What are rifampicin tablets in capsules for? Fast-acting drugs for prostatitis: the best drugs for men. Rifampicin, instructions for use: method and dosage

Name:

Rifampicin

Pharmacological
action:

Rifampiin is antibiotic wide range actions.
It is active against mycobacteria tuberculosis and leprosy, acts on gram-positive (especially staphylococci) and gram-negative (meningococci, gonococci) cocci, and is less active against gram-negative bacteria.
Rifampin is well absorbed from gastrointestinal tract.
The maximum concentration in the blood is reached 2-2"/2 hours after oral administration.
With intravenous drip administration maximum concentration of rifampicin observed towards the end of the infusion.
At the therapeutic level, the concentration of the drug when administered orally and intravenously is maintained for 8-12 hours, for highly sensitive pathogens - for 24 hours. Rifampicin penetrates well into the tissues and fluids of the body and is found in therapeutic concentrations in pleural exudate (accumulating between the membranes, protein-rich fluid surrounding the lungs), sputum, the contents of caverns (cavities in the lungs formed as a result of tissue necrosis), bone tissue.
The highest concentration of the drug is created in the tissues of the liver and kidneys.
From the body excreted in bile and urine.
Resistance to rifampicin develops rapidly. Cross-resistance with other antibiotics is not observed (with the exception of rifamiin).

Indications for
application:

Tuberculosis of the lungs and other organs;
- at various forms leprosy and inflammatory diseases lungs and respiratory tract: bronchitis (inflammation of the bronchi), pneumonia (pneumonia) - caused by multidrug-resistant (resistant to most antibiotics) staphylococci;
- for osteomyelitis (inflammation of the bone marrow and adjacent bone tissue);
- infections of the urinary and biliary tract;
- acute gonorrhea and other diseases caused by pathogens sensitive to rifampicin;
- for non-tuberculosis diseases only in cases where other antibiotics are ineffective.

Rifampicin has virulocidal (accompanied by complete or partial loss of biological activity of the virus) effect on the rabies virus, suppresses the development of rabies encephalitis (inflammation of the brain caused by the rabies virus); therefore, it is used for the complex treatment of rabies in incubation period(the period between the moment of infection and the appearance of the first signs of the disease).

Mode of application:

Rifampiiin taken orally on an empty stomach("/2-1 hour before meals) or administered intravenously (adults only).
To prepare the solution, dilute 0.15 g of rifampicin in 2.5 ml of sterile water for injection, shake the ampoules with powder vigorously until completely dissolved, and dilute the resulting solution in 125 ml of 5% glucose solution.
Inject at a rate of 60-80 drops per minute.
When treating tuberculosis, the average daily dose for adults is 0.45 g orally once a day.
In patients (especially during an exacerbation) with a body weight above 50 kg, the daily dose can be increased to 0.6 g.
The average daily dose for children over 3 years of age is 10 mg/kg (but not more than 0.45 g per day) 1 time per day.
If rifampicin is poorly tolerated, the daily dose can be divided into 2 doses.

Intravenous rifampicin is recommended in acutely progressive and widespread forms of destructive pulmonary tuberculosis (pulmonary tuberculosis occurring with a violation of the structure of the lung tissue), severe purulent-septic processes (microbial infection of the blood with subsequent formation of ulcers in the tissues), when it is necessary to quickly create a high concentration of the drug in the blood and if taking the drug inside is difficult or poorly tolerated by the patient.
When administered intravenously, the daily dose for adults is 0.45 g, for severe rapidly progressing (developing) forms - 0.6 g and is administered in 1 dose.
The drug is administered intravenously for 1 month. or more, followed by a transition to oral administration, depending on the tolerability of the drug.
The total duration of use of rifampicin for tuberculosis is determined by the effectiveness of treatment and can reach 1 year.

