Rifampicin is an antibiotic which is prescribed to treat (or prevent) a variety of serious infections.
Take your doses about an hour before a meal, or wait until two hours afterwards.
Rifampicin can interfere with a number of other medicines - please let your doctor know which other medicines you are taking.
|Type of medicine||An antibiotic and antituberculosis medicine|
|Used for||The treatment or prevention of serious infections, including tuberculosis|
|Also called||Rifadin®: Rimactane®
Combination brands: rifampicin is also in Rifinah® tablets (with isoniazid); Rifater® tablets (with isoniazid and pyrazinamide); and Voractiv® tablets (with ethambutol, isoniazid and pyrazinamide)
|Available as||Capsules, tablets, oral liquid medicine, and injection|
Rifampicin is an antibiotic which is prescribed to treat a variety of serious infections. It is frequently prescribed to treat tuberculosis (TB). When prescribed in this way, it is usually prescribed as just one of a number of medicines to treat the infection. Alternatively, rifampicin can be prescribed to protect you from getting a serious infection (including TB, meningitis, or Haemophilus influenzae) because you have been in close contact with someone who has the infection.
TB 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 need to be taken for six months. As several medicines are given together to treat TB, there are some brands of rifampicin tablets which contain the medicine in combination with one or more other medicines used to treat TB. These combination brands help to reduce the total number of tablets that need to be taken each day, and are listed in the table above.
Before taking rifampicin
Some medicines are not suitable for people with certain conditions, and sometimes a medicine can only be used if extra care is taken. For these reasons, before you start taking rifampicin it is important that your doctor knows:
- If you are pregnant or breast-feeding.
- If you have any problems with how your liver works, or any problems with the way your kidneys work.
- If you have any yellowing of your skin or the whites of your eyes (jaundice).
- If you have a rare inherited blood disorder called porphyria.
- 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 the treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about rifampicin and will provide you with a full list of the side-effects which you could experience from taking it.
- There are several ways rifampicin could be prescribed for you, depending upon the reason why you are taking it. Your doctor will tell you how much to take for each dose. It is very important that you take it exactly as your doctor tells you to. Your dose will be printed on the label of the pack to remind you about what the doctor said to you, but if you are still unsure what to do, ask your pharmacist to explain it to you again. As a guide:
- 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 serious infections such as brucellosis and Legionnaires' disease.
- You may be asked to take two doses a day, for two days. This is to protect against meningitis.
- You may be asked to take one dose every day for four days. This is to protect against 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.
- Try to take your doses at the same time of day each day, as this will help you to remember to take them regularly. You should take rifampicin 'on an empty stomach'. This means that you should take your doses about an hour before a meal, or wait until two hours afterwards. This is because your body absorbs less rifampicin if taken at the same time as food, which means it is less effective.
- If you have been given rifampicin liquid medicine to give to your child, please read the directions carefully to make sure that you give the correct amount.
- If you forget to take a dose, take one as soon as you remember. Try to take the correct number of doses each day but do not take two doses at the same time to make up for a missed dose.
- You must complete the full course of treatment (unless your doctor tells you otherwise), or your infection may come back. If you are taking rifampicin for TB, a course of treatment usually lasts for around six months.
Getting the most from your treatment
- It is important that you keep your regular appointments with your doctor. This is so your doctor can check on your progress. Your doctor may want you to have some blood tests from time to time during the treatment to make sure that your blood and liver are working properly.
- There are several different brands and strengths of tablets and capsules. Each time you collect a new supply of medicine from your pharmacy, please check to make sure it looks to be the same as you have had before. If you have any questions about what you have been given, ask your pharmacist for further advice.
- Rifampicin can cause your urine and sweat to have an orange or reddish colour. This is completely harmless - it is nothing for you to worry about.
- If you wear soft contact lenses, please be aware that rifampicin can cause your lenses to become discoloured or stained. You may want to discuss this with your doctor or optician. An alternative type of contact lens may be more suitable for you, or alternatively, 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 birth control 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 a number of other medicines (including some painkillers) and stop them from working properly. Also, some medicines (such as antacids for indigestion) can 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.
- Rifampicin can stop the oral typhoid vaccine from working as it should. If you are due to have any vaccinations, please make sure that the person treating you knows that you are taking this medicine.
- If you are due to have an operation or any dental treatment, please tell the person carrying out the treatment that you are taking an antibiotic called rifampicin.
Can rifampicin cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with rifampicin. You will find a full list in the manufacturer's information leaflet supplied with the medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.
|Common rifampicin side-effects||What can I do if I experience this?|
|Feeling or being sick, tummy (abdominal) discomfort||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 for longer than 24 hours, becomes severe, or contains blood, please let your doctor know straightaway|
|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, feeling tired or dizzy||Speak with your doctor for advice if you experience any of these|
Important: if you develop persistent sickness, extreme tiredness, or any yellowing of your skin or the whites of your eyes (jaundice), you should speak with a doctor straightaway. These are rare but serious side-effects that you must tell your doctor about as soon as possible.
If you experience any other symptoms which you think may be due to the medicine, please speak with your doctor or pharmacist for further advice.
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
Do not take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
If you have any questions about this medicine ask your pharmacist.
Further reading & references
- British National Formulary; 70th Edition (Sep 2015) British Medical Association and Royal Pharmaceutical Society of Great Britain, London
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