Rifampin 150mg Capsules

Rifampin inhibits bacterial DNA-dependent RNA polymerase activity by binding to its beta subunit. This binding prevents the initiation of RNA synthesis, leading to bactericidal activity against susceptible organisms, particularly Mycobacterium tuberculosis.

Urgent Side Effects: Seek Medical Help Right Away

Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor or seek medical attention immediately:

Signs of an allergic reaction, such as:
+ Rash or hives
+ Itching or red, swollen, blistered, or peeling skin (with or without fever)
+ Wheezing or tightness in the chest or throat
+ Difficulty breathing, swallowing, or talking
+ Unusual hoarseness or swelling of the mouth, face, lips, tongue, or throat
Signs of liver problems, including:
+ Dark urine
+ Fatigue or decreased appetite
+ Upset stomach or stomach pain
+ Light-colored stools or vomiting
+ Yellow skin or eyes
Signs of kidney problems, such as:
+ Inability to urinate or changes in urine output
+ Blood in the urine or significant weight gain
Dizziness or fainting
Flu-like symptoms
Fever, chills, or sore throat
Unexplained bruising or bleeding, or feeling extremely tired or weak
Joint pain or swelling
Muscle pain or weakness
Chest pain or excessive sweating
Abnormal heartbeat or swelling in the arms or legs
Purple spots or redness on the skin
Changes in balance or coordination
Confusion, difficulty focusing, or changes in behavior
Menstrual changes
Changes in vision, eye pain, or severe eye irritation
Changes in tooth color (which may be long-lasting)

New or Worsening Symptoms: Seek Medical Help Right Away

If you experience any new or worsening symptoms, such as:

Cough
Fever
Fatigue or weakness
Shortness of breath
Headache
Pain
Night sweats
Swollen glands
Decreased appetite
Weight loss
Skin sores

contact your doctor immediately.

Diarrhea and Antibiotic Use

Diarrhea is a common side effect of antibiotics. However, in rare cases, a severe form of diarrhea called Clostridioides difficile-associated diarrhea (CDAD) may occur. This condition can lead to a life-threatening bowel problem. If you experience stomach pain, cramps, or loose, watery, or bloody stools, contact your doctor right away. Do not treat diarrhea without consulting your doctor first.

Severe Skin Reactions: Seek Medical Help Right Away

This medication can cause severe skin reactions, including Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and other serious conditions. These reactions can be life-threatening and may affect other organs. If you notice any of the following symptoms, seek medical help immediately:

Red, swollen, blistered, or peeling skin
Red or irritated eyes
Sores in the mouth, throat, nose, eyes, genitals, or skin
Fever
Chills
Body aches
Shortness of breath
Swollen glands

Blood Problems: Seek Medical Help Right Away

In rare cases, this medication can cause severe blood problems, including thrombotic thrombocytopenic purpura/hemolytic uremic syndrome (TTP/HUS). If you experience any of the following symptoms, contact your doctor immediately:

Extreme fatigue or weakness
Bruising or bleeding
Dark urine or yellow skin and eyes
Pale skin
Changes in urine output
Changes in vision
Changes in strength or coordination
Trouble speaking or thinking
Changes in balance
Fever

Other Side Effects

Most people do not experience significant side effects, but some may occur. If you notice any of the following side effects or any other symptoms that bother you or do not go away, contact your doctor:

Drowsiness
Gas
Diarrhea, upset stomach, or vomiting
Heartburn
Stomach cramps
Changes in the color of body fluids to orange or red

Reporting Side Effects

If you have questions about side effects or want to report any side effects, contact your doctor or the FDA at 1-800-332-1088. You can also report side effects online at https://www.fda.gov/medwatch.

