Rifampin (intravenous)

Rifampin is also known by US brand name Rifadin (IV) and is used to prevent and fight bacteria from spreading in your body.

Overview

Rifampin is used in combination with other medications to treat various infections including, tuberculosis infections in a variety of areas of the body. It is part of a group of medications known as antibiotics and works by preventing or killing the growth of TB. However, rifampin will not work for flu, colds, or other virus infections. This medication is to be administered under the immediate supervision of a trained doctor or healthcare professional. It is available in the dosage form of powder for solution.

Conditions treated

  • Colonization with Menigococcus Bacteria without Symptoms of Infection
  • Treatment to Prevent Meningococcal Meningitis
  • Active/ inactive tuberculosis
  • Bacterial Infection due to Staphylococcus
  • Infection due to a Brucella Bacteria
  • Skin Infection caused by Anthrax
  • Bacterial Stomach or Intestine Infection caused by Anthrax
  • Prevention of Haemophilus Influenzae Type B
  • Infection of the Brain or Spinal Cord caused by Anthrax
  • Leprosy
  • Leprosy due to Multiple Bacteria
  • Infection of the Blood caused by the Bacteria Anthrax
  • Single Lesion Paucibacillary Leprosy
  • Paucibacillary Leprosy
  • Treatment of Staphylococcal Osteomyelitis with More Than One Medication
  • Infection due to unusual Mycobacteria
  • Pneumonia caused by the Bacteria Anthrax

Type of medicine

  • Powder for solution

Side Effects

Along with its intended effects, the use of Rifampin can produce from unwanted side effects. Not all of these side effects may occur at once, but if they do occur, you may need medical attention.

Inform your doctor or a healthcare professional urgently if you suffer from any of the following side effects whilst taking rifampin:

Rare side effects

  • Bleeding gums
  • Agitation
  • Blood in the urine or stools
  • Bruising
  • Hoarseness or a cough
  • Confusion
  • Coughing or vomiting blood
  • Darkening of the skin
  • Dark urine
  • Decreased frequency or amount of urine
  • Dizziness
  • Difficulty in swallowing and breathing
  • Fainting
  • Fever with or without chills
  • Fast heartbeat
  • General feeling of weakness or tiredness
  • Hives
  • Headache
  • Hostility
  • Increased thirst
  • Increased blood pressure
  • Light-colored stools
  • Irritability
  • Lethargy
  • Loss of appetite
  • Mental depression
  • Lower back or side pain
  • Vomiting or nausea
  • Persistent bleeding or oozing from puncture sites, mouth, or nose
  • Painful or difficult urination
  • Swelling or puffiness of the eyelids or around the face, eyes, lips, or tongue
  • Ulcers, sores, or white spots on the lips or in the mouth
  • Skin itching, rash, or redness
  • Stomach pain
  • Tightness in the chest
  • Swelling of the ankles, face, fingers, hands, or lower legs
  • Unusual bruising or bleeding
  • Yellow skin or eyes
  • Unusual weakness or tiredness
  • Weight gain

Incidence not known

  • Peeling, blistering or loosening of the skin
  • Bloody, severe, or watery diarrhea
  • Bloating
  • Bone pain
  • Chills
  • Chest pain
  • Cold, clammy skin
  • Double vision
  • Fast heartbeat
  • Difficulty with speaking
  • Fast, weak pulse
  • Inability to speak
  • Inability to move the legs, arms, or facial muscles
  • Muscle or joint pain
  • Pale skin
  • Lightheadedness
  • Pinpoint red spots on the skin
  • Red, irritated eyes
  • Red skin lesions, often with a purple center
  • Slow speech
  • Sweating
  • Sores, welting, blisters
  • Unusual weight loss
  • Swollen glands
  • Unpleasant breath odor

Seek urgent medical attention if any of the following symptoms of overdose appear whilst taking rifampin:

Symptoms of overdose

  • Blurred vision
  • Fast, pounding, or irregular heartbeat or pulse
  • Faintness, dizziness, or lightheadedness when getting up suddenly from a sitting or lying position
  • Full feeling in the upper abdomen or stomach
  • Pain in the upper abdomen or stomach
  • Low blood pressure or slow pulse
  • Reddish-orange to reddish-brown color of the urine, stool, saliva
  • Seizures
  • Sweat, and tears
  • Swelling around the face or eyes
  • Yellow skin or eyes
  • Unconsciousness

Some side effects that occur when taking rifampin won't require medical attention. These side effects will begin to disappear as your body begins to adjust to the medication. If the side effects are bothering you, you should contact your doctor or a healthcare professional about ways to prevent or lessen the intensity of the side effects.

