Rifampicin can be used as an antibiotic. Rifampicin capsules

Rifampicin (Rifadin, Benemycin, Rimpacin) is a bactericidal antibiotic drug. It is one of four drugs used in the standard treatment of tuberculosis.

Introduced oral by or by intravenous injections.

Indications for use

Rifampicin is one of the strongest and effective drugs against tuberculosis, is indicated in the treatment of all its forms and at any stage. At re-treatment tuberculosis, intravenous administration of Rifadin is prescribed. If necessary, it can be administered to children from birth (including preterm), but it is recommended to start giving the drug when the child reaches at least one year old.

Important! Microorganisms rapidly develop resistance to Rifampicin, so treatment requires regular antibiotic susceptibility tests.

Rifampicin tablets: instructions for use

At the initial stage of therapy, it is recommended to take Rifampicin in combination with Isoniazid and Pyrazinamide. Often added as a fourth remedy Streptomycin or Ethambutol. The need for a fourth drug depends on the results of susceptibility testing. With a low level of microbial resistance to antibiotics, fewer drugs can be used. The course of treatment continues within two months.

Photo 1. Packing of Rifamycin, 20 capsules of 150 mg each, manufactured by JSC Pharmasyntez.

After passing the initial phase, treatment is continued using two drugs: Rifadina and Isoniazid. The course lasts at least four months. If necessary, as well as for HIV-infected people, the course is extended for a longer period.

In the treatment of latent tuberculosis, the drug is taken for four months without Isoniazid. For children and HIV-infected people, the course can be extended up to six months.

Important! To achieve the result, you need to pass full course treatment, the duration of which is determined by the doctor. If the course is interrupted prematurely, the bacteria will not be completely killed, which will lead to a decrease in the effectiveness of the treatment. In addition, bacteria will become resistant to Rifampicin. This will require the use stronger medicines.

Rifampicin tablets are taken once a day or two(usually in the morning or evening) three or five times a week. Either you need to take an antibiotic in one hour before meals, or two hours after by drinking plenty of water. The drug should not be taken with milk.

For solution for infusion 600 mg powder diluted 10 ml sterile water. The mixture is well shaken so that the antibiotic is completely dissolved. The solution contains 60 mg rifampicin per milliliter and can be stored at room temperature for 24 hours.

Before administration, add to the required amount of the drug 100 ml infusion solution, mix well and inject intravenously for 30 minutes. When used as an infusion fluid 5% glucose solution, the drug can be stored at room temperature for 4 hours; when using saline, the drug is stable at room temperature for 24 hours.

Dosage

Oral and intravenous doses for Rifampicin are equivalent.

The maximum dose of the drug in the treatment active form tuberculosis should be:

• for adults(including seniors and adolescents) 10 mg/kg/day (max. 600 mg/day);
• for kids(including newborns) - 20 mg / kg / day (max. 600 mg / day).

The maximum dose of the drug in the treatment of latent tuberculosis should be 10 mg / kg / day (max. 600 mg / day) for both adults and children.

Reference. If the patient is unable to take the capsule, its contents are mixed with applesauce or gelatin.

The lowest dose resulting in death or acute poisoning organism has not been established. There have been cases of acute overdose of Rifampicin in adults with doses of 9 to 12 grams, as well as cases of acute overdose of adults with a fatal outcome with doses of 14 to 60 grams. In children from 1 to 4 years of age, an overdose may begin at 100 mg / kg.

Attention! Rifadin should be taken at the same time, if you miss the time of taking the medicine, you need to take the dose as soon as possible. If less than 12 hours are left before the next dose, skip the dose and return to the regular schedule. Skipping a medication can cause side effects.

Contraindications and precautions

Rifampicin is not recommended in cases where infection has not been established bacterial infection as well as for preventive purposes. This antibiotic can harm the body, its use increases the risk of developing drug-resistant bacteria.

Due to the fact that taking Rifampicin can provoke an exacerbation of a number of diseases, with some diagnoses it should be taken with great care.

For liver disease, tests to check liver function are done twice a month. Hepatic side effects include cases of hepatitis and acute hepatotoxicity. In patients with liver dysfunction, as well as in patients with normal liver function taking other hepatotoxic drugs, complications were observed leading to death.

Adrenal dysfunction may develop adrenal insufficiency.

When taking Rifadin, it is possible exacerbation of porphyria.

People suffering from diabetes, Rifampicin should be used with caution as this antibiotic will make it difficult to control this disease.

Intravenous administration of the drug is undesirable when cardio-pulmonary insufficiency and phlebitis.

Pregnant women should only use Rifampicin if the potential benefit justifies the potential risk to the baby.

With the introduction of the drug in the last trimester of pregnancy, hemorrhages both mother and baby. Women taking rifampicin should give up breastfeeding baby.

Rifadin is contraindicated in people with hypersensitivity to rifamycins. Due to high hepatocellular toxicity, Rifampicin should not be given to people taking Saquinavir in combination with Ritonavir.