Before Taking This Medication: Important Information to Share with Your Doctor

It is essential to inform your doctor about the following:

Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the allergic reaction you experienced, including any symptoms that occurred.
If you have previously experienced liver problems while taking this medication.
Any medications you are currently taking, including prescription and over-the-counter (OTC) drugs, natural products, and vitamins. This is crucial because certain medications, such as those used to treat HIV, infections, depression, and other conditions, should not be taken with this medication. Your doctor or pharmacist can advise you on potential interactions.
Please note that this is not an exhaustive list of all medications or health conditions that may interact with this medication.

To ensure your safety, it is vital to discuss all of your medications (prescription and OTC), natural products, vitamins, and health conditions with your doctor and pharmacist. This will help determine whether it is safe for you to take this medication in conjunction with your other medications and health conditions. Never start, stop, or change the dosage of any medication without first consulting your doctor.

It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication. Regular blood work and laboratory tests, as directed by your doctor, are crucial to monitor your condition.

This medication may interfere with certain laboratory tests, so it is vital to notify all your healthcare providers and laboratory personnel that you are taking this drug.

To minimize potential risks, avoid consuming alcohol while taking this medication. If you have diabetes (high blood sugar), closely monitor your blood sugar levels, as this medication may affect them. Be aware of signs of high blood sugar, such as confusion, drowsiness, increased thirst or hunger, frequent urination, flushing, rapid breathing, or fruity-smelling breath, and report them to your doctor promptly.

Additionally, this medication may cause staining of contact lenses. Do not use this medication for an extended period beyond the recommended duration, as this may increase the risk of a second infection.

Rifampin, the active ingredient in this medication, has been associated with liver problems, which can be severe and potentially life-threatening, especially in individuals with pre-existing liver disease or those taking other medications that may increase the risk of liver problems. If you have concerns, discuss them with your doctor.

This medication has also been linked to certain lung problems, which can be fatal. If you have questions or concerns, consult your doctor.

If you are 65 years or older, use this medication with caution, as you may be more susceptible to side effects.

It is essential to note that birth control pills and other hormone-based contraceptives may be less effective while taking this medication. To prevent pregnancy, use an additional form of birth control, such as a condom.

If you are pregnant, plan to become pregnant, or are breastfeeding, inform your doctor, as they will need to discuss the potential benefits and risks of this medication to you and your baby.

• Protease inhibitors (e.g., atazanavir, darunavir, fosamprenavir, saquinavir, tipranavir) - due to significant reduction in antiretroviral concentrations.
• Non-nucleoside reverse transcriptase inhibitors (e.g., rilpivirine, doravirine) - due to significant reduction in antiretroviral concentrations.
• Praziquantel - due to significant reduction in praziquantel concentrations.
• Daclatasvir, Ledipasvir/Sofosbuvir, Velpatasvir/Sofosbuvir - due to significant reduction in antiviral concentrations.

• Oral contraceptives (decreased efficacy, leading to contraceptive failure)
• Warfarin (decreased anticoagulant effect)
• Corticosteroids (decreased corticosteroid effect)
• Oral hypoglycemics (e.g., sulfonylureas) (decreased hypoglycemic effect)
• Digoxin (decreased digoxin levels)
• Phenytoin (decreased phenytoin levels)
• Theophylline (decreased theophylline levels)
• Cyclosporine, Tacrolimus (decreased immunosuppressant levels)
• Methadone (withdrawal symptoms due to decreased methadone levels)
• Statins (e.g., simvastatin, atorvastatin) (decreased statin levels)
• Azole antifungals (e.g., ketoconazole, fluconazole, itraconazole, voriconazole) (decreased antifungal levels)
• Calcium channel blockers (e.g., verapamil, diltiazem, nifedipine) (decreased antihypertensive effect)
• Beta-blockers (e.g., metoprolol, propranolol) (decreased beta-blocker effect)
• Amiodarone (decreased amiodarone levels)
• Clopidogrel (decreased antiplatelet effect)
• Dabigatran (decreased dabigatran levels)
• Quinine (decreased quinine levels)
• Selective serotonin reuptake inhibitors (SSRIs) (e.g., sertraline, paroxetine) (decreased SSRI levels)
• Tricyclic antidepressants (TCAs) (e.g., imipramine, amitriptyline) (decreased TCA levels)

