Active tuberculosis
Active tuberculosis - HIV infection
Bartonellosis - HIV infection
Brucellosis; Adjunct
Cholestasis - Pruritus
HIV infection - Inactive tuberculosis
Human anaplasmosis
Inactive tuberculosis
Infective endocarditis
Leprosy
Meningococcal infectious disease, Carrier
Mycobacterium avium complex infection, Lung disease
Reactivation tuberculosis
Staphylococcal infectious disease, For synergy
Tuberculosis, Extrapulmonary

a semisynthetic broad-spectrum bactericidal antibiotic, inhibits bacterial RNA synthesis by binding strongly to the beta subunit of DNA-dependent RNA polymerase, preventing attachment of the enzyme to DNA, and thus blocking initiation of RNA transcription

Metabolism
Active metabolite: 25-O-desacetylrifampin [30]
Excretion
Systemic: Biliary/fecal; enterohepatic recirculation of rifampin, but not of its deacetylated active metabolite [29]; 60 to 65% of dose appears in feces [29].
Renal; 6 to 15% excreted as unchanged drug, and 15% excreted as active metabolite in urine; 7% excreted as inactive 3-formyl derivative [29].
Rifampin does not accumulate in patients with impaired renal function [29]; its rate of excretion is increased during the first 6 to 10 days of therapy, probably because of auto-induction of hepatic microsomal oxidative enzymes; after high doses, excretion may be slower because of saturation of its biliary excretory mechanism.
In dialysis: Rifampin is not removed from the blood by either hemodialysis or peritoneal dialysis.
Systemic: Rifampin- Fecal: 60 to 65%; Renal: 6 to 15% unchanged 25-O-desacetylrifampin- Renal: 15% [29]
Elimination Half Life
Systemic: 3 to 5 h[30]

concomitant use with atazanavir, darunavir, fosamprenavir, saquinavir (unboosted or ritonavir-boosted), or tipranavir [24]
concomitant use with rilpivirine or elvitegravir/cobicistat [25]
hypersensitivity to rifampin, any component of the product, or any of the rifamycins [24]

C] (FDA)
C (AUS)

AAP: Maternal medication usually compatible with breastfeeding.[35]
WHO: Compatible with breastfeeding.[36]
Micromedex: Infant risk is minimal.

Cardiovascular: Decreased blood pressure, flushing, shock, vasculitis
Central nervous system: Ataxia, behavioral changes, confusion, dizziness, drowsiness, fatigue, headache, lack of concentration, myasthenia, numbness, peripheral pain, sore mouth
Dermatologic: Erythema multiforme, pemphigoid reaction, pruritus, skin rash, Stevens-Johnson syndrome, toxic epidermal necrolysis, urticaria
Endocrine & metabolic: Adrenocortical insufficiency, menstrual disease
Gastrointestinal: Abdominal cramps, anorexia, dental discoloration, diarrhea, epigastric distress, flatulence, glossalgia, heartburn, nausea, vomiting
Genitourinary: Hemoglobinuria, hematuria
Hematologic & oncologic: Decreased hemoglobin, disseminated intravascular coagulation, eosinophilia, hemolysis, hemolytic anemia, leukopenia, thrombocytopenia (especially with high-dose therapy)
Hepatic: Abnormal hepatic function tests, hepatic insufficiency, hyperbilirubinemia, jaundice
Immunologic: DRESS Syndrome
Neuromuscular & skeletal: Myopathy
Ophthalmic: Conjunctivitis, visual disturbance
Renal: Acute renal failure, interstitial nephritis, renal insufficiency, renal tubular necrosis
Respiratory: Dyspnea, flu-like symptoms, wheezing
Miscellaneous: Fever