Attention! Rifampicin is better tolerated by the body when permanent reception, intermittent therapy often causes side effects and is considered undesirable.

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Rifampicin and alcohol, their compatibility

Drinking alcohol while taking Rifampicin (or drinking too much alcohol before starting the drug) can cause severe liver damage and lead to lethal outcome. In addition, Rifampicin may be accompanied by drowsiness or dizziness. These symptoms may be aggravated by alcohol.

Side effects and overdose

Side effects may occur when taking Rifampicin. The greatest likelihood of their occurrence is associated with lengthy or intermittent course of treatment.

Side effects requiring immediate medical attention:

• pallor skin;
• painful urination;
• chest pain;
• pain in the abdomen or stomach;
• pain in the bones or joints;
• backache;
• inflammation of the joints;
• headache;
• dizziness;
• depression;
• diarrhea;
• diplopia;
• thirst;
• difficulty in swallowing;
• difficult or slow speech;
• significant weight gain or loss;
• skin itching, rash, or redness;
• cough or hoarseness;
• hives;
• bleeding gums;

Photo 2. Bleeding gums, one of the possible side effects from taking Rifampicin.

• blood in urine or stool;
• fever;
• lack of coordination;
• persistent bleeding at puncture sites, mouth, or nose;
• bad breath;
• fainting;
• chills;
• swelling of the face, ankles, fingers, hands, or feet;
• swelling of the eyelids, the area around the eyes, face, lips, tongue;
• feeling of weakness;
• paralysis;
• high blood pressure;
• redness, eye irritation;
• darkening of the skin;
• loss of appetite;
• sweating;
• psychomotor agitation;
• irritability;
• erratic breathing;

Photo 3. Yellowing of the whites of the eyes in a man.

• light feces;
• tightness in the chest;
• bruises;
• decreased frequency of urination or amount of urine;
• dark urine;
• nausea or vomiting;
• enlarged lymph nodes;
• enlargement of the tonsils;
• cardiopalmus;
• fast or weak pulse;
• cold, clammy skin;
• peeling of the skin;
• sores, pus, or white spots on the lips or in the mouth.

Some of the side effects that occur when taking Rifampicin are do not require immediate recourse medical care . As the body begins to get used to the antibiotic, they may pass. If any of the symptoms are felt long time or cause concern, a specialist should be consulted.

Side effects, not requiring immediate medical attention:

• sore throat;
• bloating;
• visual or auditory hallucinations;
• change menstrual cycle among women;
• muscle pain;
• slight weight loss;
• belching;
• the feeling that others hear your thoughts;
• Bad mood;
• increased gas formation;
• distraction of attention;
• drowsiness;
• the feeling that you are being watched or controlled in your behavior.

Important! Rifampicin can cause discoloration of urine, tears, feces, saliva, sputum, and sweat. brownish red or Orange. This is due to the excretion of the drug from the body and is not a side effect that requires a visit to a doctor.

The reaction of organs and systems of the body to the drug

From the gastrointestinal tract

At 2% of people nausea and dyspepsia are observed. Heartburn is also possible erosive gastritis, anorexia, vomiting, flatulence, convulsions, diarrhea, candidiasis, colitis, pancreatic dysfunction, decreased or loss of appetite.

From the side of the liver

Photo 4. A man on the left with a normal skin color, on the right - with a symptom of jaundice.

At 3% of patients hyperbilirubinemia and hepatitis were detected. In half of the cases, hepatotoxicity was observed during the first month of therapy. Perhaps the development of jaundice, increased levels of serum bilirubin, alkaline phosphatase and serum transaminases.

From the side of the immune system

When Rifampicin is taken intermittently, it is possible to develop flu-like syndrome, which is a complex of symptoms: malaise, fever, chills, vomiting, nausea.

From the side of the kidneys

Renal side effects include increased levels of urea and uric acid in the blood. There have been cases of hemoglobinuria, interstitial nephritis, hematuria, acute tubular necrosis, kidney failure.

From the hematopoietic system

At 1% hosts Rifampicin observed petechiae associated with thrombocytopenia. It is also possible to decrease hemoglobin, a short-term decrease in the number of leukocytes, hemolytic anemia.

From the side of the skin

Skin reactions usually flow gently and are not associated with hypersensitivity to Rifampicin. Manifested in the form of itching and redness of the skin.

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From the side of the nervous system

Side effects include headache, paresthesia and weakness. Drowsiness, fatigue, dizziness, disorientation, decreased concentration, mental disorders, ataxia, behavioral changes, fever, muscle weakness, pain and numbness. In rare cases, psychosis and myopathy may occur.

From the side of metabolism

Long-term medication ( more than 3 months) it is possible to accelerate the hepatic metabolism of thyroxine and triiodothyronine.

In some cases, it is necessary to increase the dosage of Rifampicin to keep it within the therapeutic range.

From the side of the cardiovascular system

Side effects rare. Possible reduction blood pressure if doses of the drug are administered intermittently.

From the endocrine system

Perhaps the development of adrenal insufficiency in violation of the functions of the adrenal glands and menstrual disorders in women.