• Acetaminophen (increased risk of hepatotoxicity with chronic use)
• Oral iron supplements (decreased rifampin absorption if taken concurrently)
• Antacids (decreased rifampin absorption if taken concurrently)
• Atovaquone (decreased atovaquone levels, increased rifampin levels)
• Chloramphenicol (decreased chloramphenicol levels)
• Dapsone (decreased dapsone levels)
• Erythromycin (decreased erythromycin levels)
• Linezolid (potential for serotonin syndrome if co-administered with serotonergic agents)
• Propafenone (decreased propafenone levels)
• Zidovudine (decreased zidovudine levels)

• Food (decreased absorption of rifampin)

• Signs and symptoms of hepatotoxicity (e.g., fatigue, weakness, malaise, anorexia, nausea, vomiting, dark urine, jaundice, light-colored stools).
• Flu-like syndrome (fever, chills, headache, dizziness, bone pain) - more common with intermittent dosing.
• Skin rash, pruritus, or other hypersensitivity reactions.
• Gastrointestinal upset (e.g., abdominal pain, diarrhea).
• Unusual bleeding or bruising (due to thrombocytopenia).
• Red-orange discoloration of urine, sweat, tears, saliva, and contact lenses.

Rifampin is generally considered acceptable for use during pregnancy for the treatment of active tuberculosis, especially when the benefits outweigh the risks. It is a Category C drug, meaning animal studies have shown an adverse effect on the fetus, but there are no adequate and well-controlled studies in humans. However, untreated TB poses a greater risk to both mother and fetus.

Rifampin is excreted in breast milk in small amounts. It is generally considered compatible with breastfeeding, but the infant should be monitored for potential adverse effects such as gastrointestinal upset, rash, or orange discoloration of urine. The amount transferred is usually too low to be therapeutic for the infant.

Rifampin is used in pediatric patients for the treatment of tuberculosis and other susceptible infections. Dosing is weight-based (10-20 mg/kg/day, max 600 mg/day). Close monitoring for adverse effects, particularly hepatotoxicity, is crucial.

No specific dose adjustment is typically required based on age alone, but geriatric patients may have age-related decreases in hepatic or renal function, which could necessitate closer monitoring for adverse effects, especially hepatotoxicity. Polypharmacy in this population increases the risk of drug interactions due to rifampin's potent enzyme-inducing properties.

• Rifampin is a potent inducer of multiple cytochrome P450 enzymes (especially CYP3A4) and P-glycoprotein, leading to numerous significant drug interactions. Always review a patient's full medication list.
• Causes a harmless red-orange discoloration of urine, sweat, tears, saliva, and contact lenses. Patients should be counselled about this to prevent alarm.
• Administer on an empty stomach for optimal absorption.
• Crucial component of most first-line tuberculosis treatment regimens.
• Monitor liver function tests (LFTs) regularly due to the risk of hepatotoxicity, especially when used in combination with other antitubercular drugs like isoniazid and pyrazinamide.
• Intermittent dosing (e.g., twice or thrice weekly) is associated with a higher incidence of flu-like syndrome and hypersensitivity reactions compared to daily dosing.

• Isoniazid (for TB)
• Pyrazinamide (for TB)
• Ethambutol (for TB)
• Streptomycin (for TB)
• Other rifamycins (e.g., rifabutin, rifapentine) for specific indications or drug interactions considerations.

If your symptoms or health issues persist or worsen, it's essential to contact your doctor for further guidance. To ensure your safety, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so be sure to check with your pharmacist for more information. If you have any questions or concerns about your medication, don't hesitate to reach out to your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek medical attention. When seeking help, be prepared to provide details about the medication, including the amount taken and the time it happened, to ensure you receive the best possible care.