When treating tuberculosis with rifampicin (intravenously) in patients with diabetes mellitus It is recommended to administer 2 units of insulin for every 4-5 g of glucose (solvent).
Monotherapy (treatment with one drug) of tuberculosis with rifampicin is often accompanied by the development of pathogen resistance to the antibiotic, so it should be combined with other antituberculosis drugs (streptomycin, isoniazid, ethambutol, etc., 770, 781), to which the sensitivity of Mycobacterium tuberculosis (the causative agent of tuberculosis) is preserved.
For leprosy, rifampicin is used according to the following regimens:: a) a daily dose of 0.3-0.45 g is administered in 1 dose: if tolerated poorly - in 2 doses.
Duration of treatment is 3-6 months, courses are repeated at intervals of 1 month; b) against the background of combination therapy, a daily dose of 0.45 g is prescribed in 2-3 doses for 2-3 weeks. at intervals of 2-3 months. for 1 year - 2 years or at the same dose 2-3 times every 1 week. within 6 months.
Treatment is carried out in combination with immunostimulating (increasing the body's defenses) agents.

For non-tuberculosis infections adults take rifampicin orally at 0.45-0.9 g per day, and children - 8-10 mg/kg in 2-3 doses.
Administered intravenously to adults in a daily dose of 0.3-0.9 g (2-3 injections).
Administer over 7-10 days.
As soon as the opportunity arises, switch to taking the drug orally.
For acute gonorrhea prescribed orally at a dose of 0.9 g per day once or for 1-2 days.
For the prevention of rabies adults are given orally 0.45-0.6 g per day; for severe injuries (bite to the face, head, hands) - 0.9 g per day; children under 12 years old - 8-10 mg/kg.
The daily dose is divided into 2-3 doses.
Duration of use: 5-7 days.
Treatment is carried out simultaneously with active immunization (vaccinations).

Side effects:

From the outside digestive system : nausea, vomiting, diarrhea, loss of appetite; increased levels of liver transaminases, bilirubin in the blood plasma, pseudomembranous colitis, hepatitis.
Allergic reactions: urticaria, Quincke's edema, bronchospasm, influenza-like syndrome.
From the hematopoietic system: rarely - thrombocytopenia, thrombocytopenic purpura, eosinophilia, leukopenia, hemolytic anemia.
From the side of the central nervous system: headache, ataxia, visual impairment.
From the urinary system: necrosis of kidney tubules, interstitial nephritis, acute renal failure.
From the outside endocrine system : violation menstrual cycle.
Other: red-brown coloring of urine, feces, saliva, sputum, sweat, tears.

Contraindications:

Infants;
- pregnant women;
- with jaundice;
- kidney diseases with decreased excretory function;
- for hepatitis (inflammation of liver tissue);
- with hypersensitivity to the drug.
Intravenous administration is contraindicated with pulmonary-heart failure (insufficient supply of body tissues with oxygen due to heart and lung disease) and phlebitis.

Carefully used for liver diseases and exhaustion.
When treating non-tuberculosis infections, rapid development of microbial resistance is possible; this process can be prevented by combining rifampicin with other chemotherapeutic agents.
Rifampicin is better tolerated when taken daily than when taken intermittently. If it is necessary to resume treatment with rifampicin after a break, then you should start with a dose of 75 mg/day, gradually increasing it by 75 mg/day until the desired dose is reached.
In this case, renal function should be monitored; additional administration of GCS is possible.
With long-term use of rifampicin systematic monitoring of blood patterns and liver function is indicated; You cannot use a test with a load of bromsulfalein, since rifampicin competitively inhibits its excretion.
PAS preparations containing bentonite (hydrosilicate of aluminum) should be prescribed no earlier than 4 hours after taking rifampicin.
In newborns and premature infants, rifampicin is used only when absolutely necessary.

Interaction
other medicinal
by other means:

Due to the induction of microsomal liver enzymes (isoenzymes CYP2C9, CYP3A4), rifampicin accelerates the metabolism of theophylline, oral anticoagulants, oral hypoglycemic drugs, hormonal contraceptives, digitalis preparations, verapamil, phenytoin, quinidine, corticosteroids, chloramphenicol, antifungal drugs, which leads to a decrease in their concentrations in the blood plasma and, accordingly, to a decrease in their effect.