From the side of the musculoskeletal system

Side effects include myopathy and myasthenia gravis.

From the side of view

Visual impairment, diplopia, conjunctivitis, blurred vision.

From the respiratory system

There may be shortness of breath, wheezing or wheezing, shortness of breath.

If symptoms of an overdose occur while taking Rifampicin, stop taking the drug and seek medical attention.

Overdose symptoms:

• pain in the upper part of the stomach or abdomen;
• dizziness or weakness with a sharp change in body position;
• low blood pressure;
• swelling of the face or area around the eyes;
• yellowing of the whites of the eyes or skin;
• clouding in the eyes;
• memory loss;
• loss of consciousness;
• severe weakness or fatigue;
• convulsions;
• nausea or vomiting;
• heaviness in the stomach or abdomen;
• fast, irregular, or weak heartbeat.

What is important to remember when treating with Rifampicin?

Rifampicin is the mainstay of anti-tuberculosis therapy, but at the same time it can cause significant harm to the body. At liver diseases Rifampicin is taken only in case of emergency and under constant medical supervision.

The severity of liver damage during treatment with Rifampicin ranges from asymptomatic elevation of serum aminotransferase levels and jaundice without overt liver damage to acute liver failure and death. For this reason, during the course of treatment, you should completely give up alcohol and closely monitor the occurrence possible side effects.

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The site provides reference information for informational purposes only. Diagnosis and treatment of diseases should be carried out under the supervision of a specialist. All drugs have contraindications. Expert advice is required!

Antibiotic Rifampicin

In high doses, Rifampicin acts on meningococci and gonococci, Klebsiella and Escherichia coli, Proteus, whooping cough, anthrax and tularemia. It acts on these pathogens even if they are resistant to other drugs (for example, tuberculosis bacillus resistant to Streptomycin, Isoniazid and PAS, or para-aminobenzoic acid).

In the cerebrospinal fluid, through the blood-brain barrier, Rifampicin penetrates only with meningitis.

In the kidneys and liver, the highest concentration of the drug is noted.

Excreted from the body with urine and feces. In a small amount, it is excreted with tears, sputum, sweat, breast milk, while painting them in a reddish-orange color.

The antibiotic has the appearance of a crystalline powder of red-brick color. It is practically insoluble in water, poorly soluble in alcohol. Sensitive to light, oxygen and moisture.

Release form

• Tablets of 150, 300, 450, 600 mg, 30-100 pcs. packaged;
• Capsules 150, 300, 450, 600 mg 20, 30, 100 pcs. packaged;
• Capsules for children 50 mg - 30 pcs. packaged;
• Powder for solution for intravenous administration in 150 mg ampoules - 10 ampoules per pack;
• Ear drops with Rifampicin Otofa (in 1 ml - 26 mg of Rifampicin) - in 10 ml bottles.

Instructions for use Rifampicin

Indications for use

• Tuberculosis of any localization and form (in combination with other anti-tuberculosis drugs);
• various forms of leprosy (leprosy);
• respiratory infections (pneumonia, bronchitis);
• meningococcal infection (treatment of meningococcal meningitis, meningococcal bacterial carriage and prevention for contacts);
• gonorrhea;
• biliary tract infections (cholecystitis);
• infections of the kidneys and urinary tract (pyelonephritis);
• inflammation of the ears (otitis media);
• brucellosis;
• in order to prevent tuberculosis in HIV-infected patients with a decrease in immunogram parameters;
• rabies prevention (in the latent period, after an animal bite).

Contraindications

• Individual intolerance (including other derivatives of Rifamycin);
• jaundice (infectious hepatitis and obstructive jaundice);
• pregnancy;
• children's infancy.

• phlebitis (inflammation of the veins);
• pulmonary heart failure II-III stage;
• childhood.

Side effects

• From the side digestive organs: loss of appetite, abdominal pain, vomiting, nausea, diarrhea; erosive gastritis; pseudomembranous colitis; thrush oral cavity; hepatitis with increased activity of liver enzymes and bilirubin levels; inflammation of the pancreas (pancreatitis).
• From the side nervous system: headaches, visual impairment, ataxia (gait disturbance), and spatial disorientation.
• From the side of cardio-vascular system: decrease in blood pressure (when the rate of administration of the drug into the vein is exceeded), phlebitis (inflammation of the veins) with a long course of intravenous infusion of the drug.
• From the blood and hematopoietic organs: decrease in the number of platelets; a decrease in the number of white blood cells in the blood (leukopenia); hemolytic anemia (anemia due to the destruction of red blood cells); bleeding; thrombocytopenic purpura (bleeding on the skin due to a decrease in the number of platelets).
• From the genitourinary system: inflammation of the kidneys, menstrual irregularities, acute renal failure.
• Allergic reactions: rashes like urticaria, skin itching, bronchospasm, lacrimation; increase in the number of eosinophils in the blood; temperature rise; edema subcutaneous tissue and skin.
• Other effects: joint pain, muscle weakness, flu-like syndrome, herpetic eruptions. Rifampicin can stain body secretions (urine, saliva, tears, sputum, nasal mucus) and soft contact lenses red-orange.

