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Rifampicin

Rifampicin

It is highly bacteriocidal to Mycobacterium tuberculosis. Administered orally quick absorption leads to high and well sustained blood levels. Its use in combination with various other anti-tubercular drugs which is considered highlzy effective. Amino salicylic acid may delay absorption of Rifampicin, and if given concurrently, they should be given separately at an interval of 8 to 12 hours.

Indications

Treatment of tuberculosis


Dosage

Adult: (below 50 kg : 450 mg daily as a single dose. More than 50 kg : upto 600 mg daily. Children:10-15 mg/kg body wt. daily as a single dose.


Contra-Indications

It should not be given to patients who have experienced drug induced liver disease earlier - which may include Jaundice or biliary obstruction.


Special Precautions

Impaired liver functions. Concurrent administration of anticoagulants or oral contraceptives with Rifampicin is to be avoided. Faeces, saliva, sputum, sweat, tears and urine may be discoloured orange red, due to Rifampicin. It is to be used with caution in malnourished or very young patients. Paediatrics: Reduced dose necessary. Pregnancy: Contraindicated. Lactation: Use with caution. Elderly: Reduced dose necessary because of adverse effects.


Side Effects

May include nausea, vomiting, skin rash, peripheral neuropathy and liver impairment.


Drug Interactions

Blood levels lowered by phenobarbitone, phenytoin. Increase in blood levels with probenecid. Decreases effect of tolbutamide, clofibrate, coumarin anticoagulants, diazepam, oral contraceptives. Reduces levels of metoprolol, norethisterone, quinidine. Severe hepatitis when combined with isoniazid. Reduced efficacy of corticosteroids in Addison's disease . Liver enzyme induction affects metabolism of chloramphenicol corticosteroids, clofibrate, cyclosporin, dapsone, digoxin, hexobarbitone, ketoconazole, quinidine and verapamil.


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