Pregnancy:

If it is necessary to use rifampicin during pregnancy, the expected benefit of therapy for the mother and the potential risk to the fetus should be assessed.
It should be borne in mind that the use of rifampicin in the last weeks of pregnancy increases the risk of bleeding in newborns and mothers in the postpartum period.
Rifampin is released from breast milk.
If necessary, use during lactation should stop breastfeeding.

1 ampoule of Rifampicin lyophilisate for solution for infusion (600 mg) contains:
- active substance: rifampicin - 600 mg;
- Excipients: ascorbic acid 60 mg, sodium sulfite 12 mg, sodium hydroxide to pH 8.0-9.0.

1 capsule Rifampicin (150 mg) contains:
- active ingredient: rifampicin - 150 mg;
- excipients: lactose, potato starch, sodium lauryl sulfate, liquid paraffin, purified talc, colloidal silicon oxide, magnesium stearate.

Rifampicin is a semisynthetic broad-spectrum antibiotic. The bactericidal effect of rifampicin is based on the selective inhibition of DNA-dependent RNA polymerase in the microbial cell. Active against mycobacteria tuberculosis and leprosy, affects gram-positive (especially staphylococci) and gram-negative (meningococci, gonococci) microorganisms. Less active against gram-negative bacteria. Refers to first-line anti-tuberculosis drugs. Due to the rapid development of microbial resistance to rifampicin in non-tuberculosis diseases, its use is usually limited to cases resistant to other antibiotics.
Rifampicin is well absorbed in the digestive tract, penetrates into the cavities, bone tissue etc. Its maximum concentration in the blood plasma is observed 2-2.5 hours after ingestion. The therapeutic concentration is maintained for 8-12 hours (for highly sensitive microorganisms - 24 hours). About 25% of rifampicin is metabolized in the body to form inactive metabolites. Most of the drug is excreted in the bile, a small part in the urine, and a small amount passes into breast milk. Slightly penetrates into the CSF.

Indications for use of the drug Rifampicin

Tuberculosis of the lungs and extrapulmonary localization (main indication); also prescribed for various forms of leprosy, respiratory diseases (bronchitis, pneumonia) caused by multidrug-resistant staphylococci, osteomyelitis, urinary and biliary tract, acute gonorrhea, and other diseases caused by pathogens sensitive to rifampicin.
Rifampicin has a viricidal effect against the rabies virus, inhibits the development of rabies encephalitis, and therefore it is used in complex treatment rabies during the incubation period.

Use of the drug Rifampicin

Orally on an empty stomach 0.5-1 hour before meals.
When treating tuberculosis, the average daily dose of rifampicin for adults orally is 0.45 g (1 time per day). In patients whose body weight is more than 50 kg, the daily dose can be increased to 0.6 g.
The total duration of treatment with rifampicin is determined by the nature of the disease and the effectiveness of therapy and can last up to 1 year.
The average daily oral dose for children over 3 years of age is 10 mg/kg (but not more than 0.45 g/day). If rifampicin is poorly tolerated, the daily dose can be divided into 2 doses.
For leprosy, rifampicin is used according to 2 schemes: 1) the daily dose (0.3-0.45 g) is taken in 1 dose, and in case of poor tolerance - in 2 doses. Duration of treatment is 3-6 months, courses are repeated at intervals of 1 month; 2) against the background of combination therapy, a daily dose of 0.45 g is prescribed in 2-3 doses over 2-3 weeks with an interval of 2-3 months for 1-2 years (or at the same dose 2-3 times per week for 6 months).
For infections of non-tuberculosis origin, adults are prescribed 0.45-0.9 g/day orally, and children 8-10 mg/kg in 2-3 doses.
For acute gonorrhea, it is prescribed once orally at a dose of 0.9 g/day or for 1-2 days.
To prevent rabies, adults are prescribed 0.45-0.6 g/day orally. In severe situations (bitten wounds on the head and hands), 0.9 g/day is used. Children under 12 years of age are prescribed at a dose of 8-10 mg/kg/day. The daily dose is divided into 2-3 doses with a treatment duration of 5-7 days. Rabies treatment is carried out in parallel with active immunization.
With intravenous administration, the daily dose for adults is 0.45 g, for severe, rapidly progressing forms of tuberculosis - 0.6 g, administered in one dose. The duration of IV administration depends on tolerability and is 1 month or more (with subsequent transition to oral administration). For infections of non-tuberculous etiology, the daily dose is 0.3-0.9 g (maximum - 1.2 g/day). The daily dose is divided into 2-3 injections. The duration of treatment is determined individually, depends on the effectiveness and can be 7-10 days.

