Generic name: rifampin (rif-AM-pin)
Drug class: Rifamycin derivatives
Medically reviewed by Drugs.com. Last updated on Sep 2, 2021.
Commonly used brand name(s)
In the U.S.
Available Dosage Forms:
Therapeutic Class: Antitubercular
Chemical Class: Rifamycin
Uses for rifampin
Rifampin is used together with other medicines to treat tuberculosis (TB) in many different parts of the body. It is also used by patients who have a meningitis bacteria in their nose or throat who do not show symptoms of the infection to prevent the spread of the bacteria to other patients. Rifampin belongs to the class of medicines called antibiotics and works to kill or prevent the growth of bacteria. However, it will not work for colds, flu, or other virus infections.
Rifampin is available only with your doctor's prescription.
Before using rifampin
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For rifampin, the following should be considered:
Tell your doctor if you have ever had any unusual or allergic reaction to rifampin or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.
Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of rifampin in children.
Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of rifampin in the elderly.
Studies in women suggest that this medication poses minimal risk to the infant when used during breastfeeding.
Interactions with medicines
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking rifampin, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using rifampin with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Tenofovir Alafenamide
Using rifampin with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Abiraterone Acetate
- Cholera Vaccine, Live
- Dabigatran Etexilate
- Doxorubicin Hydrochloride Liposome
- Ethinyl Estradiol
- Irinotecan Liposome
- Mycophenolate Mofetil
- Mycophenolic Acid
- Sirolimus Protein-Bound
- Vincristine Sulfate Liposome
Using rifampin with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Aripiprazole Lauroxil
- Enalapril Maleate
- Morphine Sulfate Liposome
- Valproic Acid
Interactions with food/tobacco/alcohol
Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Other medical problems
The presence of other medical problems may affect the use of rifampin. Make sure you tell your doctor if you have any other medical problems, especially:
- Adrenal gland problems or
- Blood clotting problems or
- Diabetes, history of or
- Liver disease or
- Porphyria (an enzyme problem) or
- Vitamin K deficiency—Use with caution. May make these conditions worse.
- Alcohol abuse, or history of—Use with caution. May cause side effects to become worse.
- Liver disease, chronic or
- Patients with poor nutrition status—Use with caution. May increase risk for vitamin K deficiency, which may lead to excessive bleeding.
- Meningococcal disease (including infections of the lining of the brain and spinal cord [meningitis] and bloodstream [eg, bacteremia, septicemia)—Should not be used in patients with this condition.
Proper use of rifampin
Take rifampin only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. To do so may increase the chance for side effects.
To help clear up your tuberculosis (TB) completely, it is very important that you keep using rifampin for the full time of treatment, even if you begin to feel better after a few weeks. If you have TB, you might have to take rifampin every day for several months. It is important that you do not miss any doses.
Take the capsule on an empty stomach, 1 hour before or 2 hours after a meal, with a full of glass water. It is important to take rifampin on a regular schedule.
If rifampin upsets your stomach, take it with food. Antacids may also help. However, do not take aluminum-containing antacids (eg, Maalox®, Mylanta®) within 1 hour of the time you take rifampin. They may keep rifampin from working properly.
For patients unable to swallow the capsule:
- A special liquid form of the medicine can be prepared by your pharmacist.
- Shake the bottle well before each dose.
- Measure the liquid with a marked measuring spoon, oral syringe, or medicine cup. The average household teaspoon may not hold the right amount of liquid.
If you are taking itraconazole, do not use rifampin 2 weeks before and during itraconazole treatment.
The dose of rifampin will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of rifampin. If your dose is different, do not change it unless your doctor tells you to do so.
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
- For oral dosage form (capsules):
- For the treatment of meningitis bacteria in the nose or throat:
- Adults—600 milligrams (mg) 2 times a day for 2 days.
- Children 1 month of age and older—Dose is based on body weight and must be determined by your doctor. The dose is 10 mg per kilogram (kg) of body weight every 12 hours for 2 days.
- Children younger than 1 month of age—Dose is based on body weight and must be determined by your doctor. The dose is 5 mg per kg of body weight every 12 hours for 2 days.
- For the treatment of tuberculosis:
- Adults—Dose is based on body weight and must be determined by your doctor. The dose is 10 milligrams (mg) per kilogram (kg) of body weight once a day. Your doctor may increase your dose as needed. However, the dose is usually not more than 600 mg per day.
- Children—Dose is based on body weight and must be determined by your doctor. The dose is 10 to 20 mg per kg of body weight once a day. Your doctor may increase your dose as needed. However, the dose is usually not more than 600 mg per day.
- For the treatment of meningitis bacteria in the nose or throat:
If you miss a dose of rifampin, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.
If rifampin is taken on an irregular schedule, side effects may occur more often and may be more serious than usual. If you have any questions about this, check with your doctor.
Keep out of the reach of children.
Do not keep outdated medicine or medicine no longer needed.
Ask your healthcare professional how you should dispose of any medicine you do not use.
Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.