Rare side effects

  • Feeling that others are watching you or controlling your behavior
  • Seeing, feeling or hearing things that are not there
  • Feeling that others can hear your thoughts
  • Tenderness, muscle pain, wasting, or weakness
  • Unusual behavior
  • Severe mood or mental changes

Incidence not known

  • Belching
  • Excess gas or air in the stomach or intestines
  • Bloated or full feeling
  • Drowsiness
  • Indigestion
  • Discomfort or pain in the chest, upper stomach, or throat
  • Not able to concentrate

Remember you can report all side effects to the FDA on 1-800-FDA-1088.

Dosage

The final dosage of any medication will depend on a number of factors. This includes your age, weight, height, what medications you are currently taking, your past medical history, what condition is being treated and how you react to the first dose.

Typical Adult Dose for Tuberculosis - Active

10 mg/kg (not to exceed 600 mg) via IV

Daily regimen:

10 mg/kg (up to 600 mg/day) via IV

Intermittent regimen:

10 mg/kg (up to 600 mg/dose) two or three times a week via IV

Typical Adult Dose for Tuberculosis - Latent

For those who present a positive tuberculin test without evidence of disease: 10 mg/kg (not to exceed 600 mg) via IV once a day for four months.

Typica Adult Dose for Meningococcal Meningitis Prophylaxis

Treatment of asymptomatic carriers of Neisseria meningitidis: 600 mg via IV twice a day for two days

Typical Adult Dose for Haemophilus influenzae Prophylaxis

600 mg via IV injection

Typical Adult Dose for Endocarditis

300 mg via IV injection

Typical Adult Dose for Legionella Pneumonia

600 mg via IV injection

Typical Adult Dose for Nasal Carriage of Staphylococcus aureus

600 mg via IV injection

Typical Adult Dose for Meningitis

Caused by Streptococcus pneumoniae: 600 mg via IV in patients with a severe penicillin allergy who need specific coverage or empiric.

Interactions

When drugs interact they can produce harmful side effects and actually reduce the effectiveness of each individual drug in treatment. To limit the risk of interactions, you should give your doctor or a healthcare professional a full list of all medications you are currently and have taken in the past. This list should include all prescription and non-prescription drugs, herbal remedies or vitamins. You should also let your doctor know of any medical conditions you currently suffer from any severe medical conditions that run in your family history.

The use of this medication with any of the following drugs is not recommended. Your doctor may avoid treating you with this drug or change some of the other medications you are currently taking.

  • Artemether
  • Boceprevir
  • Atazanavir
  • Cobicistat
  • Darunavir
  • Daclatasvir
  • Dasabuvir
  • Elbasvir
  • Delamanid
  • Elvitegravir
  • Grazoprevir
  • Fosamprenavir
  • Isavuconazonium
  • Lurasidone
  • Lopinavir
  • Maraviroc
  • Ombitasvir
  • Nelfinavir
  • Paritaprevir
  • Ranolazine
  • Praziquantel
  • Rilpivirine
  • Saquinavir
  • Ritonavir
  • Telaprevir
  • Voriconazole
  • Tipranavir

The use of this medication alongside any of the following drugs is not usually recommended. However, in some cases, it may be required for your treatment. If you are prescribed both medications together, your doctor may alter the dose and frequency of either medication.

