Rifampin can be administered by the oral route or by IV infusion (see
INDICATIONS AND USAGE). IV doses are the same as those for oral.
See CLINICAL PHARMACOLOGY for dosing information in patients with renal failure.
Tuberculosis
Adults: 10 mg/kg, in a single daily administration, not to
exceed 600 mg/day, oral or IV
Pediatric Patients: 10–20 mg/kg, not to exceed 600 mg/day, oral
or IV
It is recommended that oral rifampin be administered once daily, either 1 hour
before or 2 hours after a meal with a full glass of water.
Rifampin is indicated in the treatment of all forms of tuberculosis. A
three-drug regimen consisting of rifampin, isoniazid, and pyrazinamide (eg,
RIFATER®) is recommended in the initial phase of short-course therapy which is
usually continued for 2 months. The Advisory Council for the Elimination of
Tuberculosis, the American Thoracic Society, and the Centers for Disease Control
and Prevention recommend that either streptomycin or ethambutol be added as a
fourth drug in a regimen containing isoniazid (INH), rifampin and pyrazinamide
for initial treatment of tuberculosis unless the likelihood of INH resistance is
very low. The need for a fourth drug should be reassessed when the results of
susceptibility testing are known. If community rates of INH resistance are
currently less than 4%, an initial treatment regimen with less than four drugs
may be considered.
Following the initial phase, treatment should be continued with rifampin and
isoniazid (eg, RIFAMATE®) for at least 4 months. Treatment should be continued
for longer if the patient is still sputum or culture positive, if resistant
organisms are present, or if the patient is HIV positive.
Meningococcal Carriers Adults: For adults, it is recommended that 600 mg rifampin be
administered twice daily for two days.
Pediatric Patients: Pediatric patients 1 month of age or older:
10 mg/kg (not to exceed 600 mg per dose) every 12 hours for two days.
Pediatric patients under 1 month of age: 5 mg/kg every 12 hours
for two days.
Renal Dosing
The half-life does not differ in patients with renal failure at
doses not exceeding 600 mg daily, and consequently, no dosage adjustment
is required. The half-life of rifampin at a dose of 720 mg daily has not
been established in patients with renal failure. Following a single 900
mg oral dose of rifampin in patients with varying degrees of renal
insufficiency, the mean half-life increased from 3.6 hours in healthy
adults to 5.0, 7.3, and 11.0 hours in patients with glomerular
filtration rates of 30 to 50 mL/min, less than 30 mL/min, and in anuric
patients, respectively.
Hemodialysis
See comments above.
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