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Back to Infections Drug Index
Name: Rifampin
Pregnancy Category C
Drug classes
- Antituberculous drug ("first-line")
- Antibiotic
Mechanisms of action
Inhibits DNA-dependent RNA polymerase activity in susceptible
bacterial
cells.
Indications
- Treatment of pulmonary tuberculosis in conjunction with at least one
other effective antituberculous drug
- Neisseria meningitidis carriers, for asymptomatic carriers to
eliminate
meningococci from nasopharynx; not for treatment of meningitis
- Unlabeled uses: infections caused by Staphylococcus aureus and
Staphylococcus epidermis, usually in combination therapy;
gram-negative
bacteremia in infancy; Legionella (Legionella pneumophilia), not
responsive to erythromycin; leprosy (in combination with dapsone);
prophylaxis of meningitis due to Haemophilus influenzae
Contraindications/cautions
- Contraindicated in the presence of allergy to any rifamycin, acute
hepatic disease, nursing a baby.
- Use caution in pregnancy (teratogenic effects have been reported in
preclinical studies; safest antituberculous regimen for use in
pregnancy
is considered to be rifampin, isoniazid, and ethambutol).
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Adverse effects
- CNS: Headache, drowsiness, fatigue, dizziness, inability to
concentrate,
mental confusion, generalized numbness, ataxia, muscle weakness,
visual
disturbances, exudative conjunctivitis
- GI: Heartburn, epigastric distress, anorexia, nausea, vomiting, gas,
cramps, diarrhea, pseudomembranous colitis, pancreatitis, elevations
of
liver enzymes, hepatitis
- Hematologic: Eosinophilia, thrombocytopenia, transient leukopenia,
hemolytic anemia, decreased hemoglobin, hemolysis
- GU: Hemoglobinuria, hematuria, renal insufficiency, acute renal
failure,
menstrual disturbances
- Dermatologic: Rash, pruritus, urticaria, pemphigoid reaction,
flushing,
reddish-orange discoloration of body fluids-tears, saliva, urine,
sweat,
sputum
- Other: Pain in extremities, osteomalacia, myopathy, fever, "flulike"
syndrome
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