  • Afatinib
  • Amprenavir
  • Amiodarone
  • Abiraterone
  • Apixaban
  • Aprepitant
  • Apremilast
  • Atovaquone
  • Aripiprazole
  • Axitinib
  • Bosutinib
  • Bedaquiline
  • Brexpiprazole
  • Cabozantinib
  • Brivaracetam
  • Cariprazine
  • Cholera Vaccine, Live
  • Ceritinib
  • Crizotinib
  • Clozapine
  • Cobimetinib
  • Cyclosporine
  • Dabrafenib
  • Dabigatran Etexilate
  • Dasatinib
  • Delavirdine
  • Deferasirox
  • Digoxin
  • Doxorubicin
  • Dolutegravir
  • Dronedarone
  • Doxorubicin Hydrochloride Liposome
  • Eliglustat
  • Edoxaban
  • Efavirenz
  • Eluxadoline
  • Ethionamide
  • Enzalutamide
  • Erlotinib
  • Etravirine
  • Exemestane
  • Everolimus
  • Fentanyl
  • Fosphenytoin
  • Fosaprepitant
  • Gefitinib
  • Ibrutinib
  • Hydrocodone
  • Idelalisib
  • Imatinib
  • Ifosfamide
  • Indinavir
  • Irinotecan Liposome
  • Irinotecan
  • Isoniazid
  • Ivabradine
  • Itraconazole
  • Ivacaftor
  • Ixazomib
  • Ixabepilone
  • Ketoconazole
  • Ledipasvir
  • Lamotrigine
  • Lapatinib
  • Linagliptin
  • Macitentan
  • Lorcainide
  • Mifepristone
  • Manidipine
  • Mycophenolate Mofetil
  • Naloxegol
  • Netupitant
  • Mycophenolic Acid
  • Nilotinib
  • Nevirapine
  • Nifedipine
  • Nimodipine
  • Olaparib
  • Nintedanib
  • Osimertinib
  • Panobinostat
  • Palbociclib
  • Pazopanib
  • Phenytoin
  • Perampanel
  • Piperaquine
  • Pixantrone
  • Pitavastatin
  • Ponatinib
  • Pyrazinamide
  • Posaconazole
  • Quetiapine
  • Regorafenib
  • Quinine
  • Rivaroxaban
  • Rolapitant
  • Roflumilast
  • Sirolimus
  • Sonidegib
  • Romidepsin
  • Simeprevir
  • Sofosbuvir
  • Sorafenib
  • Tacrolimus
  • Sunitinib
  • Tasimelteon
  • Temsirolimus
  • Telithromycin
  • Tenofovir Alafenamide
  • Tofacitinib
  • Ticagrelor
  • Trabectedin
  • Tolvaptan
  • Vandetanib
  • Ulipristal
  • Vemurafenib
  • Velpatasvir
  • Venetoclax
  • Vincristine
  • Vilazodone
  • Vincristine Sulfate Liposome
  • Vortioxetine
  • Vinflunine
  • Vorapaxar

The use of this medication with any of the following drugs can cause an increase in the risk of some side effects. However, in some cases, the use of both drugs may be the best treatment choice for you. If you are prescribed both medications at once, your doctor may alter the dose and frequency in which you receive in either medication.

  • Aliskiren
  • Acetyldigoxin
  • Anisindione
  • Betamethasone
  • Atorvastatin
  • Buspirone
  • Bexarotene
  • Bosentan
  • Carbamazepine
  • Carvedilol
  • Chloramphenicol
  • Caspofungin
  • Chlorpropamide
  • Clarithromycin
  • Citalopram
  • Clofibrate
  • Dexamethasone
  • Cortisone
  • Desogestrel
  • Dicumarol
  • Diltiazem
  • Dienogest
  • Disopyramide
  • Drospirenone
  • Doxycycline
  • Eltrombopag
  • Enalapril Maleate
  • Enalaprilat
  • Estradiol Cypionate
  • Ethinyl Estradiol
  • Estradiol Valerate
  • Ethynodiol Diacetate
  • Etoricoxib
  • Etonogestrel
  • Fesoterodine
  • Fludrocortisone
  • Fluconazole
  • Gliclazide
  • Haloperidol
  • Glyburide
  • Levomethadyl
  • Isradipine
  • Levonorgestrel
  • Linezolid
  • Levothyroxine
  • Losartan
  • Mestranol
  • Mefloquine
  • Metformin
  • Methylprednisolone
  • Methadone
  • Metoprolol
  • Morphine Sulfate Liposome
  • Morphine
  • Moxifloxacin
  • Norethindrone
  • Nisoldipine
  • Norelgestromin
  • Norgestimate
  • Ospemifene
  • Norgestrel
  • Oxycodone
  • Pioglitazone
  • Phenprocoumon
  • Pirmenol
  • Prednisone
  • Prednisolone
  • Propafenone
  • Repaglinide
  • Raltegravir
  • Rofecoxib
  • Sertraline
  • Rosiglitazone
  • Simvastatin
  • Tamoxifen
  • Tadalafil
  • Theophylline
  • Triazolam
  • Tocainide
  • Trimetrexate
  • Warfarin
  • Valproic Acid
  • Zidovudine
  • Zaleplon

