rifampin

Brand: Rifadin, Rimactane

Prototype Drug
Drug Class: antibiotic
Drug Family: antibiotic
Subclass: rifamycin / antimycobacterial
Organ Systems: infectious-disease

Mechanism of Action

Inhibits the beta subunit of bacterial DNA-dependent RNA polymerase, blocking RNA synthesis and gene transcription; bactericidal; also penetrates biofilms and kills intracellular organisms; one of the most potent CYP inducers in pharmacology.

bacterial DNA-dependent RNA polymerase (beta subunit)

Indications

  • tuberculosis (always combined — never monotherapy to prevent resistance)
  • LTBI (3-4 months with isoniazid or 4 months alone)
  • Staphylococcal prosthetic joint/device infection (adjunctive — not monotherapy)
  • meningococcal prophylaxis (close contacts)
  • Legionella (combination therapy)

Contraindications

  • concurrent saquinavir or ritonavir-boosted saquinavir
  • hypersensitivity to rifamycins

Adverse Effects

Common

  • hepatotoxicity (elevated LFTs)
  • orange-red discoloration of body fluids (urine, sweat, tears, saliva — benign, expected)
  • nausea
  • rash
  • flu-like syndrome (intermittent dosing)

Serious

  • fulminant hepatitis (rare)
  • thrombocytopenia (intermittent high-dose therapy)
  • drug interactions via CYP induction (most significant pharmacological property)

Pharmacokinetics (ADME)

Absorption Well absorbed orally (~90%); significantly reduced by food; administer on empty stomach
Distribution Protein binding 80%; Vd ~1 L/kg; excellent intracellular penetration; crosses BBB
Metabolism Hepatic hydrolysis and autoinduction of CYP3A4, CYP2C9, CYP2C19, CYP1A2, CYP2B6 — rifampin is THE most potent CYP inducer
Excretion Biliary/fecal (60%) and renal (30%)
Half-life 2–5 hours (shortens with autoinduction over 1–2 weeks)
Onset CYP induction begins within 24 hours; maximum at 5–7 days
Peak 2–4 hours
Duration 24 hours
Protein Binding 80%
Vd ~1 L/kg

Drug Interactions

Drug / Agent Mechanism Severity
warfarin CYP2C9/CYP3A4 induction reduces warfarin levels by 60–80%; requires dose doubling; major bleeding risk when stopped major
oral contraceptives CYP3A4 induction reduces estrogen/progestin levels; contraceptive failure major
antiretrovirals (protease inhibitors, integrase inhibitors) CYP3A4 induction dramatically reduces levels of most antiretrovirals major

Nursing Considerations

  1. Counsel patients that orange-red discoloration of urine, tears, sweat, and saliva is expected and harmless — but may permanently stain soft contact lenses
  2. Rifampin is the most potent CYP inducer in clinical practice — review ALL medications before initiating; critical interactions include oral contraceptives, warfarin, antiretrovirals, immunosuppressants, antifungals, and antiepileptics
  3. Administer 1 hour before or 2 hours after meals for maximum absorption; take at the same time each day
  4. For TB therapy: NEVER prescribe rifampin as monotherapy — resistance develops within days; always use in combination (RIPE regimen: Rifampin + Isoniazid + Pyrazinamide + Ethambutol)

Clinical Pearls

  • Rifampin autoinduces its own CYP3A4-mediated metabolism — within the first 1–2 weeks of therapy, its half-life shortens by 40% as autoinduction reaches maximum, requiring reassessment of dosing intervals
  • The CYP induction from rifampin persists for 2–4 weeks after stopping — drug interactions with warfarin and other narrow therapeutic index drugs must be actively managed through the washout period

Safety Profile

Pregnancy use-with-caution
Lactation use-with-caution
Renal Adjustment Not required
Hepatic Adjustment Required
TDM Not required