Description of the active substance:
This information is a reference and it is not enough that the drug has been prescribed by a doctor ..
PHARMACHOLOGIC EFFECT
A semi-synthetic broad-spectrum antibiotic of the rifamycin group. Has a bactericidal effect. Suppresses the synthesis of bacterial RNA by inhibiting the DNA-dependent RNA polymerase of the pathogen.
Highly active against Mycobacterium tuberculosis, is an anti-tuberculosis drug of the I series.
It is active against gram-positive bacteria: Staphylococcus spp. (including multidrug resistant), Streptococcus spp., Bacillus anthracis, Clostridium spp., and also for certain gram-negative bacteria: Neisseria meningitidis, Haemophilus influenzae, Brucella spp., Legionella pneumophila.
It is active against Rickettsia prowazekii, Mycobacterium leprae, Chlamydia trachomatis.
Resistance to rifampicin develops rapidly. Cross-resistance to other anti-tuberculosis drugs (except for the other rifamycins) was not noted.
PHARMACOKINETICS
After oral administration, it is well absorbed from the digestive tract. It is distributed in most tissues and body fluids. Penetrates through the placental barrier. Binding to plasma proteins is high (89%). Metabolised in the liver. T 1/2 is 3-5 hours. It is excreted with bile, feces and urine.
INDICATIONS
Tuberculosis (including tuberculous meningitis) as part of combination therapy. MAS infection. Infectious-inflammatory diseases caused by susceptible to rifampicin pathogens (including osteomyelitis, pneumonia, pyelonephritis, leprosy, meningococcal carriage).
DOSING MODE
When administered to adults and children - 10 mg / kg 1 time / day or 15 mg / kg 2-3 times a week. Take on an empty stomach, the duration of treatment is set individually.
In / in adults - 600 mg 1 time / day or 10 mg / kg 2-3 times a week, children - 10-20 mg / kg 1 time / day or 2-3 times a week.
It is possible to introduce 125-250 mg into the pathological focus (by inhalation, intracavitary administration, and also introduction into the lesion lesion focus).
Maximum doses: when administered orally for adults, the daily dose is 1.2 g, for children 600 mg, with IV in the introduction for adults and children - 600 mg.
SIDE EFFECT
On the part of the digestive system: nausea, vomiting, diarrhea, decreased appetite; increased levels of hepatic transaminases, bilirubin in blood plasma, pseudomembranous colitis, hepatitis.
Allergic reactions: urticaria, Quincke's edema, bronchospasm, flu-like syndrome.
From the hemopoietic system: rarely - thrombocytopenia, thrombocytopenic purpura, eosinophilia, leukopenia, hemolytic anemia.
From the side of the central nervous system: headache, ataxia, impaired vision.
From the side of the urinary system: necrosis of the kidneys, interstitial nephritis, acute renal failure.
From the endocrine system: a menstrual cycle.
Other: reddish brown staining of urine, feces, saliva, sputum, sweat, tears.
CONTRAINDICATIONS
Jaundice, recently transferred (less than 1 year) infectious hepatitis, severe renal dysfunction, increased sensitivity to rifampicin or other rifamycins.
PREGNANCY AND LACTATION
If rifampicin is necessary in pregnancy, the estimated benefit of therapy for the mother and the potential risk to the fetus should be assessed.
It should be borne in mind that the use of rifampicin in the last weeks of pregnancy increases the risk of bleeding in newborns and mothers in the postpartum period.
Rifampicin is excreted in breast milk. If necessary, use during lactation should stop breastfeeding.
APPLICATION FOR FUNCTIONS OF THE LIVER
Contraindicated in severe impairment of kidney function.
APPLICATION FOR VIOLATIONS OF THE FUNCTION OF KIDNEYS
Contraindicated in jaundice, recently transferred (less than 1 year) infectious hepatitis.
APPLICATION FOR CHILDREN
In newborns and premature infants, rifampicin is used only in cases of extreme need.
SPECIAL INSTRUCTIONS
Use with caution in diseases of the liver, exhaustion. In the treatment of non-tuberculosis infections, the rapid development of resistance of microorganisms is possible; this process can be prevented by combining rifampicin with other chemotherapeutic agents. With daily administration of rifampicin, its tolerability is better than with intermittent treatment. If it is necessary to resume treatment with rifampicin after a break, you should start with a dose of 75 mg / day, gradually increasing it by 75 mg / day until the desired dose is achieved. In this case, kidney function should be monitored; additional assignment of GCS is possible.
With long-term use of rifampicin, systematic monitoring of blood and liver function is indicated; It is not possible to use a sample with bromosulfalein load, since rifampicin competitively inhibits its excretion.
PASK preparations containing bentonite (aluminum hydrosilicate) should be prescribed no earlier than 4 hours after taking rifampicin.
In newborns and premature infants, rifampicin is used only in cases of extreme need.
DRUG INTERACTION
Due to the induction of microsomal liver enzymes (isoenzymes CYP2C9, CYP3A4), rifampicin accelerates the metabolism of theophylline, oral anticoagulants, oral hypoglycemic drugs, hormonal contraceptives, digitalis preparations, verapamil, phenytoin, quinidine, GCS, chloramphenicol, antifungal agents, which leads to a decrease in their plasma concentrations blood and, accordingly, to a decrease in their action.