Contraindications to the use of the drug Rifampicin

Pregnancy, hepatitis, jaundice, kidney disease with decreased excretory function, increased sensitivity to rifampicin, infants.

Side effects of the drug Rifampicin

Possible allergic reactions, dyspeptic symptoms, dysfunction of the liver and pancreas.

Special instructions for the use of the drug Rifampicin

Due to the rapid development of microbial resistance to rifampicin in non-tuberculosis diseases, it is prescribed only if other antibiotics are ineffective. The use of rifampicin alone for tuberculosis often leads to the development of mycobacteria resistance to it, so it should be combined with streptomycin, ethambutol, isoniazid and other antituberculosis drugs.
The use of rifampicin requires strict medical supervision. With long-term use of rifampicin, it is necessary to periodically study the composition of peripheral blood (possible development of leukopenia) and liver function.
Rifampicin, especially at the beginning of use, colors urine, sputum, and tear fluid in a reddish-orange color.

Drug interactions Rifampicin

Rifampicin reduces the activity of indirect anticoagulants and oral hypoglycemic drugs.

List of pharmacies where you can buy Rifampicin:

Saint Petersburg

Semi-synthetic broad-spectrum antibiotic of the rifamycin group.
Active substance drug: RIFAMPICIN / RIFAMPICIN

Pharmacological action Rifampicin / rifampicin

Semi-synthetic broad-spectrum antibiotic of the rifamycin group. Has a bactericidal effect. Suppresses bacterial RNA synthesis by inhibiting the DNA-dependent RNA polymerase of the pathogen.
Highly active against Mycobacterium tuberculosis, it is a first-line anti-tuberculosis drug.
Active against gram-positive bacteria: Staphylococcus spp. (including multidrug-resistant), Streptococcus spp., Bacillus anthracis, Clostridium spp., as well as against some gram-negative bacteria: Neisseria meningitidis, Haemophilus influenzae, Brucella spp., Legionella pneumophila.
Active against Rickettsia prowazekii, Mycobacterium leprae, Chlamydia trachomatis.
Resistance to rifampicin develops rapidly. Cross-resistance to other anti-tuberculosis drugs (with the exception of other rifamycins) was not observed.

Pharmacokinetics of the drug.

After oral administration, it is well absorbed from the gastrointestinal tract. Distributed in most tissues and body fluids. Penetrates through the placental barrier. Plasma protein binding is high (89%). Metabolized in the liver. T1/2 is 3-5 hours. It is excreted in bile, feces and urine.

Indications for use:

Tuberculosis (incl. tuberculous meningitis) as part of combination therapy. MAS infection. Infectious and inflammatory diseases caused by pathogens sensitive to rifampicin (including osteomyelitis, pneumonia, pyelonephritis, leprosy; meningococcal carriage).

Dosage and method of administration of the drug.

When taken orally for adults and children - 10 mg/kg 1 time/day or 15 mg/kg 2-3 times a week. Take on an empty stomach, the duration of treatment is determined individually.
IV for adults - 600 mg 1 time/day or 10 mg/kg 2-3 times a week, for children - 10-20 mg/kg 1 time/day or 2-3 times a week.
It is possible to administer 125-250 mg to the pathological focus (by inhalation, intracavitary administration, as well as injection into the focus of the skin lesion).
Maximum doses: when taken orally for adults, the daily dose is 1.2 g, for children 600 mg, when administered intravenously for adults and children - 600 mg.