Treatment with Rifampicin

How to use Rifampicin?

For intravenous administration, a solution is prepared: water for injection (2.5 ml) is injected into the powder ampoule; the ampoule is shaken until the powder is completely dissolved; the resulting solution from the ampoule is injected into 125 ml of 5% glucose solution. The rate of administration of the drug into a vein is 60-80 drops per 1 minute.

Candles ( rectal suppositories) with Rifampicin is administered at night in the rectum.

Otofa ear drops are instilled into the ear (in the patient's sitting position), slightly pulling back for this auricle up and back. The bottle with drops should be warmed in the hand before instillation.

Rifampicin can be administered by inhalation and into the cavity (into the cavity or into the pleural cavity).

Often, Rifampicin is used in the form of compresses or ointments mixed with Dimexide (see point 6).

The method of administration of the drug is determined by the doctor. Daily administration of the drug is tolerated by patients more easily than intermittent administration (2-3 days per week). With the development side effect in the form of a flu-like syndrome, they switch to a daily intake (the dose increases gradually). Intravenous administration as soon as possible, it should be replaced by an internal method (due to the risk of developing phlebitis).

During treatment with Rifampicin, alcohol should be avoided. If it is necessary to use antacids (drugs that reduce the acidity of the contents of the stomach), as well as PAS, these drugs should be taken after Rifampicin after 4 or more hours.

With prolonged use of Rifampicin, laboratory monitoring of liver and kidney function should be carried out (2 times in the first month, then 1 p. per month).

Women of childbearing age receiving Rifampicin should use reliable non-hormonal contraception for the entire period of treatment.

Compresses from Rifampicin with Dimexide

Dimexide is a drug for external use that has anti-inflammatory, antiseptic and analgesic effects. It is able to dissolve and inject deeply into tissues many medicines(Rifampicin included). Dimexide, in addition, increases the sensitivity of pathogens to antibacterial drugs(including Rifampicin).

The drug is produced in the form of a concentrate for the preparation of a solution. Usually Dimexide is used in the form of a 20-25-30% solution (that is, diluted with water in ratios of 1:3 - 1:4 - 1:5).

For a compress, a solution of Rifampicin prepared from an ampoule is added to a dilute solution of Dimexide (the dose is prescribed by a doctor), a gauze napkin is moistened, slightly squeezed out and applied to the area indicated by the doctor. From above, the napkin is covered with plastic wrap and the compress is fixed with a bandage. The compress is applied for 20-30 minutes. 1 time per day.

Before using such compresses, sensitivity to Dimexide should be checked. To do this, moisten a cotton swab in the drug solution and apply it to the skin. The appearance of redness and severe itching of the skin indicate hypersensitivity to the drug and, therefore, the imposition of a compress should be canceled.

Since both Rifampicin and Dimexide have their own contraindications, treatment with compresses should only be carried out as prescribed by a doctor. With caution, it is necessary to apply compresses with Dimexide to children and the elderly, as well as to sharply weakened patients.
, beta-blockers, leukopenia.

Rifampicin analogs

• Benemycin;
• Ripampin;
• Rifadin;
• Rimactan;
• Rifamor;
• Tubocin;
• Rifaldazine;
• Riforal;
• Tibinil;
• Rilamizin;
• Riphodex;
• Tibicin;
• Rifogal;
• Rifaren;
• rimpin;
• Eremfat-600;
• Rifampicin-Ferein;
• Rifaldin;
• Rifampin;
• Rimpatsin;
• Rishima;
• Rifampicin-M.J.

Rifampicin is a semi-synthetic broad-spectrum antibiotic with bactericidal properties; first-line anti-tuberculosis drug.

Release form and composition

Dosage forms of Rifampicin:

• Capsules: #1, orange-red to dark red; the contents of the capsules are a powder from light red to brown-red with white patches (10 pcs. in a blister pack of aluminum foil and polyvinyl chloride film, in a carton pack of 1, 2 or 10 packs; for hospitals - in a carton box of 150 packs );
• Lyophilisate for solution for infusion: red to brick-red powder (150, 300 and 600 mg each in an analytical class III glass vial sealed with a butyl gray stopper and a combined aluminum cap (Flip off type); in a carton box 1 bottle; in a carton box 5 or 10 vials; 1 vial with the preparation complete with 1 solvent ampoule: 10 ml each for a dose of 600 mg, 5 ml each for a dose of 150 and 300 mg; in a blister pack made of aluminum printed varnished foil and film polyvinyl chloride, 1 set; in a cardboard pack 1 pack, packs are placed in a group package).

1 capsule contains:

• Active substance: rifampicin (in terms of 100% substance) - 150 mg;
• Additional components: calcium stearate, magnesium hydroxycarbonate, lactose monohydrate;
• Hard gelatin shell: propyl parahydroxybenzoate, gelatin, methyl parahydroxybenzoate, glycerol (glycerin), brilliant blue E-133, sodium lauryl sulfate, titanium dioxide, charming red E-129, purified water, quinoline yellow E-104.