Other medical conditions

If you suffer from any other medical conditions, this could affect the use of this medication. Ensure you inform y our doctor or healthcare professional of any other medical conditions you may be suffering from, especially:

  • Type 1 or Type 2 diabetes
  • Alcohol abuse or history of—Caution should be exercised as the use of the drug could cause side effects to worsen.
  • Porphyria (an enzyme problem)—Caution should be exercised as the use of this drug can make conditions worse.
  • Liver disease

Warnings

Allergies

Let your doctor or a healthcare professional know if you have ever had an allergic reaction to the medication or other medications. You should also let them know of any other allergies you suffer from. This includes dyes, foods, preservatives, animals etc.

The use in the pediatric population

Studies that have been conducted to date have not indicated a pediatric-specific problem that could limit the effectiveness of rifampin injection in young children.

The use in geriatric population

Studies that have been conducted to date have not indicated a geriatric-specific problem that could limit the effectiveness of rifampin injection in the older population.

Use in pregnancy and breastfeeding

This drug is under FDA pregnancy category C.

It is unknown whether this drug can harm an unborn child. However, taking rifampin during the last weeks of pregnancy can cause bleeding in the newborn baby or the mother. Let your doctor know if you are currently pregnant or are planning on becoming pregnant whilst using this medication.

The use of this drug can limit the effectiveness of birth control pills. You should speak with your doctor or a healthcare professional about using a nonhormonal birth control such as diaphragm with spermicide or condom to prevent falling pregnant while taking rifampin.

With regards to breastfeeding, this drug can pass into breast milk and could potentially harm a nursing infant. You should not breastfeed your baby when using this medication.

It is very important that you let your doctor monitor the progress of you or your child whilst receiving this medication. This will allow them to ensure the medication is working as it should and decide whether you should continue receiving it. Blood tests can also indicate unwanted side effects.

You should not take this medicine if you or your child are also receiving any of the following medications: darunavir, atazanavir, fosamprenavir, saquinavir, ritonavir, tipranavir, Aptivus®, Invirase®, Fortovase®, Lexiva®, Prezista®, Norvir®, or Reyataz®. These medications are used in the treatment of human immunodeficiency virus infections. (HIV)

Liver problems can occur with this medication. The risk of liver problems is increased when you drink alcoholic beverages on a regular basis. You should reduce the amount of alcohol you drink while you are receiving this medication. If you are concerned about this, seek guidance from a doctor or healthcare professional.

Inform your doctor right away if you or your child have dark urine, have tenderness or pain in the stomach, pale stools, loss of appetite, nausea, unusual weakness or tiredness or yellow skin or eyes. These are all symptoms of a potentially serious liver problem.

This medication can cause severe pain and tenderness at the place where the injection was given. Inform your doctor immediately if you or your child notice any of these side effects around the injection site: blistering, bleeding, burning, discoloration of the skin, coldness, feeling of pressure, hives, inflammation, infection, itching, lumps, pain, redness, numbness, rash, scarring, stinging, soreness, swelling, tenderness, warmth, tingling, or ulceration.

Rifampin can cause your urine, saliva, stools, sweat, sputum, and tears to turn a reddish-orange to reddish-brown color. This is expected when you are using this medication, and everything will return back to normal once finish using this drug. This effect can cause soft contact lenses to become permanently discolored. It's, therefore, best not to wear these type of contact lenses whilst using this medication. If you have any questions about this, speak with a healthcare professional or your doctor.

Before you have any type of medical test, let the doctor or healthcare professional know that you or your child are currently taking this medication. The results of some tests can be affected by this medication.

Storage

This drug should be stored at 68° to 77°F (20° to 25°C). It should be protected from light and moisture.
Dispense in a tightly-closed, light-resistant container with a child-resistant closure.

Summary

When used correctly, rifampin is successful in the treatment of TB and other infections in the body. A trained medical professional will administer this medication in a hospital setting. This medication will be given via a needle placed in one of your veins. Your doctor may only give you a few doses of this medication until your condition begins to improve, and then you will be switched to an oral medication that works in a similar way. Due to the high amount of interactions possible with this drug, it's important you let your doctor know about all the medications you are currently taking. You should avoid taking this drug whilst pregnant and whilst you are breastfeeding. Remember this drug can limit the effectiveness of birth control.

 

Resources
Last Reviewed:
January 31, 2018
Last Updated:
January 27, 2018