RIFAMPIN

Drugs in Pregnancy and Lactation.

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Name: RIFAMPIN
Class: Antituberculosis Agent
Risk Factor:    CM

Fetal Risk Summary

Reproduction studies with rifampin in mice and rats at doses greater than 150 mg/kg produced spina bifida in both species and cleft palates in the mouse fetuses (1). Teratogenicity in rodents has been reported with oral doses 15 to 25 times the human dose (2). Studies with pregnant rabbits revealed no evidence of teratogenicity (1).

In a surveillance study of Michigan Medicaid recipients involving 229,101 completed pregnancies conducted between 1985 and 1992, 20 newborns had been exposed to rifampin during the 1st trimester (F. Rosa, personal communication, FDA, 1993). No major birth defects were observed (one expected).

No controlled studies have linked the use of rifampin with congenital defects (3,4). One report described nine malformations in 204 pregnancies that went to term (5). This incidence, 4.4%, is similar to the expected frequency of defects in a healthy nonexposed population but higher than the 1.8% rate noted in other tuberculosis patients (5): Anencephaly (1 case) Hydrocephalus (2 cases) Limb malformations (4 cases) Renal tract defects (1 case) Congenital hip dislocation (1 case) Several reviews have evaluated the available treatment of tuberculosis during pregnancy (6,7 and 8). All concluded that rifampin was not a proven teratogen and recommended use of the drug with isoniazid and ethambutol if necessary. Other reports on the use of the agent in pregnancy have observed no fetal harm (9,10).

Rifampin crosses the placenta to the fetus (11,12 and 13). At term, the cord:maternal serum ratio ranged from 0.12–0.33 (12). In a second case involving pregnancy termination at 13 weeks' gestation, the fetal:maternal ratio 4 hours after a 300-mg dose was 0.23 (11).

Rifampin has been implicated as one of the agents responsible for hemorrhagic disease of the newborn (14). In one of the three infants affected, only laboratory evidence of hemorrhagic disease of the newborn was present, but in the other two, clinically evident bleeding was observed. Prophylactic vitamin K1 is recommended to prevent this serious complication (see Phytonadione).

Rifampin may interfere with oral contraceptives, resulting in unplanned pregnancies (see Oral Contraceptives) (15).

Breast Feeding Summary

Rifampin is excreted into human milk. In one report, the concentrations were 1–3 µg/mL with about 0.05% of the daily dose appearing in the milk (16). In another study, milk levels were 3.4–4.9 µg/mL, 12 hours after a single 450-mg oral dose (17). Maternal plasma samples averaged 21.3 µg/mL, indicating a milk:plasma ratio of about 0.20. These amounts were thought to represent a very low risk to the nursing infant (18). No reports describing adverse effects in nursing infants have been located. The American Academy of Pediatrics considers rifampin to be compatible with breast feeding (19).

"Official medicines" is the best online drugstore.

World’s leading meds delivered to your door – and you don’t even need a prescription! Only certified, first class drugs on offer! Buy more and spend less with our great discount system.

