Rifampicin



Rifampicin
Systematic (IUPAC) name
5,6,9,17,19,21-Hexahydroxy-23-methoxy-
2,4,12,16,18,20,22-heptamethyl-
8-[N-(4-methyl-1-piperazinyl)formimidoyl]-
2,7-(epoxypentadeca[1,11,13]trienimino)-
naphtho[2,1-b]furan-1,11(2H)-dione 21-acetate
Identifiers
CAS number 13292-46-1
ATC code J04AB02
PubChem 5360416
DrugBank APRD00207
Chemical data
O12 
Mol. mass 822.94 g/mol
Pharmacokinetic data
Bioavailability 90 to 95%
Metabolism Hepatic and intestinal wall
Half life 6 to 7 hours
Excretion 15 to 30% renal
60% faecal
Therapeutic considerations
Pregnancy cat.

C(AU)

Legal status

Prescription Only (S4)(AU) POM(UK)

Routes Oral, IV

Rifampicin (rifamycin group. It is a semisynthetic compound derived from Amycolatopsis rifamycinica (formerly known as Amycolatopsis mediterranei and Streptomyces mediterranei). Rifampicin may be abbreviated RIF, RMP, RD, RA or R.

Indications

Rifampicin is typically used to treat Mycobacterium infections, including tuberculosis and leprosy; and also has a role in the treatment of methicillin-resistant Staphylococcus aureus (MRSA) in combination with Amphotericin B in largely unsuccessful attempts to treat primary amoebic meningoencephalitis caused by Naegleria fowleri.

It is also used to treat infection by Listeria species, Neisseria gonorrhoeae, Haemophilus influenzae and Legionella pneumophila. For these non-standard indications, sensitivity testing should be done (if possible) before starting rifampicin therapy. Rifampicin clofazimine.

Enterobacteriaceae, Acinetobacter and Pseudomonas species are intrinsically resistant to rifampicin.

Mechanism of action

Rifampicin inhibits DNA-dependent blood-brain barrier.

Adverse effects

liver function tests including aspartate aminotransferase (AST).

The most common unwanted effects are fever, gastrointestinal disturbances, rashes and immunological reactions. Liver damage, associated with jaundice, has also been reported and in some rare cases has led to death.

Taking rifampicin can cause certain bodily fluids, such as urine and tears, to become orange-red in color, a benign but sometimes frightening side-effect. This may permanently stain soft contact lenses. It also may be excreted in breast milk, therefore breast feeding should be avoided.

Rifampicin is a potent inducer of hepatic hormonal contraception.

Preparations

In the U.S., rifampin is marketed as

In the UK, rifampicin is marketed as

  • Rifadin (Aventis),
  • Rimactan (Sandoz),
  • Rifater (in combination with pyrazinamide) (Aventis),
  • Rifinah (in combination with isoniazid) (Aventis)
  • Rimactazid (in combination with isoniazid) (Sandoz)

In Romania it is marketed as Sinerdol by Sicomed.

In Bulgaria it is marketed as Tubocin by Actavis/Balkanpharma. In Israel it is marketed as Rimactan (Sandoz).

References

  1. ^ Trevor A, Katzung B, Masters S (2004). Katzung and Trevor's Pharmacology. McGraw-Hill. ISBN 0-07-142290-0. 
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Antimycobacterials (Dapsone • Rifampicin
 
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