Rifampin (Oral)

Generic name: Rifampin
Drug class: Rifamycin derivatives

Usage of Rifampin (Oral)

Rifampin is used together with other medicines to treat tuberculosis (TB) in many different parts of the body. It is also used by patients who have a meningitis bacteria in their nose or throat who do not show symptoms of the infection to prevent the spread of the bacteria to other patients. Rifampin belongs to the class of medicines called antibiotics and works to kill or prevent the growth of bacteria. However, it will not work for colds, flu, or other virus infections.

This medicine is available only with your doctor's prescription.

Rifampin (Oral) side effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Rare

Agitation

bleeding gums

blood in the urine or stools

bruising

chest tightness

confusion

cough

coughing or vomiting blood

dark urine

darkening of the skin

decreased frequency or amount of urine

difficulty in breathing and swallowing

dizziness

fainting

fast heartbeat

fever with or without chills

general feeling of tiredness or weakness

headache

hives

hoarseness

hostility

increased blood pressure

increased thirst

irritability

light-colored stools

loss of appetite

lower back or side pain

mental depression

nausea

painful or difficult urination

persistent bleeding or oozing from puncture sites, mouth, or nose

puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue

skin itching, rash, or redness

sores, ulcers, or white spots on the lips or in the mouth

stomach pain

swelling of the face, ankles, fingers, hands, or lower legs

unusual bleeding or bruising

unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness

vomiting

weight gain

yellow eyes or skin

Incidence not known

Bleeding under the skin

blistering, peeling, or loosening of the skin

bloating

bloody, severe, or watery diarrhea

bloody nose

bone pain

chest pain

chills

cold, clammy skin

diarrhea

difficulty with speaking

double vision

dry cough

fast, weak pulse

general feeling of discomfort or illness

heavier menstrual periods

inability to move the arms, legs, or facial muscles

inability to speak

increased menstrual flow or vaginal bleeding

joint or muscle pain

lightheadedness

muscle aches

night sweats

nosebleeds

pale skin

paralysis

pinpoint red spots on the skin

prolonged bleeding from cuts

red or black, tarry stools

red or dark brown urine

red skin lesions, often with a purple center

red, irritated eyes

runny nose

shivering

slow speech

sore throat

sores, welts, blisters

sweating

swelling of the fingers, feet, or lower legs

swelling or puffiness of the face

swollen glands

trouble sleeping

unpleasant breath odor

unusual weight loss

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose

Blurred vision

dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position

fast, pounding, or irregular heartbeat or pulse

feeling of fullness in the upper abdomen or stomach

low blood pressure or slow pulse

pain in the upper abdomen or stomach

reddish-orange to reddish-brown color of the urine, stool, saliva, sputum, sweat, and tears

seizures

swelling around the eyes or face

unconsciousness

yellow eyes or skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Rare

Feeling that others are watching you or controlling your behavior

feeling that others can hear your thoughts

feeling, seeing, or hearing things that are not there

muscle tenderness, wasting, or weakness

severe mood or mental changes

unusual behavior

Incidence not known

Belching

bloated or full feeling

excess air or gas in the stomach or bowels

indigestion

not able to concentrate

pain or discomfort in the chest, upper stomach, or throat

tooth discoloration

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Before taking Rifampin (Oral)

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of rifampin in children.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of rifampin in the elderly.

Breast Feeding

Studies in women suggest that this medication poses minimal risk to the infant when used during breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

