How does it work?
Rifampicin is an antibiotic which is most frequently used to treat tuberculosis (TB). Rifampicin targets and inactivates a bacterial chemical called RNA-polymerase. The tuberculosis bacteria use RNA-polymerase to make essential proteins and to copy their own genetic information (DNA). Without this chemical the bacteria cannot reproduce and they die.
There are two stages in the treatment for tuberculosis. In the first two months after infection (the initial phase), treatment is aimed at killing as many bacteria as possible. Therefore several anti-TB drugs with different mechanisms of action are used in combination. After this time some of the mediciations are stopped and the others are continued for a further four months (continuation phase) to kill any remaining bacteria. Rifampicin is used in both stages of treatment.
The bacteria that cause TB are difficult to treat. By using medications in combination, the bacteria can be targeted in different ways and hence treatment is more likely to be effective than a single medicine alone. In addition, using different medications make it less likely that bacteria will develop resistance to treatment.
Rifampicin can also be used to treat infections such as brucellosis, leporosy, legionnaire's disease and serious staphylococcal infections. As for TB, rifampicin should be used in combination with another antibiotic to prevent resistance occuring.
Rifampicin is also used to prevent certain types of meningitis.
What is it used for?
- Infection caused by Brucella bacteria (brucellosis)
- Legionnaires' disease
- Leprosy
- Prevention of infection from the bacterium H. influenzae in those who may have been exposed to it
- Prevention of meningococcal meningitis
- Treatment of serious staphylococcal bacterial infections
- Treatment of tuberculosis in combination with other drugs
Warning!
- People taking this medicine should have regular blood tests.
- Discolours contact lenses
- Your liver functioning should be monitored while you are taking this medicine. Symptoms that may suggest a liver problem include persistent nausea and vomiting, abdominal pain, or the development of jaundice (a yellow colouring to the skin and the whites of the eyes). Consult your doctor if you experience any of these symptoms.
- This medicine reduces the effectiveness of the oral contraceptive pill. Additional precautions should be taken to avoid pregnancy (seek advice).
Use with caution in
- Decreased kidney function
- Decreased liver function
Not to be used in
- Jaundice
- Life long inherited blood diseases which can cause a variety of symptoms, including mental health problems (porphyrias)
This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.
If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.
Pregnancy and Breastfeeding
Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.
- There is no information available about the safety of this medicine during pregnancy, therefore it is not recommended for use during pregnancy, unless considered essential by your doctor. Seek medical advice from your doctor.
- The medicine passes into the breast milk, but at normal doses it is unlikely to harm the baby. Discuss with your doctor.
Label warnings
- Do not stop taking this medication except on your doctor's advice.
- Take this medication half to one hour before food.
- This medication may cause your urine to be coloured.
Side effects
Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.
- Rash
- Diarrhoea
- Red colouration of urine
- Inflammation of the large intestine (colitis)
- Yellowing of the skin and eyes (jaundice)
- Alteration in results of liver function tests
- Excessive breakdown of red blood cells that reduces red blood cell count (haemolytic anaemia)
- Cold or flu-like symptoms
- Nausea and vomiting
- Loss of appetite
- Shortness of breath
- Decrease in the number of platelets in the blood (thrombocytopenia)
- Kidney failure
The side effects listed above may not include all of the side effects reported by the drug's manufacturer.
For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.
How can this medicine affect other medicines?
Rifampicin decreases the concentration of the following medications in the blood:
- Methadone
- Disopyramide, mexiletine, propafenone and quinidine (anti-arrhythmics)
- Chloramphenicol
- Dapsone
- Nicoumalone and warfarin (blood-thinning medications)
- Chlorpropamide and tolbutamide (and possibly other sulphonylurea antidiabetic drugs), repaglinide
- Phenytoin (antiepileptic)
- Fluconazole, itraconazole, ketoconazole, terbinafine (antifungals)
- Indinavir, efavirenz, nelfinavir, saquinavir (antivirals)
- Atovaquone
- Diltiazem, nifedipine, verapamil and possibly isradipine, nicardipine and nisoldipine (calcium channel blockers)
- Corticosteroids
- Cyclosporin
- Oral contraceptives
- Tacrolimus
- Cimetidine
The concentration of rifampicin in the blood may be decreased by ketoconazole.
Rifampicin may cause transplant rejection when given with azathioprine. |
