Rifampin

C. diff Risk

NA

Oral Bioavailability

Good (70 to 90%)

Approximate Cost

$0.99 (PO)
$48.99 (IV)

Spectrum Of Activity

Dosing

General Information

Acceptable Uses

Synergistic therapy of gram positive organisms in some cases (i.e. prosthetic valve endocarditis)

Unacceptable Uses

Monotherapy of any infection (use as single-agent prophylaxis in N. meningitidis outbreak settings is acceptable)

Common Usage

  • Mycobacterial infections

  • Brucellosis

  • Osteomyelitis

  • Prosthetic joint infections due to Staphyloccocus aureus (always use in combination with other agents).

Drug Monitoring

Lab

  • Basline and periodic LFTs

Clinical

  • Multiple drug interactions

Adverse Effects

  • Nausea/vommiting, diarrhea

  • Abnormal liver enzymes

  • Rash (Steven-Johnson syndrome)

  • Myopathy

Major Interactions

Inducer of many CYP enzymes including 3A4, and 2C9.

Anticoagulants and anticonvulsants are among those affected but list of interacting drugs is large.

A Pharmacy consult is recommended when initiating rifampin therapy.

Tablet/Capsule Strengths

OPEN BENEFIT (PO)
No prescribing restrictions

Additional Information

Capsules may be opened and given via NG route

Suspension is available but has to be made by Pharmacy Department

EH Prescribing Restrictions
(PO): None
(IV): Use restricted via Special Access Program

For special access drug availability contact:

Eastern Health provides rifampin prophylaxis during meningococcal outbreak free of charge as per policy 440-PHA-DDD-176

Prescription Processing and Dispensing (Outpatients)

The Pharmacy Department provides services to the Department of Health (Communicable Disease) as and when required, for the provision of medication required in the prevention of diseases such as Meningococcal outbreak, etc.

During regular working hours (1030 to 1600), this service may be accessed by calling the Pharmacy Department at 777-6244(5). After hours, the main Health Sciences Centre hospital pharmacy or Pharmacist-on-call may be contacted for emergency only.

All costs incurred in the completion of such requests are directed to the Department of Health.

Pharmacology

Antimicrobial class: Antimycobacterial

Pregnancy category: C

Average serum half life: 3-4 hr

Biliary penetration: Therapeutic

CSF penetration: Therapeutic

Lung penetration: Therapeutic

Route of Elimination: Feces