Rifampicin

Drug Class:	Commonly Known As:	Category:
Antitubercular		Adult, Children

Rifampicin - What is it for

Rifampicin is an antibiotic that is commonly used together with other medications for the treatment of tuberculosis (TB).

Tuberculosis is an infection caused by the bacterium Mycobacterium tuberculosis. You can get infected by breathing in droplets containing this bacterium that are sprayed into the air when an infected person coughs or sneezes.

There are two types of tuberculosis:

Active TB

An infection with M. tuberculosis could present with symptoms. It is possible to spread the infection when you have active tuberculosis that is not treated.
Common signs and symptoms include coughing for more than three weeks, may be coughing up blood, fever, night sweats, loss of appetite, weight loss, pain in the chest.
Your doctor may do an X-ray of your chest to observe for any unusual signs in your lungs, or a phlegm test to check for the presence of the tuberculosis bacteria under the microscope.
Usually treated with a combination of the following four medications: Rifampicin, Isoniazid, Ethambutol and Pyrazinamide. These medications can work together to kill the tuberculosis bacteria.

2. Latent TB

An infection with tuberculosis bacteria but with NO symptoms.
If you have latent TB, you cannot spread it to another person.
Usually treated with either Isoniazid or Rifampicin.

You might have to take the medication for six to nine months. For active tuberculosis, the first two months usually consists of a combination of the four medications stated above, and the remaining four to seven months is completed using the two medications, Rifampicin and Isoniazid. Do not miss any dose of medication. This may lead to a relapse or worsening of tuberculosis, or a condition with a more resistant form of tuberculosis. In such cases, a longer duration of treatment or use of stronger medications may be needed.

Depending on your condition, you may need to attend Directly Observed Therapy (DOT) sessions to help you complete your course of treatment. DOT refers to a healthcare worker or trained volunteer supervising the patient taking each dose of tuberculosis medications. The number of DOT sessions can range from once a day to three times a week.

Rifampicin - Side Effects, Precautions, and Contraindications

What side effects can Rifampicin cause?

You may notice orange-red discolouration of bodily fluids such as urine, tears and sweat.

This is a normal reaction by your body to the medication. Do not be alarmed.
It is also recommended not to wear contact lenses while taking this medication as it can stain the contact lenses.

If you experience any of these symptoms, you should stop your medication and seek immediate medical attention:

Drug allergy symptoms such as swollen face/eyes/lips/tongue, difficulty in breathing, itchy skin rashes over your whole body
Signs of liver issues such as dark coloured urine or light coloured stools, nausea and vomiting that does not go away, loss of appetite, stomach pain, yellowing of your eyes or skin
Fever, chills, feeling tired or weak (flu-like symptoms)
Unexplained bruising or bleeding

There are some tests that are required to better monitor and manage possible side effects from treatment of tuberculosis. These include:

Regular blood tests, especially to monitor your liver function

Before taking Rifampicin , what precautions must I follow?

Before starting TB treatment, inform your healthcare professional if:

You are allergic to this medication or any of the other ingredients of this medication
You have pre-existing medical conditions such as kidney and/or liver problems, gout
You consume alcohol regularly
You intend to become pregnant (conceive) or breastfeed while taking this medication
You are pregnant or breastfeeding

If you have active TB, you should stay at home for the first two weeks of your treatment. This is to prevent spreading the bacteria to others, as you are more likely to be able to infect others during this period. If you have close, regular contact with family members or friends, encourage them to visit a doctor to test for TB.
If you need to leave the house, wear a surgical mask in public spaces and avoid crowded places. Avoid close contact with anyone who may have low immunity (including elderly, young children, pregnant women).
After taking at least two weeks of effective treatment, you are generally considered non-infectious, meaning less likely to infect others, provided that you continue with the rest of the treatment.
If you have latent TB, seeing a doctor early and receiving treatment can help to prevent your loved ones from getting active TB in the future.

What food or medicine must I avoid when I take Rifampicin ?

Avoid alcohol as it may increase the risk of liver problems.
Oral contraceptives may not work while you are on Rifampicin. Use a combination of different birth control methods to prevent unplanned pregnancy.
It is important that you inform your healthcare provider if you are taking other medications – including those for current medical conditions, chronic medications, oral contraceptives (birth control pills), over-the-counter medications, supplements and traditional/herbal remedies – as they may interact with TB medications.

Rifampicin - Dosage and How to Use

How should Rifampicin be used?

Do not stop taking your medication without checking with your healthcare professional.
This medication should be taken at least 30 minutes before food, on an empty stomach. However, if you are having stomach discomfort, you can take them after food instead.
Take your medication at the same time every day to maintain the same amount of medication in your body.
In children, an oral liquid formulation (in-house preparation) may be available. Use a medicine spoon or the graduated syringe provided to measure the medication. Do not use household spoons as they may not be accurate.

What should I do if I miss a dose?

If you forget to take a dose, take it as soon as you remember. Then take your next dose at the usual time. Do not take two doses to make up for the missed dose.
It is important to complete the entire course of medication, even when you start feeling better during the treatment. This ensures that the tuberculosis bacteria in your body is fully killed.