Pregnancy Category C
- Antituberculous drug ("first-line")
Mechanisms of action
Inhibits DNA-dependent RNA polymerase activity in susceptible bacterial cells.
- 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
- 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).
- 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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