Side effects of Rifampicin / rifampicin:

From the digestive system: nausea, vomiting, diarrhea, loss of appetite; increased levels of liver transaminases, bilirubin in the blood plasma, pseudomembranous colitis, hepatitis.
Allergic reactions: urticaria, eosinophilia, Quincke's edema, bronchospasm, influenza-like syndrome.
From the hematopoietic system: rarely - thrombocytopenia, thrombocytopenic purpura, eosinophilia, leukopenia, hemolytic anemia.
From the central nervous system: headache, ataxia, blurred vision.
From the urinary system: necrosis of the kidney tubules, interstitial nephritis, acute renal failure.
From the endocrine system: menstrual irregularities.
Other: red-brown coloring of urine, feces, saliva, sputum, sweat, tears.

Contraindications to the drug:

Jaundice, recent (less than 1 year) infectious hepatitis, severe renal dysfunction, hypersensitivity to rifampicin or other rifamycins.

Use during pregnancy and lactation.

If it is necessary to use rifampicin during pregnancy, the expected benefit of therapy for the mother and the potential risk to the fetus should be assessed.
It should be borne in mind that the use of rifampicin in the last weeks of pregnancy increases the risk of bleeding in newborns and mothers in the postpartum period.
Rifampin is excreted in breast milk. If necessary, use during lactation should stop breastfeeding.

Special instructions for use of Rifampicin / rifampicin.

Use with caution for liver diseases and exhaustion. When treating non-tuberculosis infections, rapid development of microbial resistance is possible; this process can be prevented by combining rifampicin with other chemotherapeutic agents. Rifampicin is better tolerated when taken daily than when taken intermittently. If it is necessary to resume treatment with rifampicin after a break, then you should start with a dose of 75 mg/day, gradually increasing it by 75 mg/day until the desired dose is reached. In this case, renal function should be monitored; additional administration of GCS is possible.
With long-term use of rifampicin, systematic monitoring of blood counts and liver function is indicated; You cannot use a test with a load of bromsulfalein, since rifampicin competitively inhibits its excretion.
PAS preparations containing bentonite (hydrosilicate of aluminum) should be prescribed no earlier than 4 hours after taking rifampicin.
In newborns and premature infants, rifampicin is used only when absolutely necessary.

Interaction of Rifampicin / rifampicin with other drugs.

Due to the induction of microsomal liver enzymes (CYP2C9, CYP3A4 isoenzymes), rifampicin accelerates the metabolism of theophylline, oral anticoagulants, oral hypoglycemic drugs, hormonal contraceptives, digitalis drugs, verapamil, phenytoin, quinidine, corticosteroids, chloramphenicol, antifungal drugs, which leads to a decrease in their plasma concentrations blood and, accordingly, to a decrease in their effect.

Rifampicin (Rifadin, Benemicin, Rimpacin) - bactericidal antibiotic medicine. It is one of the four drugs used in the standard treatment of tuberculosis.

Introduced oral by or by intravenous injections.

Indications for use

Rifampin is one of the the most powerful 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 premature babies), but it is recommended to start giving the drug when the child reaches at least one year old.

Important! Microorganisms quickly develop resistance to Rifampicin, so regular antibiotic sensitivity tests are required during treatment.

Rifampicin tablets: instructions for use

On initial stage therapy, it is recommended to take Rifampicin in combination with Isoniazid And Pyrazinamide. Often added as a fourth drug Streptomycin or Ethambutol. The need for a fourth drug depends on the results of susceptibility testing. If the level of resistance of microorganisms to antibiotics is low, it is possible to use fewer drugs. The course of treatment continues in within two months.

Photo 1. Packaging of Rifamycin, 20 capsules of 150 mg, manufactured by JSC Pharmasintez.

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 more long term.

When treating a latent form of tuberculosis, the drug is taken for four months without isoniazid. For children and HIV-infected people, the course can be extended to six months.

