Spectrum: Local Antimicrobial Stewardship, for Billings Clinic

Rifampin

C. diff Risk

Low

Oral Bioavailability

Excellent

Approximate Cost

PO: $1/day
IV: $75/day

Spectrum Of Activity

General Spectrum of Activity

Spectrum Of Activity

General Spectrum of Activity

Antibiogram Data

Dosing

Adult

  • Do NOT use as monotherapy for Staphylococcal infections

  • 300 mg BID for orthopedic infections

  • 300 mg TID for endocarditis

  • 600 mg daily Mycobacterial infections (poor tolerability may consider splitting the dose into BID dosing or thrice weekly dosing in specific scenarios)

Hepatic

No dose adjustments provided. Use with caution.

General Information

Common Usage

Common Usage

  •  Tuberculosis

  •  Nontuberculosis Mycobacterial infections (NTM)

  •  Prosthetic valve endocarditis or prosthetic joint infections caused by Staphylococci in combination with other agents (cefazolin, nafcillin, vancomycin, etc)

Adverse Effects

Adverse Effects

  •  Discoloration (reddish-orange) of body fluids

  •  Hepatitis

  •  GI intolerance

  •  Flu-like syndrome

Major Interactions

Major Interactions

LOTS!

  •  Potent inducer of CYP3A4

  •  Inducer of CYP 2B6, 2C8, 2C9, 2C19 and p-glycoprotein

  •  Commonly seen interactions in the hospital: amiodarone, atorvastatine (change to rosuvastatin), digoxin, azole antifungals, warfarin, thyroid medication, etc. Contact pharmacist for further details.

  •  Inductive effects typically take 1-2 weeks to reach steady state. Typically resolve 1-2 weeks after discontinuation of therapy

Additional Information

Additional Information

  •  Check drug drug interactions upon stopping and starting rifampin

  •  Food reduces absorption. If possible take on empty stomach.

Pharmacology

Pharmacology

Antimicrobial class: Rifamycin

Pregnancy category: C

Average serum half life: 2-5 hours

Route of Elimination: Hepatic