Rifampin: Difference between revisions
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== Background == |
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* Inhibits bacterial DNA-dependent RNA polymerase |
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* Never given alone due to rapid resistance |
* Never given alone due to rapid resistance |
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== Dosing == |
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* Near use in liver? Failure |
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* As adjunct to fluoroquinolone for [[Staphylococcus aureus]]: |
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** Weight <60 kg: 600 mg p.o. daily |
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** Weight >60 kg: 450 mg p.o. twice daily |
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== Safety == |
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* '''Avoid in liver failure''' |
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=== Adverse Effects === |
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* Orange or red discoloration of body fluids |
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* [[Adverse drug reaction::drug-drug interactions|Drug-drug interactions]], [[Adverse drug reaction::rash]], [[Adverse drug reaction::hepatitis]], [[Adverse drug reaction::influenza-like illness]], [[Adverse drug reaction::neutropenia]], and [[Adverse drug reaction::thrombocytopenia]] |
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* Flu-like syndrome[[CiteRef::dhhar2023ri]], a type III [[hypersensitivity reaction]] characterized by fevers, chills, myalgias, and arthalgias usually 1-4 hours (but up to 12 hours) after a dose, and lasts for 8 hours; if rechallenged, can develop hypotension and shock |
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=== Drug-Drug Interactions === |
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* Multiple |
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* Induces [[Induces::CYP2B6]], [[Induces::CYP2C8]], [[Induces::CYP2C9]], [[Induces::CYP2C19]], [[Induces::CYP2D6]], and [[Induces::CYP3A]] |
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* Other antibiotics include [[clindamycin]], [[doxycycline]], [[linezolid]], [[moxifloxacin]], [[trimethoprim]], and [[fusidic acid]] |
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[[Category:Rifamycins]] |
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Latest revision as of 14:13, 23 September 2024
Background
- Inhibits bacterial DNA-dependent RNA polymerase
- Never given alone due to rapid resistance
Dosing
- As adjunct to fluoroquinolone for Staphylococcus aureus:
- Weight <60 kg: 600 mg p.o. daily
- Weight >60 kg: 450 mg p.o. twice daily
Safety
- Avoid in liver failure
Adverse Effects
- Orange or red discoloration of body fluids
- Drug-drug interactions, rash, hepatitis, influenza-like illness, neutropenia, and thrombocytopenia
- Drug-drug interactions
- Flu-like syndrome1, a type III hypersensitivity reaction characterized by fevers, chills, myalgias, and arthalgias usually 1-4 hours (but up to 12 hours) after a dose, and lasts for 8 hours; if rechallenged, can develop hypotension and shock
Drug-Drug Interactions
- Multiple
- Induces CYP2B6, CYP2C8, CYP2C9, CYP2C19, CYP2D6, and CYP3A
- Other antibiotics include clindamycin, doxycycline, linezolid, moxifloxacin, trimethoprim, and fusidic acid
References
- ^ Gousia Dhhar, Jeanine McColl, Ian Kitai, Deborah M. Levy, Ruud H.J. Verstegen. Rifampin-induced flu-like syndrome with shock in a patient with tuberculosis infection. Canadian Medical Association Journal. 2023;195(34):E1151-E1153. doi:10.1503/cmaj.230317.