Artemether

Atazanavir

Bictegravir

Boceprevir

Cabotegravir

Cobicistat

Daclatasvir

Darunavir

Dasabuvir

Delamanid

Doravirine

Elbasvir

Elvitegravir

Fosamprenavir

Fostemsavir

Glecaprevir

Grazoprevir

Isavuconazonium

Lenacapavir

Lopinavir

Lorlatinib

Lurasidone

Maraviroc

Mavacamten

Nelfinavir

Nirmatrelvir

Ombitasvir

Pacritinib

Paritaprevir

Pibrentasvir

Praziquantel

Ranolazine

Rilpivirine

Ritonavir

Saquinavir

Sofosbuvir

Telaprevir

Tenofovir Alafenamide

Tipranavir

Velpatasvir

Voriconazole

Voxilaprevir

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Abemaciclib

Abiraterone Acetate

Abrocitinib

Acalabrutinib

Adagrasib

Afatinib

Alfentanil

Alpelisib

Amiodarone

Amlodipine

Amprenavir

Apixaban

Apremilast

Aprepitant

Aripiprazole

Atogepant

Atovaquone

Avacopan

Avapritinib

Avatrombopag

Axitinib

Benzhydrocodone

Betrixaban

Bortezomib

Bosutinib

Brexpiprazole

Brigatinib

Brivaracetam

Buprenorphine

Bupropion

Ceritinib

Cholera Vaccine, Live

Clopidogrel

Clozapine

Cobimetinib

Codeine

Copanlisib

Crizotinib

Cyclosporine

Dabigatran Etexilate

Daprodustat

Daridorexant

Darolutamide

Dasatinib

Deferasirox

Deflazacort

Delavirdine

Desogestrel

Dexamethasone

Dienogest

Digoxin

Dihydrocodeine

Dolutegravir

Doxorubicin

Doxorubicin Hydrochloride Liposome

Dronedarone

Drospirenone

Duvelisib

Edoxaban

Efavirenz

Elacestrant

Elagolix

Elexacaftor

Eliglustat

Eluxadoline

Encorafenib

Entrectinib

Enzalutamide

Eravacycline

Erdafitinib

Erlotinib

Estetrol

Estradiol

Ethinyl Estradiol

Ethionamide

Ethynodiol

Etonogestrel

Etrasimod

Etravirine

Everolimus

Exemestane

Fedratinib

Fenfluramine

Fentanyl

Fexinidazole

Finerenone

Fosaprepitant

Fosnetupitant

Fosphenytoin

Fostamatinib

Futibatinib

Gefitinib

Gepirone

Gestodene

Gilteritinib

Glasdegib

Halothane

Hemin

Hydrocodone

Hydroxychloroquine

Ibrexafungerp

Ibrutinib

Idelalisib

Ifosfamide

Imatinib

Indinavir

Infigratinib

Irinotecan

Irinotecan Liposome

Isoniazid

Istradefylline

Itraconazole

Ivabradine

Ivacaftor

Ivosidenib

Ixabepilone

Ixazomib

Ketoconazole

Lamotrigine

Lapatinib

Larotrectinib

Ledipasvir

Lefamulin

Lemborexant

Leniolisib

Letermovir

Levoketoconazole

Levonorgestrel

Linagliptin

Lorcainide

Lumateperone

Lurbinectedin

Macimorelin

Macitentan

Manidipine

Maribavir

Medroxyprogesterone

Meperidine

Mestranol

Methadone

Methotrexate

Metoprolol

Midostaurin

Mifepristone

Mirtazapine

Mitapivat

Mobocertinib

Momelotinib

Mycophenolate Mofetil

Mycophenolic Acid

Naloxegol

Neratinib

Netupitant

Nevirapine

Nifedipine

Nilotinib

Nimodipine

Nintedanib

Nomegestrol

Norelgestromin

Norethindrone

Norgestimate

Norgestrel

Olanzapine

Olaparib

Olutasidenib

Omaveloxolone

Omeprazole

Osimertinib

Oxcarbazepine

Oxycodone

Ozanimod

Palbociclib

Paliperidone

Palovarotene

Panobinostat

Pazopanib

Pemigatinib

Pentazocine

Perampanel

Pexidartinib

Phenobarbital

Phenytoin

Pimavanserin

Piperaquine

Pirtobrutinib

Pitavastatin

Pitolisant

Ponatinib

Ponesimod

Posaconazole

Pralsetinib

Pretomanid

Primidone

Pyrazinamide

Quetiapine

Quinine

Quizartinib

Regorafenib

Relugolix

Revefenacin

Ribociclib

Rimegepant

Ripretinib

Risperidone

Ritlecitinib

Rivaroxaban

Roflumilast

Rolapitant

Romidepsin

Ruxolitinib

Samidorphan

Segesterone

Selexipag

Selpercatinib

Selumetinib

Sildenafil

Simeprevir

Siponimod

Sirolimus

Sirolimus Protein-Bound

Sonidegib

Sorafenib

Sotagliflozin

Sotorasib

Sparsentan

Stiripentol

Sufentanil

Sunitinib

Tacrolimus

Tamoxifen

Tasimelteon

Tazemetostat

Telithromycin

Temsirolimus

Tezacaftor

Thiotepa

Ticagrelor

Tivozanib

Tofacitinib

