Rifampicin

MEDICATION TYPE

Antibiotic

INDICATIONS

Treatment and prophylaxis of Tuberculosis but always as a combination with other drugs. Used for the treatment of severe Staphylococcal pneumonia. Used as part of MRSA eradication protocol.

DRUG INTERACTIONS

Antacids
Reduced absorption of rifampicin.

Anti-Arrythmics
Their metabolism is increased by rifampicin.

Antidepressants (tricyclics)
Metabolism is increased by rifampicin for some agents.

Antiepileptics (lamotrigine, phenytoin)
Metabolism is increased by rifampicin.

Antifungal (itraconazole, ketoconazole,fluconazole)
Metabolism is increased by rifampicin and concentration of rifampicin may be reduced by ketoconazole. Plasma concentration of rifabucin increased by fluconazole.

Beta blockers
Metabolism is increased by rifampicin.

Calcium channel blockers
Metabolism is increased by rifampicin.

Chloramphenicol
Metabolism is increased by rifampicin.

Cimetidine
Metabolism is increased by rifampicin.

Clarithromycin and other macrolides
Increase plasma concentration of rifabutin.

Corticosteroids
Metabolism is increased by rifampicin. Double the steroid dose.

Cyclosporin
Metabolism is increased by rifampicin.

Haloperidol
Rifampicin accelerates metabolism.

Levothyroxine
Metabolism is increased by rifampicin.

Methadone
Increased metabolism of methadone.

Mycophenolate
Reduces plasma concentration.

Oral contraceptive
Metabolism is increased by rifampicin. Inform patient.

Posaconazole
Rifampicin reduces plasma concentration.

Rosiglitazone
Reduces plasma concentration. Consider increasing dose of rosiglitazone.

Sulphonylureas
Metabolism is increased by rifampicin.

Tacrolimus, Sirolimus
Metabolism is increased by rifampicin.

Theophylline
Metabolism is increased by rifampicin.

Voriconazole
Plasma concentration decreased by rifampicin ; avoid concomitant use.

Warfarin
Metabolism is increased by rifampicin.

NOTES

Potent CYP inducer — many interactions (e.g. tacrolimus, contraceptives).