteins now rifampin has a particular property which is that it can kill semi dormant TB. what is semi dormant TB as you might guess it's TB that's less metabolically active and dividing less rapidly the fact that rifampin can kill these guys is important because isoniazid and ethambutol cannot why well the reason is isoniazid and Nathaniel both stop micro bacteria from being able to make new cell wall semi-dormant TB is not making much cell wall so it can survive treatment with those drugs the reason we're making a point of this is that it explains why refampin allows short-course treatment so with rifampin.
you can treat for six to nine months and eradicate the TB whereas without rifampin you would need 18 to 24 months because without rifampin you would need to wait for all these semi-dormant TBs to become active and then be killed by isoniazid or ethambutol or to be killed by the immune system,
Side effects of Rifampin
Like all medications, rifampin can cause side effects. Some of the common side effects of rifampin include:
- Gastrointestinal disturbances include nausea, vomiting, diarrhea, abdominal pain, and loss of appetite.
- Discoloration of bodily fluids such as urine, feces, sweat, saliva, and tears turns them red-orange. This is harmless and is not a cause for concern.
- Liver problems such as elevated liver enzymes, hepatitis, and jaundice.
- Rash, itching, and other allergic reactions.
- Flu-like symptoms such as fever, chills, and muscle aches.
- Headache and dizziness.
- Low blood counts, can lead to anemia, bruising, and an increased risk of infections.
- Rarely, rifampin can cause severe allergic reactions or a condition called drug-induced immune thrombocytopenia, which can lead to bleeding.
Contraindication of rifampin:-
Hypersensitivity: Rifampin should not be used in individuals who have a known hypersensitivity to rifampin or any of its components. |
Porphyria: Rifampin can exacerbate symptoms of porphyria, a group of rare genetic disorders that affect the production of heme, a component of hemoglobin. It is contraindicated in individuals with acute intermittent porphyria. |
HIV medications: Rifampin can decrease the effectiveness of some HIV medications, and therefore should not be used in combination with certain antiretroviral drugs. |
Liver disease: Rifampin can cause liver damage and should be used with caution in individuals with pre-existing liver disease. |
Pregnancy and breast-feeding: Rifampin can pass into breast milk and cross the placenta, potentially harming the developing fetus. It should only be used during pregnancy or breastfeeding if the benefits outweigh the risks. |
Severe renal impairment: Rifampin should be used with caution in individuals with severe renal impairment. |
Drug-Drug interaction to rifampin:-
Drug Class |
Examples of Medications |
Potential Interaction |
Anticoagulants |
Warfarin, heparin |
Decreased effectiveness of anticoagulants |
Oral Contraceptives |
Birth control pills |
Decreased effectiveness of oral contraceptives |
HIV Medications |
Protease inhibitors (e.g. indinavir, lopinavir) |
Decreased effectiveness of HIV medications |
Antidepressants |
Selective serotonin reuptake inhibitors (SSRIs) |
Decreased effectiveness of antidepressants |
Immunosuppressants |
Cyclosporine, tacrolimus |
Decreased effectiveness of immunosuppressants |
Corticosteroids |
Prednisone, dexamethasone |
Increased metabolism of corticosteroids |
Dosing for rifampin:-
The dosing for rifampin can vary depending on the condition
being treated, the age and weight of the patient, and other factors. Here are
some general guidelines for dosing in adults, children, and elderly
individuals:
Adults: The typical dose of rifampin for adults is 600mg to 1200mg once daily or in divided doses. For tuberculosis, the dose is typically 10mg/kg once daily (up to a maximum of 600mg/day) or in divided doses. The duration of treatment can range from a few weeks to several months depending on the condition being treated. |
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Children: The dose of rifampin for children depends on their age and weight. For tuberculosis, the typical dose is 10mg/kg once daily (up to a maximum of 600mg/day) or in divided doses. For other conditions, the dose can range from 10mg/kg to 20mg/kg once daily or in divided doses. The duration of treatment can range from a few weeks to several months. |
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Elderly: The dose of rifampin in elderly individuals should be adjusted based on their age, weight, and overall health. In general, the starting dose should be lower than that of younger adults, with careful monitoring for side effects. The duration of treatment may also be longer in elderly individuals. |
How to take rifampin drug:-
- Rifampin should be taken on an empty stomach, at least one hour before or two hours after a meal, to ensure optimal absorption.
- Rifampin is usually taken once daily, although it may be divided into two doses if the daily dose is high or if side effects occur.
- Rifampin should be taken with a full glass of water to help prevent stomach upset.
- Do not crush, chew, or break the rifampin tablet. Swallow it whole.
- If you miss a dose of rifampin, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed dose.
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