Tolvaptan

Trabectedin

Tramadol

Tucatinib

Ubrogepant

Ulipristal

Upadacitinib

Valbenazine

Vandetanib

Vemurafenib

Venetoclax

Vilazodone

Vincristine

Vincristine Sulfate Liposome

Vinflunine

Voclosporin

Vonoprazan

Vorapaxar

Vortioxetine

Voxelotor

Zanubrutinib

Zavegepant

Zolpidem

Zuranolone

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Acetyldigoxin

Aliskiren

Anisindione

Aripiprazole Lauroxil

Atorvastatin

Betamethasone

Bexarotene

Bosentan

Buspirone

Carbamazepine

Carvedilol

Caspofungin

Chloramphenicol

Chlorpropamide

Citalopram

Clarithromycin

Clofibrate

Cortisone

Dicumarol

Diltiazem

Disopyramide

Doxycycline

Eltrombopag

Enalaprilat

Enalapril Maleate

Etoricoxib

Fluconazole

Fludrocortisone

Gliclazide

Glyburide

Haloperidol

Isradipine

Levomethadyl

Levothyroxine

Linezolid

Losartan

Mefloquine

Metformin

Methylprednisolone

Morphine

Morphine Sulfate Liposome

Moxifloxacin

Nisoldipine

Ospemifene

Phenprocoumon

Pioglitazone

Pirmenol

Prednisolone

Prednisone

Propafenone

Raltegravir

Repaglinide

Rofecoxib

Rosiglitazone

Sertraline

Simvastatin

Tadalafil

Theophylline

Tocainide

Triazolam

Trimetrexate

Valproic Acid

Warfarin

Zaleplon

Zidovudine

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Relate drugs

How to use Rifampin (Oral)

Take this medicine only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. To do so may increase the chance for side effects.

To help clear up your tuberculosis (TB) completely, it is very important that you keep using this medicine for the full time of treatment, even if you begin to feel better after a few weeks. If you have TB, you might have to take rifampin every day for several months. It is important that you do not miss any doses.

Take the capsule on an empty stomach, 1 hour before or 2 hours after a meal, with a full of glass water. It is important to take this medicine on a regular schedule.

If this medicine upsets your stomach, take it with food. Antacids may also help. However, do not take aluminum-containing antacids (eg, Maalox®, Mylanta®) within 1 hour of the time you take rifampin. They may keep this medicine from working properly.

For patients unable to swallow the capsule:

A special liquid form of the medicine can be prepared by your pharmacist.

Shake the bottle well before each dose.

Measure the liquid with a marked measuring spoon, oral syringe, or medicine cup. The average household teaspoon may not hold the right amount of liquid.

If you are taking itraconazole, do not use rifampin 2 weeks before and during itraconazole treatment.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

For oral dosage form (capsules):

For the treatment of meningitis bacteria in the nose or throat:

Adults—600 milligrams (mg) 2 times a day for 2 days.

Children 1 month of age and older—Dose is based on body weight and must be determined by your doctor. The dose is 10 mg per kilogram (kg) of body weight every 12 hours for 2 days.

Children younger than 1 month of age—Dose is based on body weight and must be determined by your doctor. The dose is 5 mg per kg of body weight every 12 hours for 2 days.

For the treatment of tuberculosis:

Adults—Dose is based on body weight and must be determined by your doctor. The dose is 10 milligrams (mg) per kilogram (kg) of body weight once a day. Your doctor may increase your dose as needed. However, the dose is usually not more than 600 mg per day.

Children—Dose is based on body weight and must be determined by your doctor. The dose is 10 to 20 mg per kg of body weight once a day. Your doctor may increase your dose as needed. However, the dose is usually not more than 600 mg per day.