Active tuberculosis
Intensive phase: 600 mg (about 10 mg/kg) orally/IV once daily for 8 weeks (56 doses) or 5 days per week for 8 weeks (40 doses); give in combination with isoniazid 300 mg (about 5 mg/kg) orally/IM once daily; pyrazinamide 1000 mg (40 to 55 kg), 1500 mg (56 to 75 kg), or 2000 mg (76 to 90 kg) orally once daily or 5 days/week; and ethambutol 800 mg (40 to 55 kg), 1200 mg (56 to 75 kg), or 1600 mg (76 to 90 kg) orally once daily or 5 days/week (guideline dosage) [5].
Continuation phase, once daily regimen: 600 mg (about 10 mg/kg) orally/IV once daily for 4 months (126 doses); give in combination with isoniazid 300 mg (about 5 mg/kg) orally/IM once daily (guideline dosage) [5].
Continuation phase, 3 times weekly regimen: 600 mg (about 10 mg/kg) orally/IV 3 days/week for 4 months (54 doses); give in combination with isoniazid 900 mg (about 15 mg/kg) orally/IM 3 days/week, on same days rifampin is administered (guideline dosage) [5].
Active tuberculosis - HIV infection
Intensive phase: 600 mg (about 10 mg/kg) orally/IV once daily for 8 weeks (56 doses); give in combination with isoniazid 300 mg (about 5 mg/kg) orally/IM once daily; pyrazinamide 1000 mg (40 to 55 kg), 1500 mg (56 to 75 kg), or 2000 mg (76 to 90 kg) orally once daily; and ethambutol 800 mg (40 to 55 kg), 1200 mg (56 to 75 kg), or 1600 mg (76 to 90 kg) orally once daily. Additionally, administer pyridoxine 25 to 50 mg orally once daily (guideline dosage) [6][5].
Continuation phase: 600 mg orally/IV once daily for 4 months (126 doses); give in combination with isoniazid 300 mg (about 5 mg/kg) orally/IM once daily. Additionally, administer pyridoxine 25 to 50 mg orally once daily (guideline dosage) [6][5].
Bartonellosis - HIV infection
(CNS infection or severe infections) 300 mg ORALLY or IV every 12 hours plus doxycycline 100 mg ORALLY or IV every 12 hours for 4 months [8]
Brucellosis; Adjunct
15 to 20 mg/kg/day ORALLY/IV in 1 or 2 divided doses for at least 6 weeks in combination with a tetracycline; MAX 600 to 900 mg/day (guideline dosing) [9]
Cholestasis - Pruritus
300 to 600 mg/day orally or 10 mg/kg orally for 7 to 14 days (Off-label dosage) [10]
HIV infection - Inactive tuberculosis
600 mg orally daily for 4 months (guideline dosage) [8]
Human anaplasmosis
(in patients with mild human granulocytic anaplasmosis (HGA) illness without concomitant Lyme disease and intolerant of doxycycline, or during pregnancy) 300 mg ORALLY twice daily for 7 to 10 days [11]
Inactive tuberculosis
Initial, 10 mg/kg/day (in combination with isoniazid and pyrazinamide) oral/IV once daily for 2 months; MAX, 600 mg/day; then 10 mg/kg/day (in combination with isoniazid) once daily for 4 months or longer as needed [12][13]
Infective endocarditis
(Prosthetic valve, oxacillin-susceptible staphylococci) 300 mg IV or orally every 8 hours for at least 6 weeks plus nafcillin or oxacillin 12 g/day IV given in 6 divided doses for at least 6 weeks plus gentamicin 3 mg/kg/day IV/IM given in 2 or 3 divided doses for the first 2 weeks of therapy (guideline dosage) [14]
(Prosthetic valve, oxacillin-resistant staphylococci) 300 mg IV or orally every 8 hours for at least 6 weeks plus vancomycin 30 mg/kg/day IV given in 2 divided doses for at least 6 weeks plus gentamicin 3 mg/kg/day IV/IM given in 2 or 3 divided doses for the first 2 weeks of therapy (guideline dosage) [14]
Leprosy
600 mg ORALLY or IV once daily, in combination with dapsone, with or without clofazimine
Meningococcal infectious disease, Carrier
600 mg ORALLY twice daily for 2 days; MAX dose, 600 mg [12]
Mycobacterium avium complex infection, Lung disease
(nodular/bronchiectatic disease) initial, 600 mg ORALLY 3 times weekly in combination with clarithromycin 1000 mg or azithromycin 500 to 600 mg ORALLY 3 times weekly plus ethambutol 25 mg/kg ORALL