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

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

To obtain a solution for infusion 600 mg powder is diluted 10 ml sterile water. The mixture is shaken well 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 administer intravenously for 30 minutes. When using a 5% glucose solution as an infusion liquid, the drug can be stored at room temperature for 4 hours; When using saline solution, the drug is stable at room temperature for 24 hours.

Dosage

Oral and intravenous doses for Rifampicin are equivalent.

Maximum dose drug for treatment active form tuberculosis should be:

for adults(including the elderly and adolescents) - 10 mg/kg/day (max. 600 mg/day);
for children(including newborns) - 20 mg/kg/day (max. 600 mg/day).

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

Reference. If the patient cannot take the capsule, its contents are mixed with applesauce or gelatin.

Minimum dose, leading to fatal outcome or acute poisoning body, not established. Cases of acute overdose of adults with Rifampicin have been recorded with doses ranging from 9 to 12 grams, as well as cases of acute overdose of adults with fatal outcome with doses ranging from 14 to 60 grams. In children aged 1 to 4 years, an overdose may occur when taking 100 mg/kg.

Attention! Rifadine should be taken at the same time If you miss a time to take your medication, you should take the dose as quickly as possible. If you have less than 12 hours until your next dose, skip the dose and return to your regular schedule. Skipping a medication may cause side effects.

Contraindications and precautions

Rifampicin is not recommended for use in cases where the fact of infection has not been established bacterial infection , as well as for preventive purposes. This antibiotic can be harmful to the body, and taking it increases the risk of developing drug-resistant bacteria.

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

For liver diseases, tests are done to check liver function 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.

If adrenal function is impaired, it is possible to develop adrenal insufficiency.

When taking Rifadin it is possible exacerbation of porphyria.

People suffering from diabetes should use Rifampicin with caution, as taking this antibiotic will make it more difficult to control the disease.

It is undesirable to administer the drug intravenously when cardiopulmonary insufficiency And phlebitis.

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

When administering the drug in the last trimester of pregnancy, possible hemorrhages both mother and baby. Women taking Rifampicin should give up breastfeeding baby.

Rifadin is contraindicated in people with hypersensitivity to rifamycins. Due to its 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 constant reception, intermittent therapy often causes side effects and is considered undesirable.

Rifampicin and alcohol, their compatibility

Drinking alcohol while taking Rifampicin (or drinking too much alcohol before starting the drug) may cause serious liver damage and lead to fatal outcome. In addition, taking Rifampicin may be accompanied by drowsiness or dizzy. These symptoms may be worsened by alcohol.

Side effects and overdose

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

Side effects, requiring contact a doctor immediately:

pallor skin;
painful urination;
chest pain;
pain in the abdomen or stomach;
bone or joint pain;
backache;
joint inflammation;
headache;
dizziness;
depression;
diarrhea;
diplopia;
thirst;
difficulty 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;
continuous bleeding in the puncture sites, mouth or nose;
bad smell from mouth;
fainting;
chills;
swelling of the face, ankles, fingers, hands, or feet;
swelling of the eyelids, areas around the eyes, face, lips, tongue;
feeling of weakness;
paralysis;
high blood pressure;
redness, irritation of the eyes;
darkening of the skin;
loss of appetite;
sweating;
psychomotor agitation;
irritability;
shortness of breath;

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

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

Some side effects that occur when taking Rifampicin are: do not require immediate treatment medical care . As the body begins to get used to the antibiotic, they may go away. If any of the symptoms are felt long time or causes concern, you should consult a specialist.

Side effects, not requiring immediate medical attention:

a sore throat;
bloating;
visual or auditory hallucinations;
changes in the menstrual cycle in women;
muscle pain;
slight weight loss;
belching;
the feeling that others can hear your thoughts;
Bad mood;
increased gas formation;
absentmindedness;
drowsiness;
the feeling that you are being watched or that your behavior is being controlled.

Important! Rifampicin may cause changes in the color of urine, tears, stool, saliva, sputum, and sweat. brownish red or orange. This is due to the removal of the drug from the body and is not a side effect requiring consultation with a doctor.

