Skip to Content

Rifapentine Dosage

Medically reviewed on December 11, 2017.

Applies to the following strengths: 150 mg

Usual Adult Dose for Tuberculosis - Active

Initial phase: 600 mg orally 2 times a week PLUS daily doses of isoniazid, ethambutol, and pyrazinamide
-Duration of therapy: 2 months

Continuation phase: 600 mg orally once a week PLUS isoniazid (or another appropriate agent)
-Duration of therapy: 4 months

Comments:
-An interval of at least 3 consecutive days (72 hours) should be followed during the initial phase.
-Each dose of this drug should be administered via directly observed therapy (DOT).
-Following the initial phase, most patients should continue with continuation phase dosing; patients with HIV should avoid once a week continuation phase dosing due to a higher risk of failure and/or relapse with rifampin-resistant organisms.

Use: Treatment for active pulmonary tuberculosis caused by drug-susceptible Mycobacterium tuberculosis as part of regimens consisting of a 2-month initial phase followed by a 4-month continuation phase

American Thoracic Society (ATS), US Centers for Disease Control and Prevention (US CDC), and Infectious Diseases Society of America (IDSA) Recommendations:
10 to 20 mg/kg orally once a week

Use: Treatment of drug-susceptible tuberculosis

Usual Adult Dose for Tuberculosis - Latent

10 to 14 kg: 300 mg orally once a week PLUS isoniazid
14.1 to 25 kg: 450 mg orally once a week PLUS isoniazid
25.1 to 32 kg: 600 mg orally once a week PLUS isoniazid
32.1 to 50 kg: 750 mg orally once a week PLUS isoniazid
Over 50 kg: 900 mg orally once a week PLUS isoniazid
Maximum dose: 900 mg/week
Duration of therapy: 12 weeks

Comments:
-Active tuberculosis should be ruled out prior to starting treatment.
-This drug is not recommended in patients presumed to be exposed to rifamycin- or isoniazid-resistant M tuberculosis.

Use: Treatment of latent tuberculosis infection caused by M tuberculosis in patients at high risk of progression to tuberculosis disease (e.g., close contact with active tuberculosis patients, recent conversion to a positive tuberculin skin test, patients with HIV, those with pulmonary fibrosis on radiograph)

US Department of Health and Human Services (US HHS), National Institutes of Health (NIH), Health Resources and Services Administration (HRSA), and US CDC Recommendations:
LATENT TUBERCULOSIS:
Alternative therapy:
32.1 to 49.9 kg: 750 mg orally once a week PLUS isoniazid
50 kg and greater: 900 mg orally once a week PLUS isoniazid
Maximum dose: 900 mg/week
Duration of therapy: 12 weeks

Comments:
-Pyridoxine 50 mg orally once a week should be given to patients during treatment for latent tuberculosis.
-DOT is recommended for patients with HIV-related tuberculosis.

Uses:
-Alternative treatment to prevent tuberculosis in patients with a positive screening test for latent tuberculosis infection, no evidence of active tuberculosis, and no prior history of treatment for active or latent tuberculosis who receiving a raltegravir OR efavirenz-based antiretroviral therapy (ART) regimen
-Alternative treatment to prevent tuberculosis in patients with close contact with a person with infectious tuberculosis, regardless of a screening test result who receiving a raltegravir OR efavirenz-based ART regimen

Usual Pediatric Dose for Tuberculosis - Active

12 years and older:
Initial phase: 600 mg orally 2 times a week PLUS daily doses of isoniazid, ethambutol, and pyrazinamide
-Duration of therapy: 2 months

Continuation phase: 600 mg orally once a week PLUS isoniazid (or another appropriate agent)
-Duration of therapy: 4 months

Comments:
-An interval of at least 3 consecutive days (72 hours) should be followed during the initial phase.
-Each dose of this drug should be administered via DOT.
-Following the initial phase, most patients should continue with continuation phase dosing; patients with HIV should avoid once a week continuation phase dosing due to a higher risk of failure and/or relapse with rifampin-resistant organisms.