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

If rifampin is taken on an irregular schedule, side effects may occur more often and may be more serious than usual. If you have any questions about this, check with your doctor.

Storage

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

The specially prepared oral liquid form may be kept at room temperature or in a refrigerator for 4 weeks. Do not use the liquid after the expiration date on the label.

Warnings

It is very important that your doctor check your or your child's progress at regular visits. Blood and urine tests may be needed to check for unwanted effects.

Do not use this medicine if you or your child are also receiving certain medicines to treat HIV infection (eg, atazanavir, darunavir, fosamprenavir, ritonavir, saquinavir, tipranavir, Aptivus®, Fortovase®, Invirase®, Lexiva®, Norvir®, Prezista®, or Reyataz®).

Do not use this medicine together with praziquantel. If you or your child need to take praziquantel, you should stop using rifampin 4 weeks before starting praziquantel. You may restart rifampin one day after the last dose of praziquantel.

Liver problems may be more likely to occur if you drink alcoholic beverages regularly while you are using this medicine. Also, the regular use of alcohol may keep this medicine from working properly. Therefore, you should strictly limit the amount of alcoholic beverages you drink while you are using this medicine.

Check with your doctor right away if you or your child have fever, chills, cough, sore throat, swollen, painful, or tender lymph glands in the neck, armpit, or groin, or yellow skin or eyes while using this medicine. These could be symptoms of a serious condition called drug reaction with eosinophilia and systemic symptoms (DRESS).

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

Serious skin reactions (eg, Stevens-Johnson syndrome, toxic epidermal necrolysis, and acute generalized exanthematous pustulosis) can occur with this medicine. Check with your doctor right away if you or your child have blistering, peeling, or loosening of the skin, red skin lesions, severe acne or a skin rash, sores or ulcers on the skin, or fever or chills with this medicine.

Tell your doctor right away if you have chest pain, cough, coughing or spitting up blood, difficulty in breathing, sore throat, muscle aches, night sweats, sudden high fever, or unusual tiredness. These could be symptoms of a paradoxical drug reaction to this medicine. If your symptoms do not improve within a few days or if they become worse, check with your doctor.

This medicine may cause blood clotting problems, which may lead to bleeding. Check with your doctor right away if you or your child cough up blood, have bleeding gums, difficulty in breathing or swallowing, dizziness, headache, increased menstrual flow or vaginal bleeding, nosebleeds, prolonged bleeding from cuts, red or dark brown urine, or red or black, tarry stools after using this medicine.

This medicine may cause lung or breathing problems (eg, interstitial lung disease, pneumonitis, pneumonia, respiratory failure, pulmonary fibrosis, acute respiratory distress syndrome), which can be life-threatening and require immediate medical attention. Check with your doctor right away if you have chest pain, chills, dry cough, fever, general feeling of discomfort or illness, thickening of bronchial secretions, or trouble breathing.

Rifampin will cause urine, saliva, sputum, sweat, teeth, and tears to turn a reddish-orange to reddish-brown color. This is to be expected while you are using this medicine. This effect may also cause soft contact lenses to become permanently discolored. Standard cleaning solutions may not take out all the discoloration. Therefore, it is best not to wear soft contact lenses while using this medicine. Hard contact lenses are not discolored by this medicine. This condition will return to normal once you stop using this medicine. If you have any questions about this, check with your doctor.

If you or your child develop a skin rash, hives, or any allergic reaction to this medicine, check with your doctor right away.

This medicine may cause thrombotic microangiopathy (damage in the smallest blood vessels), including hemolytic uremic syndrome and thrombotic thrombocytopenic purpura. Tell your doctor right away if you have a change in mental status, dark or bloody urine, decreased urine output, difficulty speaking, fever, pale color of the skin, pinpoint red spots on the skin, seizures, severe chest pain, sudden weakness in the arms or legs, unusual bleeding or bruising, or yellow eyes or skin.

Birth control pills may not work properly while you are using this medicine. To keep from getting pregnant, use another form of birth control together with your birth control pills. Other forms include condoms, diaphragms, or contraceptive foams or jellies.

Before you have any medical tests, tell the doctor in charge that you or your child are using this medicine. The results of some tests may be affected by this medicine.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

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