Reaction of organs and body systems to the drug

From the gastrointestinal tract

U 2% of people Nausea and dyspepsia are observed. Heartburn is also possible erosive gastritis, anorexia, vomiting, flatulence, cramps, diarrhea, candidiasis, colitis, disruption of the pancreas, decreased or loss of appetite.

From the liver

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

U 3% of patients hyperbilirubinemia and hepatitis were detected. In half of the cases, hepatotoxicity was observed during the first month of therapy. Jaundice and increased levels of serum bilirubin, alkaline phosphatase and serum transaminases may develop.

From the immune system

When taking Rifampicin intermittently, it is possible to develop influenza-like syndrome, which is a complex of symptoms: malaise, elevated temperature, chills, vomiting, nausea.

From the kidneys

Renal side effects include increased urea levels and uric acid in blood. Cases of hemoglobinuria, interstitial nephritis, hematuria, acute tubular necrosis, renal failure.

From the hematopoietic system

U 1% of hosts Petechiae associated with thrombocytopenia have been observed with rifampicin. A decrease in hemoglobin, a short-term decrease in the number of leukocytes, and hemolytic anemia are also possible.

From the skin

Skin reactions are usually flow smoothly and are not associated with hypersensitivity to Rifampicin. They manifest themselves in the form of itching and redness of the skin.

From 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.

Metabolism

If you take the medicine for a long time ( 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 maintain it in the therapeutic range.

From the cardiovascular system

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

From the endocrine system

It is possible to develop adrenal insufficiency due to dysfunction of the adrenal glands and menstrual irregularities in women.

From the musculoskeletal system

Side effects include myopathy and myasthenia gravis.

From the point of view

Visual impairment, diplopia, conjunctivitis, blurred vision.

From the respiratory system

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

If overdose symptoms occur while taking Rifampicin, you should stop taking the drug And seek medical help.

Overdose symptoms:

pain in the upper stomach or abdomen;
dizziness or weakness with a sudden 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;
blurred vision;
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 basis of anti-tuberculosis therapy, but at the same time it can cause significant harm to the body. At liver diseases Rifampicin is only taken when in case of emergency And under constant medical supervision.

The severity of liver injury during treatment with Rifampicin ranges from asymptomatic elevations in serum aminotransferase levels and jaundice without overt liver injury 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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Rifampicin is a semisynthetic broad-spectrum antibiotic characterized by bactericidal and antituberculosis properties.

Release form and composition

Dosage forms of Rifampicin:

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

The active ingredient of the drug is rifampicin.

Indications for use

All forms of tuberculosis and tuberculous meningitis (as part of combination therapy);
Infectious and inflammatory diseases caused by microorganisms sensitive to rifampicin, including bronchitis, pneumonia, osteomyelitis, leprosy, brucellosis, biliary and urinary tract infections (including pyelonephritis), acute gonorrhea, etc.;
MAS infection;
Meningococcal meningitis (prevention for Neisseria meningitidis bacilli 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 suppresses the development of rabies encephalitis caused by this virus. Given these properties, the drug is often used in the composition complex therapy rabies in the incubation period - before the first signs of the disease appear.

Contraindications

Both dosage forms Rifampicin is contraindicated in the following cases:

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

Intravenous administration is also contraindicated in childhood, at cardiopulmonary failure II–III degrees and phlebitis.

The drug is used with caution in cases of exhaustion, 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 second and third 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. No adverse reactions were recorded; however, it is recommended to stop breastfeeding during treatment.

Directions for use and dosage

Capsules are taken orally 30-60 minutes before meals or 2 hours after meals, washed down 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, and 125 ml of a 5% glucose solution is added to the resulting solution. Administered intravenously at a rate of 60-80 drops/minute.