1 bottle with lyophilisate contains:

• Active substance: rifampicin - 150, 300 and 600 mg;
• Additional components: sodium hydroxide, sodium formaldehyde sulfoxylate dihydrate.

Solvent: water for injection, solvent for preparation dosage forms for injection.

Indications for use

• Tuberculosis, all forms with different localization (as part of combination therapy);
• Leprosy in combination with dapsone and in addition to the solution - with clofazimine (solution in combination with dapsone - only for patients over 18 years of age);
• Infectious diseases caused by microorganisms sensitive to rifampicin (in case of resistance to other antibacterial agents, as well as in combination antimicrobial therapy, after excluding the diagnosis of leprosy and tuberculosis);
• Brucellosis - in the composition complex treatment with an antibiotic of the tetracycline group (doxycycline).

Capsules are additionally used for prophylaxis in persons who have been in close contact with patients meningococcal meningitis, as well as in Neisseria meningitidis bacillus carriers.

Contraindications

• Chronic renal failure;
• Infectious hepatitis (including the period for 1 year after recovery);
• Jaundice;
• Pulmonary heart failure II-III degree;
• Age up to 2 months - for solution, up to 3 years - for capsules;
• The period of breastfeeding;
• Hypersensitivity to the components of the drug.

With caution, the drug should be used in children from 2 to 12 months (for solution), persons who abuse alcohol, malnourished patients, as well as in liver diseases (including history data).

During pregnancy, Rifampicin is prescribed only for health reasons. When using the solution in the last weeks of pregnancy, bleeding may develop in the newborn and in the mother in the postpartum period. In this case, vitamin K is recommended.

Method of application and dosage

Lyophilisate for solution for infusion
The drug is used intravenously.

To prepare an infusion solution, 150 mg of lyophilisate is diluted with 2.5 ml of water for injection, vigorously shaken until completely dissolved, and 125 ml of isotonic (5%) dextrose solution is added to the resulting solution. Infusion is carried out at a rate of 60-80 drops per minute.

Intravenous drip administration of Rifampicin is recommended for severe purulent-septic processes, common and acutely progressive forms of destructive pulmonary tuberculosis, in cases where it is necessary to quickly achieve high concentrations of the agent in the focus of infection and in the blood, as well as in case of poor tolerance or the impossibility of oral administration.

For the treatment of tuberculosis, the drug is used in combination with isoniazid, pyrazinamide, ethambutol or streptomycin. Adults with a body weight of less than 50 kg are administered 450 mg of the drug per day, with a weight of more than 50 kg - 600 mg. For children, rifampicin is prescribed per day at the rate of 10-20 mg/kg of body weight. The maximum allowable daily dose should not exceed 600 mg. The duration of the course of intravenous infusions is set taking into account the tolerability of the drug and can be 30 days or more (with a further transition to taking capsules). The total duration of treatment for tuberculosis with a drug depends on its therapeutic effect and can be up to 1 year old.

In the treatment of borderline, borderline-lepromatous and lepromatous types of leprosy, the solution is administered to adults once a month, 600 mg in combination with clofazimine and dapsone. The duration of treatment is at least 2 years. In the treatment of tuberculoid and borderline tuberculoid types of leprosy, the drug is prescribed once a month in the same dose, only in combination with dapsone. Course - 6 months.

At infectious diseases, excited by microorganisms sensitive to rifampicin, the solution is used in combination with other antimicrobial agents. Adults are prescribed a dose of 600-1200 mg per day, children - at the rate of 10-20 mg / kg, divided into 2-3 injections. The course of treatment is determined individually and can vary from 7 to 14 days.

For the treatment of brucellosis, adults are prescribed 900 mg of rifampicin per day in combination with doxycycline, the course is 45 days.

Capsules
Rifampicin capsules are taken orally, on an empty stomach, 30 minutes before meals.

In the treatment of tuberculosis, the drug is combined with anti-tuberculosis drugs (streptomycin, ethambutol, pyrazinamide, isoniazid) in a daily dose depending on the age and weight of the patient:

• Adults, with body weight<50 кг – 450 мг;
• Adults weighing ≥50 kg - 600 mg;
• Children over 3 years old - 10 mg / kg body weight, but not more than 450 mg.

It is allowed to divide the daily dose into 2 doses (in case of poor tolerance).

For the treatment of tuberculous meningitis, disseminated tuberculosis, tuberculous lesions of the spine with neurological manifestations, when HIV infection is combined with tuberculosis, the drug is used daily for 9 months: during the first 2 months, combined with ethambutol, pyrazinamide, isoniazid (or streptomycin), the next 7 months with isoniazid.

