|Type of medicine||Antibiotic and antituberculosis medicine|
|Used for||Serious infections, including tuberculosis|
|Also called||Rifadin®, Rimactane®
Rifampicin is also in Rifinah® tablets (with isoniazid) and Rifater® tablets (with isoniazid and pyrazinamide)
|Available as||Capsules, tablets, oral liquid, and injection
Rifampicin is an antibiotic used to treat infections, including tuberculosis (TB). It is usually prescribed as one of a number of medicines to treat the infection. You may have been prescribed it for this reason. Alternatively, you may have been prescribed it to protect you from a serious infection caused by certain bacteria. Rifampicin works by stopping the bacteria causing the infection from growing and multiplying.
Tuberculosis is a bacterial infection which is mostly found in the lungs but which can affect any part of your body. TB is treatable with a course of medicines which usually last six months. Several medicines are given together to treat TB. There are some brands of tablets available which contain rifampicin in combination with one or more of the other medicines used to treat TB.
Before taking rifampicin
Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking rifampicin it is important that your doctor or pharmacist knows:
- If you are pregnant, trying for a baby or breast-feeding. (You can take rifampicin if you are having a baby or breast-feeding, but it is important that your doctor knows about this.)
- If you drink a lot of alcohol.
- If you have any problems with your liver or kidneys.
- If you have had jaundice (yellowing of your skin or the whites of your eyes).
- If you have porphyria. (This is a rare inherited blood disorder.)
- If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, such as herbal and complementary medicines.
- If you have ever had an allergic reaction to a medicine.
How to take rifampicin
- Before you start this treatment, read the manufacturer's printed information leaflet from inside your pack. The leaflet will give you more information about the specific brand of rifampicin you have been given, and a full list of side-effects which you may experience from taking it.
- There are several ways rifampicin may be prescribed for you. Your doctor will tell you which way is right for you, and also how many capsules or tablets to take for each dose. It is very important you take rifampicin exactly as you have been told. Your dose will be on the label of the pack to remind you, but if you are still unsure what to do, ask your pharmacist to explain it to you again.
- You may be asked to take one dose a day. This is the standard treatment for TB.
- You may be asked to take one dose three times a week while you are being supervised. This is called directly observed therapy (DOT) for TB.
- You may be asked to take one dose several times a day. This is the treatment for infections such as brucellosis and legionnaires' disease.
- You may be asked to take one or two doses every day for 2-4 days. This is to protect against infections such as meningitis and Haemophilus influenzae.
- You may be asked to take one dose once a month while you are being supervised. This is the standard dose for leprosy.
- You should take rifampicin 'on an empty stomach'. This means you should take it about an hour before a meal, or wait until two hours afterwards. This is because your body absorbs less rifampicin after a meal, which means it is less effective. Also, try to take your doses at the same time of day each day, as this will help you to remember to take them.
- If you do forget to take a dose, take it as soon as you remember. If it is almost time to take your next dose, skip the missed dose and take your next dose when it is due. Do not take two doses together to make up for a forgotten dose.
- You must complete the course of rifampicin (unless your doctor tells you otherwise) or your infection may come back. If you are taking it for TB, the course of treatment will last at least six months.
Getting the most from your treatment
- It is important you keep your regular appointments with your doctor. This is so your doctor can check on your progress. Your doctor may want to do some blood tests before and during this treatment. The tests will check that your liver is working properly.
- There are several different brands and strengths of rifampicin. Each time you collect a new supply of this medicine from your pharmacy, make sure it looks to be the same as you have had before. If you are unsure, ask your pharmacist to check for you.
- This medicine may cause your urine and sweat to turn reddish. This is harmless and nothing for you to worry about.
- If you wear soft contact lenses, rifampicin may cause your lenses to become discoloured. If this affects you, speak with your doctor or optician about this, as you may be advised to wear glasses instead.
- Make sure you have discussed with your doctor which types of contraception are suitable for you and your partner. The contraceptive effect of 'the pill', 'mini pill', contraceptive patches and vaginal rings is reduced by rifampicin and so these on their own are not suitable types of contraception while you are on rifampicin.
- If you buy any medicines, check with a pharmacist that they are suitable for you to take. This is because rifampicin can interfere with some medicines (for example, some painkillers) and stop them from working properly. Also, some medicines (such as antacids for indigestion) may stop rifampicin from working properly and must not be taken at the same time.
- If for any reason you miss any doses, you should let your doctor know about this. If your treatment is interrupted for any length of time, your doctor may want to adjust your dose.
- This antibiotic may stop the oral typhoid vaccine from working. If you are having any vaccinations, make sure the person treating you knows that you are taking this medicine. Also, if you are having an operation or dental treatment, you should tell the person carrying out the treatment that you are taking rifampicin.
- If you have diabetes, you may need to monitor your blood glucose levels more frequently. Your doctor will be able to advise you about this.
Can rifampicin cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. These usually improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following side-effects continue or become troublesome.
|Common rifampicin side-effects||What can I do if I experience this?|
|Feeling or being sick, loss of appetite||Stick to simple or bland meals (avoid rich and spicy foods)|
|Diarrhoea||Drink plenty of water to replace any lost fluids. If the diarrhoea continues or becomes severe, speak with your doctor straightaway|
|Feeling sleepy or weak||If this happens, do not drive or use tools or machines|
|Headache||Ask your pharmacist to recommend a suitable painkiller. If the headache continues, speak with your doctor|
|Flu-like symptoms, feeling short of breath, flushing, skin rashes, or itching||Speak with your doctor if you experience any of these|
Important: Your doctor will have discussed with you the possibility of unwanted side-effects of treatment with rifampicin. If you start vomiting, feel generally unwell or develop jaundice (yellowing of your skin or the whites of your eyes) you must contact your doctor straightaway as you will need to stop taking rifampicin and have your treatment changed.
If you experience any other symptoms which you think may be due to this medicine, speak with your doctor or pharmacist.
How to store rifampicin
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
Important information about all medicines
Further reading & references
- British National Formulary; 63rd Edition (Mar 2012) British Medical Association and Royal Pharmaceutical Society of Great Britain, London
- Manufacturer's PIL, Rifadin® 150 mg Capsules; sanofi-aventis, The electronic Medicines Compendium. Dated November 2010.
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.
Dr John Cox