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Rifapentine Side Effects

In Summary

More frequently reported side effects include: diarrhea. See below for a comprehensive list of adverse effects.

For the Consumer

Applies to rifapentine: oral tablet

As well as its needed effects, rifapentine may cause unwanted side effects that require medical attention.

Major Side Effects

If any of the following side effects occur while taking rifapentine, check with your doctor immediately:

More common:
  • Blood in the urine
  • joint pain
  • lower back or side pain
  • swelling of the feet or lower legs
Less common:
  • Aggressive reaction
  • black, tarry stools
  • blood in the stools
  • nausea
  • pinpoint red spots on the skin
  • severe abdominal or stomach pain
  • sore throat and fever
  • unusual bleeding or bruising
  • unusual tiredness or weakness
  • vomiting
  • yellow eyes or skin
  • Diarrhea
  • dizziness
  • increase in blood pressure
  • severe or continuing headaches

Minor Side Effects

Some rifapentine side effects may not need any medical attention. As your body gets used to the medicine these side effects may disappear. Your health care professional may be able to help you prevent or reduce these side effects, but do check with them if any of the following side effects continue, or if you are concerned about them:

Less common:
  • Acne
  • constipation
  • loss of appetite

For Healthcare Professionals

Applies to rifapentine: oral tablet


In general, there are no data concerning the adverse effects of rifapentine in monotherapy. The following adverse effects have been reported during treatment in the intensive phase (i.e., rifapentine 2 times a week and isoniazid, pyrazinamide and ethambutol daily for 2 months) and the continuation phase (i.e., rifapentine and isoniazid once a week for 4 months) in a clinical study in which 361 patients were randomized to the rifapentine regimen.[Ref]


Hematologic side effects have included neutropenia (12.5%), lymphopenia (12.7%), anemia (12.2%), leukopenia (6.6%), thrombocytosis (5.5%), leukocytosis (3%), neutrophilia (2.5%), thrombocytopenia (2.5%), polycythemia (2.2%), and lymphadenopathy (1.1%). Lymphocytosis, hematoma, purpura, hypochromic anemia, normocytic anemia, and thrombosis have been reported in less than 1% of patients.[Ref]


Metabolic side effects have included hyperuricemia (31.9), hypoglycemia (10%), hyperkalemia (9.1%), increased nonprotein nitrogen (3.9%), hyperglycemia (3.6%), increased lactate dehydrogenase (1.4%), and hyperphosphatemia (1.4%). Weight decrease, diabetes mellitus, increased alkaline phosphatase, hypophosphatemia, hypercalcemia, hypovolemia, and weight increase have been reported in less than 1% of patients.[Ref]

Hyperuricemia was most likely related to pyrazinamide as only 2 cases were reported during the continuation phase, when pyrazinamide was no longer part of the regimen.[Ref]


Genitourinary side effects have included proteinuria (13%), pyuria (21.6%), urinary tract infection (13.3%), urinary casts (8%), cystitis (1.7%), and hematuria (17.7%). Urethral disorder, dysuria, pyelonephritis, urinary incontinence, urination disorder, penis disorder, vaginitis, vaginal hemorrhage, positive cervical smear test, leukorrhea, male mastitis, prostatic disorder, and abortion have been reported in less than 1% of patients.[Ref]


Respiratory side effects have included hemoptysis (8.3%), coughing (8%), upper respiratory tract infection (4.7%), bronchitis (2.5%), pharyngitis (1.9%), epistaxis (1.4%), and pleuritis (1.1%). Abnormal breath sounds, pneumothorax, pneumonia, pleural effusion, rhinitis, dyspnea, pneumonitis, sinusitis, increased sputum, pulmonary fibrosis, upper respiratory congestion, asthma, abnormal chest x-ray, bronchospasm, laryngeal edema, laryngitis, and respiratory disorder have been reported in less than 1% of patients.