With pulmonary tuberculosis and the detection of mycobacteria in sputum, the following 3 treatment regimens are used (the course of each is 6 months):

• First 2 months - as recommended above; the next 4 months - daily, combining with isoniazid;
• First 2 months - as recommended above; the next 4 months - every week 2-3 times, in combination with isoniazid;
• All six months - 3 times each week, combined with ethambutol, pyrazinamide, isoniazid (or streptomycin).

When using Rifampicin 2-3 times a week, as well as in case of treatment failure or the development of exacerbations of the lesion, it is required to take it under medical supervision.

For the treatment of multibacillary types of leprosy, the drug is prescribed for adults 1 time per month, 600 mg per day in combination with dapsone (100 mg 1 time per day), for children - 10 mg / kg in combination with dapsone at a dose of 1-2 mg / kg / day. day The course of therapy for borderline, lepromatous and borderline-lepromatous types of leprosy is at least 2 years, tuberculoid and borderline-tuberculoid - 6 months.

In the treatment of infectious diseases caused by susceptible microorganisms, as part of combination therapy, adults take the drug at 600-1200 mg per day, children - 10-20 mg / kg / day. (not exceeding 450 mg per day), divided into two times.

With brucellosis, 900 mg of rifampicin is taken once a day in combination with doxycycline, the course is 45 days.

In order to prevent meningococcal meningitis, adults are prescribed 600 mg, children - 10 mg / kg, every 12 hours for 2 days.

When prescribing doses exceeding 600 mg per day, patients with impaired renal excretory function require dose adjustment.

Side effects

• Digestive system: erosive gastritis, loss of appetite, nausea, diarrhea, vomiting, pseudomembranous colitis, hyperbilirubinemia, increased activity of "liver" transaminases in the blood serum, hepatitis, hyperbilirubinemia;
• Nervous system: disorientation, ataxia, decreased visual acuity, headache;
• Allergic reactions: fever, arthralgia, bronchospasm, angioedema, eosinophilia, urticaria;
• Urinary system: interstitial nephritis, nephronecrosis;
• Others: exacerbation of gout, hyperuricemia, myasthenia gravis, induction of porphyria, dysmenorrhea, leukopenia.

In case of irregular use or when the course is resumed after a break, skin reactions, flu-like syndrome (myalgia, dizziness, headache, chills, fever), thrombocytopenic purpura, hemolytic anemia, acute renal failure may occur.

Overdose symptoms: convulsions, confusion, lethargy, pulmonary edema. In this condition, symptomatic therapy is prescribed, forced diuresis.

special instructions

During drug therapy, staining of the skin, lacrimal fluid, sweat, sputum, urine, feces in orange-red color is observed. Permanent staining of soft contact lenses is also possible.

When conducting intravenous infusion, it is necessary to control blood pressure; in the case of prolonged administration, phlebitis may develop.

Rifampicin must be used in combination with other antimicrobial agents to prevent the emergence of microbial resistance.

If bronchospasm, hemolytic anemia, uncomplicated thrombocytopenia, shortness of breath, flu-like syndrome, renal failure, shock occur against the background of an intermittent regimen, it is recommended to consider the possibility of daily administration of the drug. In such cases, the dose should be slowly increased, starting with 75-150 mg on the first day, and gradually increasing over 3-4 days to the required therapeutic. If the above complications persist after adjusting the dose, drug therapy is canceled.

During the period of treatment, it is necessary to monitor the activity of the kidneys, additional use of glucocorticosteroids may be required.

Women of reproductive age using the drug should use reliable methods of contraception.

When taking Rifampicin for prophylactic purposes in bacilli-carriers of meningococcus, it is necessary to strictly monitor the patient's condition for the timely detection of signs of the disease in case of development of resistance to the agent.

During therapy, microbiological methods for determining the level of vitamin B 12 and folic acid in the blood serum cannot be used.

drug interaction

Possible interaction reactions when combining rifampicin with other drugs:

• Ketoconazole, cholinesterase inhibitors, opiates, antacids (when taken orally) - the bioavailability of rifampicin in the form of capsules decreases;
• Statins - the level of their content in the blood decreases, which helps to reduce their hypocholesterolemic effects;
• Pyrazinamide and / or isoniazid - the risk of an increase in the frequency and severity of manifestations of functional liver disorders in patients with its previous lesion is aggravated;
• HIV protease inhibitors - their concentration in the blood decreases;
• Azathioprine, cyclosporine, itraconazole, ketoconazole, chloramphenicol, theophylline, sex hormones, benzodiazepine, nortriptyline, hexobarbital, phenytoin, dapsone, glucocorticosteroids, antiarrhythmic drugs (tocainide, mexiletine, quinidine, pyrmenol, disopyramide), cardiac glycosides, hormonal contraceptives, indirect coagulants, blockers of "slow" calcium channels, beta-blockers, cimetidine, enalapril, oral hypoglycemic agents - the activity of these drugs decreases.

Terms and conditions of storage

Store in a place protected from moisture and light, out of the reach of children, at a temperature not exceeding 25 °C.

Shelf life - 2 years.

Release form: Liquid dosage forms. Injection.