The specially prepared oral liquid form may be kept at room temperature or in a refrigerator for 4 weeks. Do not use the liquid after the expiration date on the label.
Precautions while using rifampin
It is very important that your doctor check your or your child's progress at regular visits. Blood and urine tests may be needed to check for unwanted effects.
Do not use rifampin if you or your child are also receiving certain medicines to treat HIV infection (eg, atazanavir, darunavir, fosamprenavir, ritonavir, saquinavir, tipranavir, Aptivus®, Fortovase®, Invirase®, Lexiva®, Norvir®, Prezista®, or Reyataz®).
Do not use rifampin together with praziquantel. If you or your child need to take praziquantel, you should stop using rifampin 4 weeks before starting praziquantel. You may restart rifampin one day after the last dose of praziquantel.
Liver problems may be more likely to occur if you drink alcoholic beverages regularly while you are using rifampin. Also, the regular use of alcohol may keep rifampin from working properly. Therefore, you should strictly limit the amount of alcoholic beverages you drink while you are using rifampin.
Check with your doctor right away if you or your child have fever, chills, cough, sore throat, swollen, painful, or tender lymph glands in the neck, armpit, or groin, or yellow skin or eyes while using rifampin. These could be symptoms of a serious condition called drug reaction with eosinophilia and systemic symptoms (DRESS).
Check with your doctor right away if you or your child have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, unusual tiredness or weakness, or yellow eyes or skin. These could be symptoms of a serious liver problem.
Serious skin reactions (eg, Stevens-Johnson syndrome, toxic epidermal necrolysis, and acute generalized exanthematous pustulosis) can occur with rifampin. Check with your doctor right away if you or your child have blistering, peeling, or loosening of the skin, red skin lesions, severe acne or a skin rash, sores or ulcers on the skin, or fever or chills with rifampin.
Tell your doctor right away if you have chest pain, cough, coughing or spitting up blood, difficulty in breathing, sore throat, muscle aches, night sweats, sudden high fever, or unusual tiredness. These could be symptoms of a paradoxical drug reaction to rifampin. If your symptoms do not improve within a few days or if they become worse, check with your doctor.
Rifampin may cause blood clotting problems, which may lead to bleeding. Check with your doctor right away if you or your child cough up blood, have bleeding gums, difficulty in breathing or swallowing, dizziness, headache, increased menstrual flow or vaginal bleeding, nosebleeds, prolonged bleeding from cuts, red or dark brown urine, or red or black, tarry stools after using rifampin.
Rifampin may cause lung or breathing problems (eg, interstitial lung disease, pneumonitis), which can be life-threatening and require immediate medical attention. Check with your doctor right away if you have chest pain, chills, dry cough, fever, general feeling of discomfort or illness, thickening of bronchial secretions, or trouble breathing.
Rifampin will cause urine, saliva, sputum, sweat, teeth, and tears to turn a reddish-orange to reddish-brown color. This is to be expected while you are using rifampin. This effect may also cause soft contact lenses to become permanently discolored. Standard cleaning solutions may not take out all the discoloration. Therefore, it is best not to wear soft contact lenses while using rifampin. Hard contact lenses are not discolored by rifampin. This condition will return to normal once you stop using rifampin. If you have any questions about this, check with your doctor.
If you or your child develop a skin rash, hives, or any allergic reaction to rifampin, check with your doctor right away.
Birth control pills may not work properly while you are using rifampin. To keep from getting pregnant, use another form of birth control together with your birth control pills. Other forms include condoms, diaphragms, or contraceptive foams or jellies.
Before you have any medical tests, tell the doctor in charge that you or your child are using rifampin. The results of some tests may be affected by rifampin.
Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.
Rifampin side effects
Along with its needed effects, a medicine 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:
- bleeding gums
- blood in the urine or stools
- chest tightness
- coughing or vomiting blood
- dark urine
- darkening of the skin
- decreased frequency or amount of urine
- difficulty in breathing and swallowing
- fast heartbeat
- fever with or without chills
- general feeling of tiredness or weakness
- increased blood pressure
- increased thirst
- light-colored stools
- loss of appetite
- lower back or side pain
- mental depression
- 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
- weight gain
- yellow eyes or skin
Incidence not known
- Bleeding under the skin
- blistering, peeling, or loosening of the skin
- bloody, severe, or watery diarrhea
- bone pain
- chest pain
- cold, clammy skin
- difficulty with speaking
- double vision
- dry cough
- fast, weak pulse
- general feeling of discomfort or illness
- inability to move the arms, legs, or facial muscles
- inability to speak
- increased menstrual flow or vaginal bleeding
- joint or muscle pain
- muscle aches
- night sweats
- pale skin
- 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
- slow speech
- sore throat
- sores, welts, blisters
- 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:
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
- swelling around the eyes or face
- yellow eyes or skin
Some side effects 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:
- 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
- bloated or full feeling
- excess air or gas in the stomach or bowels
- not able to concentrate
- pain or discomfort in the chest, upper stomach, or throat
- tooth discoloration
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Frequently asked questions
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