RIFADIN IV Rx
Generic Name and Formulations:
Rifampin 600mg/vial; lyophilized pwd for IV infusion after reconstitution.
Indications for RIFADIN IV:
Initial treatment and retreatment of susceptible tuberculosis, when oral therapy is not feasible.
10mg/kg once daily; max 600mg/day. Caps: give 1hr before or 2hrs after meals with water. IV: infuse over 30mins (100mL) or within 3hrs (500mL). Initial phase: treat for up to 2 months with isoniazid and pyrazinamide (streptomycin or ethambutol may be added as fourth drug if resistance to isoniazid exists). After initial phase, continue rifampin with isoniazid for at least 4 months; longer if sputum or culture remains (+), with resistant organisms, or HIV (+).
10–20mg/kg once daily; max 600mg/day. Caps: give 1hr before or 2hrs after meals with water. IV: infuse over 30mins (100mL) or within 3hrs (500mL). Initial phase: treat for up to 2 months with isoniazid and pyrazinamide (streptomycin or ethambutol may be added as fourth drug if resistance to isoniazid exists). After initial phase, continue rifampin with isoniazid for at least 4 months; longer if sputum or culture remains (+), with resistant organisms, or HIV (+). Preparation of suspension: see full labeling.
Concomitant ritonavir-boosted saquinavir (increased risk of severe hepatotoxicity). Concomitant atazanavir, darunavir, fosamprenavir, saquinavir, tipranavir. Rifamycin hypersensitivity.
Not recommended for intermittent therapy (risk of renal hypersensitivity reactions; rare). Monitor for hypersensitivity reactions (eg, DRESS); discontinue if occur. Hepatic impairment; monitor LFTs at baseline, then every 2–4 weeks. Discontinue if signs of hepatocellular damage occurs. Diabetes. May stain teeth, body secretions, contact lenses. IV: avoid extravasation. Elderly. Pregnancy (Cat.C). Nursing mothers: not recommended.
See Contraindications. Antagonizes anticonvulsants, digitoxin, antiarrhythmics, oral anticoagulants (monitor prothrombin time), azole antifungals, barbiturates, β-blockers, CCBs, chloramphenicol, clarithromycin, corticosteroids, cyclosporine, cardiac glycosides, clofibrate, oral or other hormonal contraceptives (consider nonhormonal methods), dapsone, diazepam, doxycycline, fluoroquinolones, haloperidol, sulfonylureas, levothyroxine, methadone, narcotic analgesics, progestins, quinine, tacrolimus, theophylline, tricyclic antidepressants, zidovudine, atovaquone, enalapril, sulfasalazine; may need to adjust dose. May be potentiated by atovaquone, probenecid, cotrimoxazole. May be antagonized by ketoconazole. Separate dosing of antacids by at least 1hr. Avoid concomitant halothane. May cause false (+) urine tests for opiates. May inhibit assays for serum folate and Vit. B12 (consider alternative methods). Perform LFTs and use contrast media prior to morning dose.
GI disturbances, jaundice, headache, fever, drowsiness, fatigue, ataxia, dizziness, inability to concentrate, mental confusion, muscular weakness, pain in extremities, generalized numbness, visual disturbances, elevated BUN and serum uric acid, menstrual disturbances, urticaria, rash, edema; rare: hepatitis, abnormal LFTs, blood dyscrasias, hypersensitivity reactions.
Caps 150mg—30; 300mg—60, 100; Vials—1
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