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

For tuberculosis, Rifampicin is prescribed either orally or intravenously, followed by switching to oral administration. The dose for adult patients weighing less than 50 kg is 450 mg, for patients weighing more than 50 kg – 600 mg. Take/administer the drug 1 time per day, daily or 3 times a week. The daily dose for newborns and children over 3 years of age is 10-20 mg per kilogram of weight, but not more than 450 mg per day. The duration of treatment is 6-9-12 months or more. Rifampin can be combined with other antituberculosis drugs (for example, isoniazid, streptomycin, ethambutol).

When treating leprosy, the drug is used according to one of two schemes:

As a single drug: in a daily dose of 300-450 mg in 1 or 2 doses in courses of 3-6 months at 30-day intervals;
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 for 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.

For brucellosis in adults, the drug is prescribed orally in combination with doxycycline. Dose – 900 mg per day, course of treatment – 45 days.

For infections caused by rifampicin-sensitive microorganisms of non-tuberculosis etiology, the following is prescribed:

Orally: 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 switching to oral administration.

For prevention meningococcal meningitis Rifampicin is prescribed 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.

To prevent rabies, take capsules: 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, for severe injuries (in case of a bite to the head, face or hand 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 to patients with impaired renal function, dose adjustment is necessary.

Side effects

Digestive system: loss of appetite, candidiasis oral cavity, diarrhea, abdominal pain, nausea, vomiting, pseudomembranous colitis, erosive gastritis, hepatitis, increased bilirubin and the level of hepatic transaminases in the blood plasma, jaundice, damage to the pancreas;
Hematopoietic system: rarely - leukopenia, eosinophilia, hemolytic anemia, thrombocytopenia and thrombocytopenic purpura;
Central nervous system: visual disturbances, headache, ataxia, disorientation;
Urinary system: interstitial nephritis, renal tubular necrosis, acute renal failure;
Endocrine system: menstrual irregularities;
Cardiovascular system: with long-term intravenous administration - phlebitis, with rapid administration - a decrease in blood pressure;
Allergic reactions: flu-like syndrome, urticaria, itching, rash, bronchospasm, eosinophilia, lacrimation, Quincke's edema;
Other: staining of saliva, sputum, tears, sweat, urine and feces in a red-brown color, muscle weakness, arthralgia, induction of porphyria, herpes.

When using Rifampicin for last weeks pregnancy may develop postpartum hemorrhage in the mother and bleeding in the newborn.

Symptoms of overdose: abdominal pain, nausea, vomiting, “red man syndrome” (coloration of the mucous membranes, sclera and skin in a red-orange color), enlarged liver, jaundice, swelling of the face or periorbital edema, pulmonary edema, convulsions, confusion, mental disorders, lethargy. In case of taking a high dose of Rifampicin, gastric lavage is performed, Activated carbon and forced diuresis, further treatment is symptomatic.

special instructions

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

Better tolerability of Rifampicin is observed when taken daily than with intermittent treatment.

If therapy is resumed after a break, it is recommended to start taking the drug with daily dose 75 mg, increasing it by 75 mg daily until the dose prescribed by the doctor is reached. At the same time, it is necessary to control functional state kidney If necessary, you can additionally take a glucocorticosteroid.

Due to the rapid development of resistance in the treatment of non-tuberculosis infections, Rifampicin is prescribed only if other antibiotics are ineffective. For the same reason, it is often combined with other chemotherapy drugs.

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

If PAS anti-tuberculosis drugs containing aluminum hydrosilicate are prescribed, 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 administering the drug intravenously to patients with diabetes, it is recommended to administer 2 units of insulin for every 4-5 g of glucose used as a solvent.

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

When administered prophylactically to carriers of the Neisseria meningitidis bacilli, particularly careful monitoring of the patient is necessary in order to promptly identify symptoms of the disease (if they appear during the development of pathogen resistance).

Drug interactions

Rifampicin accelerates the metabolism of antifungal and antiepileptic drugs, sex hormones (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 concentration in the blood plasma decreases and, as 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 (as their plasma concentrations are significantly reduced by accelerating metabolism), isoniazid and pyrazinamide (as the frequency and severity of liver dysfunction increases and the risk of developing neutropenia appears).

Terms and conditions of storage

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

Shelf life – 2 years.