Active tuberculosis
(Younger than 15 years and 40 kg or less) Intensive phase: 10 to 20 mg/kg orally/IV once daily for 8 weeks (56 doses) or 5 days/week for 8 weeks (40 doses); give in combination with isoniazid 10 to 15 mg/kg orally/IM once daily or 5 days/week, pyrazinamide 30 to 40 mg/kg orally once daily or 5 days/week, and ethambutol 15 to 25 mg/kg orally once daily or 5 days/week (guideline dosage) [5].
(Younger than 15 years and 40 kg or less) Continuation phase, once daily regimen: 10 to 20 mg/kg orally/IV for 4 months; give in combination with isoniazid 10 to 15 mg/kg orally/IM once daily (guideline dosage) [5].
(15 years or older or greater than 40 kg) Intensive phase: 600 mg (about 10 mg/kg) orally/IV once daily for 8 weeks (56 doses) or 5 days per week for 8 weeks (40 doses); give in combination with isoniazid 300 mg (about 5 mg/kg) orally/IM once daily or 5 days/week; pyrazinamide 1000 mg (40 to 55 kg), 1500 mg (56 to 75 kg), or 2000 mg (76 to 90 kg) orally once daily or 5 days/week; and ethambutol 800 mg (40 to 55 kg), 1200 mg (56 to 75 kg), or 1600 mg (76 to 90 kg) orally once daily or 5 days/week (guideline dosage) [5].
(15 years or older or greater than 40 kg) Continuation phase, once daily regimen: 600 mg (about 10 mg/kg) orally/IV once daily for 4 months (126 doses); give in combination with isoniazid 300 mg (about 5 mg/kg) orally/IM once daily (guideline dosage) [5].
(15 years or older or greater than 40 kg) Continuation phase, 3 times weekly regimen: 600 mg (about 10 mg/kg) orally/IV 3 days/week for 4 months (126 doses); give in combination with isoniazid 900 mg (about 15 mg/kg) orally/IM 3 days/week, on same days rifampin is administered (guideline dosage) [5].
Active tuberculosis - HIV infection
(Younger than 15 years and 40 kg or less) Intensive phase: 10 to 20 mg/kg orally/IV once daily for 8 weeks (56 doses); give in combination with isoniazid 10 to 15 mg/kg orally/IM once daily, pyrazinamide 30 to 40 mg/kg orally once daily, and ethambutol 15 to 25 mg/kg orally once daily [5]. Additionally, administer pyridoxine 1 to 2 mg/kg (MAX 50 mg) orally once daily (guideline dosage) [16].
(Younger than 15 years and 40 kg or less) Continuation phase: 10 to 20 mg/kg orally/IV once daily for 4 [5] or 7 months [16]; give in combination with isoniazid 10 to 15 mg/kg orally/IM once daily [5]. Additionally, administer pyridoxine 1 to 2 mg/kg (MAX 50 mg) orally once daily (guideline dosage) [16].
(15 years or older or greater than 40 kg) Intensive phase: 600 mg (about 10 mg/kg) orally/IV once daily for 8 weeks (56 doses); give in combination with isoniazid 300 mg (about 5 mg/kg) orally/IM once daily; pyrazinamide 1000 mg (40 to 55 kg), 1500 mg (56 to 75 kg), or 2000 mg (76 to 90 kg) orally once daily; and ethambutol 800 mg (40 to 55 kg), 1200 mg (56 to 75 kg), or 1600 mg (76 to 90 kg) orally once daily. Additionally, administer pyridoxine 25 to 50 mg orally once daily (guideline dosage) [5].
(15 years or older or greater than 40 kg) Continuation phase: 600 mg (about 10 mg/kg) orally/IV once daily for 4 months (126 doses); give in combination with isoniazid 300 mg (about 5 mg/kg) orally/IM once daily. Additionally, administer pyridoxine 25 to 50 mg orally once daily (guideline dosage) [5].
Bacterial meningitis, Staphylococcus aureus or epidermidis
(neonates age 8 to 28 days) 10 to 20 mg/kg/day IV divided every 12 hours in combination with vancomycin (guideline dosing) [7]
(older than 28 days) 10 to 20 mg/kg/day IV divided every 12 to 24 hours (maximum 600 mg once daily) in combination with vancomycin (guideline dosing) [7]
Bacterial meningitis, Streptococcus pneumoniae
(neonates age 8 to 28 days) 10 to 20 mg/kg/day IV divided every 12 hours in combination with a third-generation cephalosporin, with or without vancomycin (guideline dosing) [7]
(older than 28 days) 10 to 20 mg/kg/day IV divided every 12 to 24 hours (maximum 600 mg da

chronic kidney disease or ESRD and HIV: CrCl 50 mL/min or less, 50% to 100% of the full dose [20]
chronic kidney disease or ESRD and HIV: hemodialysis, 50% to 100% of the full dose with no supplement following hemodialysis [20]
chronic kidney disease or ESRD and HIV: peritoneal dialysis, 50% to 100% of the full dose, with an extra 50% to 100% of the full dose after peritoneal dialysis [20]

significantly prolonged half-life has been reported in patients with liver disease; no specific dosing recommendations available

N/A