Indications
- Staphylococcus Aureus (see Staphylococcus Aureus, [[Staphylococcus Aureus]])
- Leprosy (Hansen’s Disease) (see Leprosy, [[Leprosy]])
- Tuberculosis (see Tuberculosis, [[Tuberculosis]])
- Active Tuberculosis
- Latent Tuberculosis (Positive PPD)
Pharmacology
- Rifamycin Group Antibiotic: inhibits bacterial DNA-dependent RNA polymerase -> inhibits bacterial RNA synthesis
- Rifamycins (a subclass of the ansamycins) are produced by the bacterium Amycolatopsis Rifamycinica (originally named Streptomyces Mediterranei when it was first isolated in 1957) or synthesized
- Rifamycins were originally named after the French crime story Rififi (which was favored by the researchers who discovered these agents)
- Members of Rifamycin Group
- Rifamycins
- Rifabutin (see Rifabutin, [[Rifabutin]])
- Rifalazil
- Rifampin (Rifampicin)
- Rifapentine
Metabolism
Administration
Dose Adjustment
Breast Feeding
- Rifampin is Excreted in Breast Milk: breast feeding should be avoided during rifampin administration
Drug Interactions
- Upregulation of Hepatic Cytochrome P450 Enzymes (CYP2C9, CYP3A4)
- Increased Coumadin Metabolism (see Coumadin, [[Coumadin]]): decreasing efficacy of coumadin anticoagulation
- Increased Oral Contraceptive Hormonal Metabolism (see Oral Contraceptives, [[Oral Contraceptives]]): decreasing efficacy
Adverse Effects
Constitutional Adverse Effects
- Flu-Like Symptoms: may be due to excellent penetration of drug into the brain
- Fever/Chills (see Fever, [[Fever]])
- Headache (see Headache, [[Headache]])
- Arthralgias (see Arthralgias, [[Arthralgias]])
- Malaise
Dermatologic Adverse Effects
- Flushing (see Flushing, [[Flushing]])
- Pruritus (see Pruritus, [[Pruritus]])
- Rash
Gastrointestinal Adverse Effects
Hepatotoxicity
Other Gastrointetsinal Manifestations
Pulmonary Adverse Effects
Drug-Induced Pulmonary Eosinophilia (see Drug-Induced Pulmonary Eosinophilia, [[Drug-Induced Pulmonary Eosinophilia]])
Dyspnea (see Dyspnea, [[Dyspnea]])
Other Adverse Effects
- Orange-Red Secretions/Tears: may stain contact lenses
- Orange-Red Urine (see Urine Discoloration, [[Urine Discoloration]])
References