General characteristics. Compound:

Pharmacological properties:

Indications for use:

Side effects:

Interaction with other drugs:

Contraindications:

Overdose:

Storage conditions:

In a place protected from light at a temperature not exceeding 25 ° C. Keep out of the reach of children. Shelf life 2 years. Do not use after the expiry date stated on the package.

Leave conditions:

On prescription

Package:

In ampoules in package No. 10 or in vials in package No. 1, No. 40.

Rifampicin is a semi-synthetic broad-spectrum antibiotic characterized by bactericidal and anti-tuberculosis properties.

Release form and composition

Dosage forms of Rifampicin:

• Capsules for oral administration 150 and 300 mg (10 pcs in blister packs; 20, 30 or 100 pcs in polymer jars; 500, 1000, 2000 and 5000 in plastic jars);
• Lyophilisate for solution for injection 150 mg (in ampoules), 300, 450 and 600 mg (in vials).

The active substance of the drug is rifampicin.

Indications for use

• All forms of tuberculosis and tuberculous meningitis (as part of combination therapy);
• Infectious and inflammatory diseases, the causative agents of which are microorganisms sensitive to rifampicin, including bronchitis, pneumonia, osteomyelitis, leprosy, brucellosis, infections of the biliary and urinary tract (including pyelonephritis), acute gonorrhea, etc .;
• MAC infection;
• Meningococcal meningitis (prophylaxis in Neisseria meningitidis bacillus carriers and people who have been in close contact with the patient).

In addition, Rifampicin has a virucidal effect on the rabies virus, which is manifested by a complete or partial loss of its biological activity, and also inhibits the development of rabies encephalitis caused by this virus. Given these properties, the drug is often used as part of the complex therapy of rabies in the incubation period - before the first signs of the disease appear.

Contraindications

Both dosage forms of Rifampicin are contraindicated in the following cases:

• Severe violations of kidney / liver function;
• Infectious hepatitis, as well as within 1 year after recovery;
• Jaundice, incl. mechanical;
• I trimester of pregnancy;
• Hypersensitivity to rifampicins or excipients.

Intravenous administration, in addition, is contraindicated in childhood, with cardiopulmonary insufficiency II-III degree and phlebitis.

With caution, the drug is used for malnutrition, liver disease, alcoholism and HIV infection in patients receiving HIV protease inhibitors. Only in case of emergency it is prescribed to newborns and premature babies.

In the II and III trimesters of pregnancy, Rifampicin is used only if the expected benefit to the woman outweighs the potential risks to the fetus.

The drug is excreted in milk, but the child receives less than 1% of the dose taken by the mother. Adverse reactions were not registered, however, it is recommended to stop breastfeeding for the duration of treatment.

Method of application and dosage

Capsules are taken orally 30-60 minutes before a meal or 2 hours after a meal with plenty of water (at least 1 glass).

A solution is prepared from the lyophilisate: 150 mg of rifampicin is diluted with 2.5 ml of sterile injection water, shaken well until the powder is completely dissolved, 125 ml of 5% glucose solution is added to the resulting solution. Enter intravenously drip at a rate of 60-80 drops / minute.

In case of poor tolerance of the drug, the daily dose can be divided into 2 doses / injections.

For tuberculosis, Rifampicin is given either orally or intravenously, followed by a switch to oral administration. The dose for adult patients with a body weight of less than 50 kg is 450 mg, with a weight of more than 50 kg - 600 mg. Take / inject the drug 1 time per day daily or 3 times a week. The daily dose for newborns and children over 3 years old is 10-20 mg per kilogram of weight, but not more than 450 mg per day. The duration of the course of treatment is 6-9-12 months or more. Rifampicin may be combined with other anti-TB drugs (eg, isoniazid, streptomycin, ethambutol).

In the treatment of leprosy, the drug is used according to one of two schemes:

1. As a monopreparation: in a daily dose of 300-450 mg in 1 or 2 doses in courses of 3-6 months with 30-day intervals;
2. As part of combination therapy (usually in combination with dapsone and clofazimine): at a daily dose of 450 mg in 2-3 doses in courses of 2-3 weeks at 2-3-month intervals for 1-2 years or at the same dose 2- 3 times a week for 6 months.

For children, the drug is prescribed at the rate of 10 mg per kilogram of body weight.

In adults with brucellosis, the drug is prescribed orally in combination with doxycycline. The dose is 900 mg per day, the course of treatment is 45 days.

In infections caused by microorganisms sensitive to rifampicin, non-tuberculous etiology is prescribed:

• Inside: adults - 450-900 mg per day, children - 8-10 mg / kg / day in 2-3 doses;
• Intravenously: 300-900 mg per day for 7-10 days, followed by the transition to oral administration.

For the prevention of meningococcal meningitis, Rifampicin is administered orally every 12 hours for 2 days: adults - 600 mg, children - 10 mg / kg, newborns - 5 mg / kg.

The daily dose for acute gonorrhea is 900 mg. Sometimes a single dose is enough, in some cases it takes 2 days.

