Rifampin Side Effects

Medically reviewed by Drugs.com. Last updated on Dec 5, 2023.

Applies to rifampin: oral capsule. Other dosage forms:

intravenous powder for solution

Serious side effects of Rifampin

Along with its needed effects, rifampin may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking rifampin:

Rare

Agitation
bleeding gums
blood in the urine or stools
bruising
chest tightness
confusion
cough
coughing or vomiting blood
dark urine
darkening of the skin
decreased frequency or amount of urine
difficulty in breathing and swallowing
dizziness
fainting
fast heartbeat
fever with or without chills
general feeling of tiredness or weakness
headache
hives
hoarseness
hostility
increased blood pressure
increased thirst
irritability
light-colored stools
loss of appetite
lower back or side pain
mental depression
nausea
painful or difficult urination
persistent bleeding or oozing from puncture sites, mouth, or nose
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
skin itching, rash, or redness
sores, ulcers, or white spots on the lips or in the mouth
stomach pain
swelling of the face, ankles, fingers, hands, or lower legs
unusual bleeding or bruising
unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness
vomiting
weight gain
yellow eyes or skin

Incidence not known

Bleeding under the skin
blistering, peeling, or loosening of the skin
bloating
bloody, severe, or watery diarrhea
bloody nose
bone pain
chest pain
chills
cold, clammy skin
diarrhea
difficulty with speaking
double vision
dry cough
fast, weak pulse
general feeling of discomfort or illness
heavier menstrual periods
inability to move the arms, legs, or facial muscles
inability to speak
increased menstrual flow or vaginal bleeding
joint or muscle pain
lightheadedness
muscle aches
night sweats
nosebleeds
pale skin
paralysis
pinpoint red spots on the skin
prolonged bleeding from cuts
red or black, tarry stools
red or dark brown urine
red skin lesions, often with a purple center
red, irritated eyes
runny nose
shivering
slow speech
sore throat
sores, welts, blisters
sweating
swelling of the fingers, feet, or lower legs
swelling or puffiness of the face
swollen glands
trouble sleeping
unpleasant breath odor
unusual weight loss

Get emergency help immediately if any of the following symptoms of overdose occur while taking rifampin:

Symptoms of overdose

Blurred vision
dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
fast, pounding, or irregular heartbeat or pulse
feeling of fullness in the upper abdomen or stomach
low blood pressure or slow pulse
pain in the upper abdomen or stomach
reddish-orange to reddish-brown color of the urine, stool, saliva, sputum, sweat, and tears
seizures
swelling around the eyes or face
unconsciousness
yellow eyes or skin

Other side effects of Rifampin

Some side effects of rifampin may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Rare

Feeling that others are watching you or controlling your behavior
feeling that others can hear your thoughts
feeling, seeing, or hearing things that are not there
muscle tenderness, wasting, or weakness
severe mood or mental changes
unusual behavior

Incidence not known

Belching
bloated or full feeling
excess air or gas in the stomach or bowels
indigestion
not able to concentrate
pain or discomfort in the chest, upper stomach, or throat
tooth discoloration

For Healthcare Professionals

Applies to rifampin: compounding powder, intravenous powder for injection, oral capsule.

Dermatologic

Uncommon (0.1% to 1%): Serious cutaneous reactions

Frequency not reported: Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome, erythema multiforme, face edema, itching with/without rash, mild cutaneous reactions, pemphigoid reaction, pruritus, rash, self-limiting cutaneous reactions, Stevens-Johnson syndrome, toxic epidermal necrolysis, urticaria^[Ref]

Hypersensitivity

Hypersensitivity reactions included acute renal failure, acute tubular necrosis, hematuria, hemoglobinuria, hemolysis, interstitial nephritis, renal insufficiency, and serious cutaneous reactions.^[Ref]

Uncommon (0.1% to 1%): Hypersensitivity reactions

Rare (0.01% to 0.1%): Anaphylaxis^[Ref]

Renal

Rare (0.01% to 0.1%): Acute renal failure, acute tubular necrosis, interstitial nephritis, renal insufficiency

Frequency not reported: Blood urea nitrogen elevations^[Ref]

Acute renal failure, acute tubular necrosis, interstitial necrosis, renal insufficiency were hypersensitivity reactions and usually occurred during intermittent therapy or during the resumption of intentional/accidental interruption of a daily dosage regimen. The effects were usually reversible when treatment was discontinued and appropriate therapy was instituted.^[Ref]

Hematologic

Rare (0.01% to 0.1%): Disseminated intravascular coagulation, hemolysis, thrombocytopenia

Very rare (less than 0.01%): Agranulocytosis

Frequency not reported: Decreased hemoglobin, eosinophilia, hemolytic anemia, leukopenia^[Ref]

Thrombocytopenia usually occurred with high-dose intermittent therapy, but has occurred with well-supervised daily therapy and after resumption of interrupted treatment; the effect is reversible if treatment is discontinued as soon as purpura occurs.