Immunologic side effects have included influenza (7.8%), tuberculosis infection (2.5%), infection (1.4%), and herpes zoster (1.1%). Fungal infection, parasitic infection, and protozoan infection have been reported in less than 1% of patients.


Hepatic side effects have included elevated ALT (6.9%) and AST (5.8%). Bilirubinemia, hepatomegaly, jaundice, and hepatitis have been reported in less than 1% of patients.[Ref]


Other side effects have included back pain (6.9%), pain (6.1%), chest pain (5.5%), accident injury (4.7%), abdominal pain (1.9%), fever (1.4%), fatigue (1.1%), dependent edema (1.1%), at least one case of influenza-like syndrome, and orange-red discoloration of body tissues and/or fluids (e.g., skin, teeth, tongue, urine, tears, sputum, saliva, feces, sweat, and cerebral spinal fluid). Abnormal laboratory test, legs edema, asthenia, face edema, abscess, peripheral edema, malaise, ear disorder not specified, otitis media, earache, otitis externa, and tympanic membrane perforation have been reported in less than 1% of patients.[Ref]


Dermatologic side effects have included increased sweating (6.4%), rash (6.1%), pruritus (3.6%), acne (2.5%), skin disorder (1.4%), maculopapular rash (1.7%), and eczema (1.1%). Skin ulceration, urticaria, dry skin, furunculosis, skin discoloration, fungal dermatitis, nail disorder, alopecia, and erythematous rash have been reported in less than 1% of patients.[Ref]


Clostridium difficile should be suspected in any patient who develops persistent or severe diarrhea following rifapentine therapy.[Ref]

Gastrointestinal side effects have included anorexia (5.8%), nausea (2.5%), vomiting (2.5%), dyspepsia (2.8%), constipation (1.9%), diarrhea (1.9%), and hemorrhoids (1.4%). Tooth disorder, gastroenteritis, gastritis, esophagitis, cheilitis, dry mouth, pancreatitis, proctitis, salivary gland enlargement, tenesmus, and gastrointestinal disorder not specified have been reported in less than 1% of patients. Clostridium difficile associated diarrhea has been reported with almost all antibiotics, including the rifamycins.[Ref]

Nervous system

Nervous system side effects have included headache (3.9%), dizziness (1.7%), tremor (1.4%), and insomnia (1.1%). Somnolence, seizure not specified, dysphonia, hypoesthesia, torticollis, hypertonia, hyporeflexia, meningitis, migraine headache, stupor, and taste loss have been reported in less than 1% of patients.[Ref]


Musculoskeletal side effects have included arthralgia (4.4%), arthritis (1.1%), arthrosis (1.1%), and gout (1.1%). Myalgia, myositis, bone fracture, muscle weakness, and muscle spasm have been reported in less than 1% of patients.


Cardiovascular side effects have included hypertension (1.7%). Syncope, tachycardia, palpitation, orthostatic hypotension, pericarditis, deep thrombophlebitis, vascular disorder, and vasodilation have been reported in less than 1% of patients.


Ocular side effects have included conjunctivitis (2.5%). Eye pain and eye abnormality have been reported in less than 1% of patients.


Psychiatric side effects have included anxiety, confusion, drug abuse, aggressive reaction, and agitation in less than 1% of patients.


Oncologic side effects have included pulmonary carcinoma, neoplasm not specified, carcinoma, and lipoma in less than 1% of patients.


Renal side effects have included increased BUN (less than 1%).


1. "Product Information. Priftin (rifapentine)." Hoechst Marion-Roussel Inc, Kansas City, MO.

2. Munsiff SS, Kambili C, Ahuja SD "Rifapentine for the treatment of pulmonary tuberculosis." Clin Infect Dis 43 (2006): 1468-75

3. Jarvis B, Lamb HM "Rifapentine." Drugs 56 (1998): 607-16

It is possible that some side effects of rifapentine may not have been reported. These can be reported to the FDA here. Always consult a healthcare professional for medical advice.

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