Bula do remedy Rifampicin

the package insert of the medicine Rifampin. Therapeutic class of the Antibiotics. Active principles Rifampin.

what For?

rifampin is indicated in the treatment of various forms of tuberculosis and leprosy caused by micro-organisms sensitive, always in association with other antibiotics. It is also indicated in the prevention in individuals who have had close contact with patients with meningitis.

Use the adult and paediatric – oral Use.

Pharmacokinetics

How it works?

Rifampicin acts by inhibiting the multiplication of bacteria sensitive to this drug.

Dosage

How to use?

the Treatment of pulmonary tuberculosis and extra-pulmonary:

    the

  • Patients with a weight less than 20 kg: 10 mg/kg of body weight a day (a child of 10 kg weight, for example, will receive 5 ml of the oral suspension).
  • the

  • Patients with more than 20 kg of weight up to 35 kg: 300 mg/day (one capsule of 300 mg or 15 ml of oral suspension).
  • the

  • Patients with more than 35 kg of weight up to 45 kg: 450 mg/day (one capsule of 300 mg, and 7.5 ml or 22,5 ml of oral suspension).
  • the

  • Patients with more than 45 kg: 600 mg/day (two capsules of 300 mg or 30 ml of oral suspension).

The duration of treatment is six months, always in combination with other drugs for the treatment of tuberculosis.

tuberculosis meningoencefálica doses of rifampicin following the same scheme as above but has a duration of 9 months.

For the prevention of meningococcal disease (meningitis or non-tuberculous), the dose is equal to the quoted for tb meningitis, during only two days.

The newly-born form an exception because they should receive 5 mg/kg of body weight, twice a day, for two days.

Leprosy:

    the

  • the monthly Dose of 600 mg (two capsules) or 30 ml oral suspension for adults, always under a combined basis.
  • the

  • in adult Patients with less than 35 kg should receive doses monthly of 450 mg.
  • the

  • Children can receive doses equivalent to 10 mg/kg, provided they do not exceed the doses mentioned above.

preferably, the drug should be taken one hour before or two after meals.

The bottle of the suspension should always be shaken before use, and after opening should be kept tightly closed.

The capsules can not be broken or chewed.

Side Effects

What are the evils that can cause me?

The most common side effects are: loss of appetite, nausea, vomiting, and diarrhea. Can occur colitis (intestinal inflammation) associated with the use of the antibiotic. Can also occur changes in the skin (redness of the face, hives and rashes), pancreatitis (inflammation of the pancreas), jaundice (yellowing of the skin and/or eyes), failure of the liver (liver problem), the presence of spots or red patches on the skin, bleeding from nose or gums, vaginal bleeding, anemia by destruction of red blood cells, flu-like symptoms (such as fever, weakness, headache, tremors, and muscle pain) and serious problems in the kidneys, with the loss of the body and shock, disorders of the central nervous system (mental confusion, disturbances of motor coordination, visual changes, transient), neuritis peripheral (inflammation of the peripheral nerves) and venous thrombosis (formation of clots inside the veins).

Can arise even reddish in color and brown urine, feces, saliva, sweat, and tears.

Other side effects include chills, shortness of breath, dizziness, muscle pain, tremors, and hematuria (urine in blood).

Contraindications

When should I not use?

Rifampin should not be used in patients with a history of allergy to rifampicin or the other drugs of the group of rifampicinas or any other component of the product.

Some patients who have serious illnesses of the liver or kidneys can not use rifampicin, it is up to your doctor to assess the risk-benefit ratio. Concomitant use with oral contraceptives or drugs hepatotoxic.

Warnings and Precautions

what should I know before using?

should Not be used alone for the treatment of tuberculosis and leprosy.

The use of rifampicin may cause a red coloration of urine, saliva, tears and soft contact lenses, being that the latter can tarnish in a definitive character.

In some patients it may occur an increase of bilirubin and other substances in the blood that can be transitive without requiring completion of treatment, the doctor will evaluate each case.

Some patients who have serious illnesses of the liver or kidneys can not use rifampicin, it is up to your doctor to evaluate.

Avoid use of alcoholic beverages during the treatment.

capsules and suspension should be taken on an empty stomach, preferably one hour before or two after meals. In case of discomfort the digestive, it is recommended to administer together with a light meal.

Attention: this medicine in the presentation of oral suspension contains sugar , therefore should be used with caution in patients with diabetes.

Rifampin in pregnancy and lactation: immediately tell your doctor the occurrence of pregnancy during treatment or after its termination.

Tell your doctor if you are breast-feeding.

This medicine should not be used by pregnant or nursing women without the guidance of the doctor or surgeon-dentist.

The use must be cautious in patients with problems in the liver and kidneys, because they present a greater risk of made toxic. In these cases, the treatment should only be employed in case of real necessity and under medical supervision.

Drug Interactions

The absorption of rifampicin is reduced when taken along with food.

antacids and ketoconazole reduce the absorption of rifampicin, therefore, must be taken at times separated by at least two hours.

Many of the drugs have their action lowered by the concomitant use with rifampicin. They are: diazepam, quinidine, disopyramide, chloramphenicol, dapsone, cumarinas, warfarin reduces the anticoagulant effect), imipramine, clomipramine, carbamazepine, phenytoin, (which makes it difficult the control of epilepsy), fluconazole, itraconazole, ketoconazole, haloperidol, propranolol, diltiazem, nifedipino, verapamil, isradipino, nisoldipino, cyclosporine, azathioprine (use with rifampicin possibly leads to rejection of transplants), corticosteroids (prednisone), levothyroxine, tacrolimus, theophylline, methadone, digoxin, paracetamol, clofibrate, amitriptyline, and nortriptyline.

Estrogens in combination with progestogens or progestogens (oral contraceptive): if it reduces the contraceptive effect, requiring the use of other methods to avoid pregnancy.

The use of antiretrovirals such as indinavir, nelfinavir, saquinavir, efavirenz, and nevirapine, rifampicin can increase the risk of reactions. The associated use of rifampin with ritonavir and saquinavir has a high risk of causing toxic effects in the liver.

The reduction in the effect of clorpropamida, tolbutamide, and, possibly, other oral anti-diabetics may hinder the control of the disease.

The concomitant use of rifampicin with trimethoprim may increase the elimination of this damaging the effectiveness. The employment along with the miconazole may increase the risk of injury in the liver.

The herb St.-John can decrease the action of rifampicin. Avoid taking it during the treatment.

Alcohol: the daily consumption of alcohol may increase the risk of toxic effects and metabolism of rifampin.

The plasma concentrations of ALT, AST, alkaline phosphatase, bilirubin, urea and uric acid (blood tests) may be increased.

Overdose

what to do if someone use a larger amount than is recommended?

The use of large doses of rifampicin may cause staining of the skin-tone orange red, swelling around the eyes or on the face, itching, nausea, vomiting, diarrhea and other manifestations such as those described in the previous item.