Tuberculosis:
Indications for: RIFADIN IV
Initial treatment and retreatment of susceptible tuberculosis, when oral therapy is not feasible.
Adult Dosage:
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 Dosage:
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.
RIFADIN IV Contraindications:
Concomitant ritonavir-boosted saquinavir (increased risk of severe hepatotoxicity). Concomitant atazanavir, darunavir, fosamprenavir, saquinavir, tipranavir. Concomitant praziquantel. Concomitant lurasidone. Rifamycin hypersensitivity.
RIFADIN IV 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. Vitamin K-dependent coagulation disorders, bleeding; monitor. Pulmonary toxicity. Thrombotic microangiopathy (including thrombotic thrombocytopenic purpura, hemolytic uremia syndrome). Diabetes. May stain teeth, body secretions, contact lenses. IV: avoid extravasation. Elderly. Pregnancy. Nursing mothers: not recommended.
See Also:
RIFADIN IV Classification:
Rifamycin.
RIFADIN IV 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, ticagrelor, 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. Risk of bleeding with clopidogrel; do not use. 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, paradoxical drug reaction, interstitial lung disease; rare: blood dyscrasias, anaphylaxis.
Drug Elimination:
Renal (up to 30%). Total body clearances: 0.19±0.06 L/hr/kg (for 300 mg IV dose); 0.14±0.03 L/hr/kg (for 600 mg IV dose).
How Supplied:
Caps—contact supplier; Vials—1