For the prevention of rabies, capsules are taken: children under 12 years old - 8-10 mg per kg per day, adults and children over 12 years old - at a dose of 450-600 mg / day, with severe injuries (in case of a bite to the head, face or hands hands) it is increased to 900 mg. The daily dose is divided into 2-3 doses. The duration of treatment is 5-7 days, while active immunization is carried out.

When prescribing more than 600 mg of rifampicin per day, patients with impaired renal function require dose adjustment.

Side effects

• Digestive system: decreased appetite, oral candidiasis, diarrhea, abdominal pain, nausea, vomiting, pseudomembranous colitis, erosive gastritis, hepatitis, increased bilirubin and hepatic transaminase levels in blood plasma, jaundice, pancreatic damage;
• Hematopoietic system: rarely - leukopenia, eosinophilia, hemolytic anemia, thrombocytopenia and thrombocytopenic purpura;
• CNS: visual disturbances, headache, ataxia, disorientation;
• Urinary system: interstitial nephritis, renal tubular necrosis, acute renal failure;
• Endocrine system: violation of the menstrual cycle;
• Cardiovascular system: with prolonged intravenous administration - phlebitis, with rapid administration - a decrease in blood pressure;
• Allergic reactions: flu-like syndrome, urticaria, itching, rash, bronchospasm, eosinophilia, lacrimation, angioedema;
• Others: red-brown staining of saliva, sputum, tears, sweat, urine and feces, muscle weakness, arthralgia, porphyria induction, herpes.

When using Rifampicin in the last weeks of pregnancy, the development of postpartum hemorrhage in the mother and bleeding in the newborn is possible.

Overdose symptoms: abdominal pain, nausea, vomiting, "red man syndrome" (staining of the mucous membranes, sclera and skin in red-orange color), liver enlargement, jaundice, swelling of the face or periorbital edema, pulmonary edema, convulsions, blurred consciousness, mental disorders, lethargy. In the case of taking a high dose of Rifampicin, gastric lavage is done, activated charcoal and forced diuresis are prescribed, further treatment is symptomatic.

special instructions

Women of childbearing age should be warned about the need to use reliable methods of contraception during therapy.

Rifampicin is better tolerated with daily administration than with intermittent treatment.

In case of resumption of therapy after a break, it is recommended to start taking the drug with a daily dose of 75 mg, increasing it by 75 mg daily until the dose prescribed by the doctor is reached. In this case, the functional state of the kidneys should be monitored. If necessary, you can additionally take a glucocorticosteroid.

Due to the rapid development of resistance in the treatment of non-tuberculous infections, rifampicin is prescribed only when other antibiotics have failed. For the same reason, it is often combined with other chemotherapeutic agents.

During treatment, it is necessary to control the blood picture, liver and kidney function - first 1 time in 2 weeks, then 1 time per month. Rifampicin competitively inhibits the excretion of bromsulfalein, so a test with its load cannot be used.

In the case of the appointment of anti-tuberculosis drugs PAS containing aluminum hydrosilicate, they should be taken no earlier than 4 hours after taking Rifampicin.

To prevent bleeding in newborns, the drug is prescribed simultaneously with vitamin K.

When prescribing the drug intravenously to patients with diabetes mellitus, it is recommended to administer 2 IU of insulin for every 4-5 g of glucose used as a solvent.

When symptoms of influenza-like syndrome appear in patients adhering to an intermittent treatment regimen, it is recommended, if possible, to switch to a daily intake. The dose is increased gradually.

Prophylactic administration of Neisseria meningitidis in bacillus carriers requires particularly careful monitoring of the patient in order to promptly identify the symptoms of the disease (if they appear during the development of resistance of the pathogen).

drug interaction

Rifampicin accelerates the metabolism of antifungal and antiepileptic drugs, sex hormone drugs (including hormonal contraceptives), oral anticoagulants, beta-blockers, digitalis drugs, glucocorticosteroids, oral hypoglycemic and antiarrhythmic drugs, calcium channel blockers, benzodiazepines, as well as phenytoin, verapamil , quinidine, theophylline, chloramphenicol, methadone, dapsone, hexobarbital, haloperidol, doxycycline, nortriptyline, thyroxine, terbinafine, ketoconazole, itraconazole, fluvastatin, enalapril, azathioprine, cimetidine, cyclosporine A. As a result, their plasma concentration decreases and, as a result, consequence, efficiency.

Antacids and PAS preparations containing aluminum hydrosilicate interfere with the absorption of rifampicin. Its concentration in the blood is increased by probenecid and co-trimoxazole. Its bioavailability is reduced by anticholinergics, opiates and ketoconazole.

Rifampicin is not recommended to be taken simultaneously with nelfinavir and indinavir sulfate (since their plasma concentrations are significantly reduced due to the acceleration of metabolism), isoniazid and pyrazinamide (since the frequency and severity of liver dysfunction increases, there is a risk of developing neutropenia).

Terms and conditions of storage

Store in a dry, dark place out of the reach of children at temperatures up to 25 °C.

Shelf life - 2 years.