Use: Treatment for active pulmonary tuberculosis caused by drug-susceptible M tuberculosis as part of regimens consisting of a 2-month initial phase followed by a 4-month continuation phase

ATS, US CDC, and IDSA Recommendations:
12 years and older: 10 to 20 mg/kg orally once a week

Use: Treatment of drug-susceptible tuberculosis

Usual Pediatric Dose for Tuberculosis - Latent

2 years and older:
10 to 14 kg: 300 mg orally once a week PLUS isoniazid
14.1 to 25 kg: 450 mg orally once a week PLUS isoniazid
25.1 to 32 kg: 600 mg orally once a week PLUS isoniazid
32.1 to 50 kg: 750 mg orally once a week PLUS isoniazid
Over 50 kg: 900 mg orally once a week PLUS isoniazid
Maximum dose: 900 mg/week
Duration of therapy: 12 weeks

Comments:
-Active tuberculosis should be ruled out prior to starting treatment.
-This drug is not recommended in patients presumed to be exposed to rifamycin- or isoniazid-resistant M tuberculosis.

Use: Treatment of latent tuberculosis infection caused by M tuberculosis in patients at high risk of progression to tuberculosis disease (e.g., close contact with active tuberculosis patients, recent conversion to a positive tuberculin skin test, patients with HIV, those with pulmonary fibrosis on radiograph)

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Liver dysfunction, patients with abnormal liver tests, and/or those starting treatment for active tuberculosis: Frequent monitoring recommended (e.g., at baseline and every 2 to 4 weeks during treatment)

Signs/symptoms of liver injury during treatment: Discontinue treatment.

Dose Adjustments

Coadministration with other agents metabolized by CYP450 3A4 and/or 2C8/9: This drug may induce metabolism of the other agents; dose adjustments of the coadministered agents may be necessary.

Hypersensitivity reaction: Discontinue treatment and administer supportive measures to patients at the first sign/symptom of a hypersensitivity reaction.

Precautions

CONTRAINDICATIONS:
-Hypersensitivity to either active component, any of the rifamycins, or to any of the ingredients

Safety and efficacy in the treatment of active tuberculosis have not been established in patients younger than 12 years.
Safety and efficacy in the treatment of latent tuberculosis have not been established in patients younger than 2 years.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration advice:
-Take with food/meals.

Storage requirements:
-Protect from moisture.

Reconstitution/preparation techniques:
-This drug may be crushed and added to semi-solid foods immediately prior to administration for patients who cannot swallow tablet formulations; this preparation should be consumed immediately.

General:
-Food may decrease gastrointestinal upset, nausea, and/or vomiting.
-Limitation of use: This drug should not be used as monotherapy for the initial or continuation phases of active M tuberculosis treatment OR in the treatment of latent tuberculosis.
-This drug has not been studied in the treatment of active tuberculosis in patients with HIV.

Monitoring:
-Hepatic: Signs/symptoms of liver injury; liver function tests at baseline and every 2 to 4 weeks thereafter in patients with liver dysfunction, patients with abnormal liver tests, and/or those starting treatment for active tuberculosis
-Hypersensitivity: Signs/symptoms of hypersensitivity reactions

Patient advice:
-Patients should be advised to avoid missing doses and to complete the entire course of therapy.
-Patients should be warned that treatment may produce a discoloration of sputum, sweat, tears, teeth, and urine; soft contact lenses may be permanently stained.
-Patients should be instructed to report signs/symptoms of Clostridium difficile (e.g., watery/bloody stools, stomach cramps, fever), for up to 2 months after stopping treatment.
-Patients should be told to immediately report cough, darkened urine, fever, joint pain/swelling, loss of appetite, malaise, nausea and vomiting, rash with fever/blisters with/without peeling skin, shortness of breath, swollen lymph nodes, yellowish discoloration of the skin and eyes, or wheezing.
-Advise patients to speak to their healthcare provider if they become pregnant, intend to become pregnant, or are breastfeeding.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Hide