Hemolysis was a hypersensitivity reaction and usually occurred during intermittent therapy or during the resumption of intentional/accidental interruption of a daily dosage regimen. This effect was usually reversible when treatment was discontinued and appropriate therapy was instituted.^[Ref]

Hepatic

Rare (0.01% to 0.1%): Abnormal liver function tests, hepatitis, shock-like syndrome with hepatic involvement

Frequency not reported: Jaundice, transient liver function test abnormalities, serum bilirubin elevations, serum transaminase elevations^[Ref]

Genitourinary

Hematuria and hemoglobinuria were hypersensitivity reactions and usually occurred during intermittent therapy or during the resumption of intentional/accidental interruption of a daily dosage regimen. The effects were usually reversible when treatment was discontinued and appropriate therapy was instituted.^[Ref]

Rare (0.01% to 0.1%): Hematuria, hemoglobinuria

Frequency not reported: Menstrual disturbances^[Ref]

Musculoskeletal

Rare (0.01% to 0.1%): Myopathy

Frequency not reported: Bone pain, extremity pain, muscular weakness^[Ref]

Bone pain was included in flu syndrome, and occurred in patients receiving intermittent regimens; however, this event may occur in patients taking this drug irregularly or if daily administration is resumed after a drug-free interval.^[Ref]

Psychiatric

Rare (0.01% to 0.1%): Psychoses

Frequency not reported: Behavioral changes, mental confusion^[Ref]

Endocrine

Rare (0.01% to 0.1%): Adrenal insufficiency^[Ref]

Adrenal insufficiency occurred in patients with compromised adrenal function.^[Ref]

Gastrointestinal

Frequency not reported: Cramps, diarrhea, epigastric distress, flatulence, heartburn, nausea, pseudomembranous colitis, sore mouth, sore tongue, tooth discoloration/permanent tooth discoloration, vomiting^[Ref]

Nervous system

Frequency not reported: Ataxia, cerebral hemorrhage, dizziness, drowsiness, generalized numbness, headache, inability to concentrate^[Ref]

Cerebral hemorrhage occurred in patients who continued or resumed treatment after the appearance of purpura.

Dizziness and headache were included in flu syndrome, and occurred in patients receiving intermittent regimens; however, the events may occur in patients taking this drug irregularly or if daily administration is resumed after a drug-free interval.^[Ref]

Cardiovascular

Frequency not reported: Decreased blood pressure, extremity edema, flushing with/without rash, shock, vasculitis^[Ref]

Decreased blood pressure and shock were included in flu syndrome, and occurred in patients receiving intermittent regimens; however, the events may occur in patients taking this drug irregularly or if daily administration is resumed after a drug-free interval.^[Ref]

Other

Frequency not reported: Chills, fatalities, fatigue, fever^[Ref]

Chills and fever were included in flu syndrome, and occurred in patients receiving intermittent regimens; however, the events may occur in patients taking this drug irregularly or if daily administration is resumed after a drug-free interval.

Fatalities occurred in patients who continued or resumed treatment after the appearance of purpura.^[Ref]

Metabolic

Frequency not reported: Alkaline phosphatase elevations, anorexia, serum uric acid elevations^[Ref]

Ocular

Frequency not reported: Conjunctivitis, visual disturbances^[Ref]

Immunologic

Flu syndrome occurred in patients receiving intermittent regimens, but may occur in patients taking this drug irregularly or if daily administration is resumed after a drug-free interval.^[Ref]

Frequency not reported: Flu syndrome^[Ref]

Respiratory

Frequency not reported: Shortness of breath, wheezing^[Ref]

Shortness of breath and wheezing were included in flu syndrome, and occurred in patients receiving intermittent regimens; however, the events may occur in patients taking this drug irregularly or if daily administration is resumed after a drug-free interval.^[Ref]