References

  1. Tuchmann-Duplessis H, Mercier-Parot L. Influence d'un antibiotique, la rifampicine, sur le developpement prenatal des ronguers. C R Acad Sci (d) (Paris) 1969;269:2147–9. As cited in Shepard TH. Catalog of Teratogenic Agents. 6th ed. Baltimore, MD: Johns Hopkins University Press, 1989:558–9.
  2. Product information. Rifadin. Hoechst Marion Roussel, 2000.
  3. Reimers D. Missbildungen durch Rifampicin. Bericht ueber 2 faelle von normaler fetaler entwicklung nach rifampicin-therapie in der fruehsch wangerschaft. Munchen Med Wochenschr 1971;113:1690.
  4. Warkany J. Antituberculous drugs. Teratology 1979;20:133–8.
  5. Steen JSM, Stainton-Ellis DM. Rifampicin in pregnancy. Lancet 1977;2:604–5.
  6. Snider DE, Layde PM, Johnson MW, Lyle MA. Treatment of tuberculosis during pregnancy. Am Rev Respir Dis 1980;122:65–79.
  7. American Thoracic Society. Treatment of tuberculosis and tuberculosis infection in adults and children. Am Rev Respir Dis 1986;134:355–63.
  8. Medchill MT, Gillum M. Diagnosis and management of tuberculosis during pregnancy. Obstet Gynecol Surv 1989;44:81–4.
  9. Shneerson JM, Frances RS. Ethambutol in pregnancy: foetal exposure. Tubercle 1979;60:167–9.
  10. Kingdon JCP, Kennedy DH. Tuberculosis meningitis in pregnancy. Br J Obstet Gynaecol 1989;96:233–5.
  11. Rocker I. Rifampicin in early pregnancy. Lancet 1977;2:48.
  12. Kenny MT, Strates B. Metabolism and pharmacokinetics of the antibiotic rifampin. Drug Metab Rev 1981;12:159–218.
  13. Holdiness MR. Transplacental pharmacokinetics of the antituberculosis drugs. Clin Pharmacokinet 1987;13:125–9.
  14. Eggermont E, Logghe N, Van De Casseye W, Casteels-Van Daele M, Jaeken J, Cosemans J, Verstraete M, Renaer M. Haemorrhagic disease of the newborn in the offspring of rifampicin and isoniazid treated mothers. Acta Paediatr Belg 1976;29:87–90.
  15. Gupta KC, Ali MY. Failure of oral contraceptives with rifampicin. Med J Zambia 1980;15:23.
  16. Vorherr H. Drug excretion in breast milk. Postgrad Med J 1974;56:97–104.
  17. Lenzi E, Santuari S. Preliminary observations on the use of a new semi-synthetic rifamycin derivative in gynecology and obstetrics. Atti Accad Lancisiana Roma 1969;13(Suppl 1):87–94. As cited in Snider DE Jr, Powell KE. Should women taking antituberculosis drugs breast-feed? Arch Intern Med 1984;144:589–90.
  18. Snider DE Jr, Powell KE. Should women taking antituberculosis drugs breast-feed? Arch Intern Med 1984;144:589–90.
  19. Committee on Drugs, American Academy of Pediatrics. The transfer of drugs and other chemicals into human milk. Pediatrics 1994;93:137–50.

Index

Q&A about Rifampin

Jennifer W
Can the medication Rifampin cause false negative pregnancy test results?
dedum
All commercially available tests for pregnancy look for the presence of the beta subunit of hCG or human chorionic gonadotropin in the blood or urine. They are usually performed after a missed menstruation or 2-3 weeks after ovulation. (wiki). There is no reason for an antibiotic to cause a false negative when testing for hCG.

You may need to wait longer for the hCG in your system to build up to adequate levels for the testing product to detect hCG in your system.

However,studies clearly show that rifampin decreases the effectiveness of birth control pills in preventing ovulation.

Please use a barrier method of birth control while on this or any other antibiotics.
john c
Why rifampin or other anti tuberculosis drugs cause body fluids to turn into red colour?
Louie
Of all anti-TB drugs only Rifampin may cause side effects in your urine, stools, saliva, sputum, sweat, and tears to turn red-orange; this effect is harmless. Tell your doctor if any of these symptoms are severe or do not go away: headache, muscle pain, bone pain, heartburn, upset stomach, vomiting, stomach cramps, chills, diarrhea

If you experience any of the following symptoms, call your doctor immediately: skin rash (hives), sores on skin or in the mouth, fever, yellowing of the skin or eyes
erisac
My 7 year old was given rifampin 300mg and Septra 400-80mg for sinuses. Is this normal?
After a cold, she has had cough for 5 months now, thick. Her Ct scan showed stuffed sinuses, and X-ray was normal. I read rifampin is given for TB, but I am wondering if this combination will do wonders for her cough. No other symptoms. Cough has been persistent after Biaxin and Azythromycin. Any thoughts?
Rae
My son has chronic sinus problems. when he was 5 he had his first sinus surgery. He had been so plugged that after surgery he told me to roll up the window because air was going through his nose. he had never breathed through his nose before. He has never had either medicine you mention before. He has had 2 surgeries to clear him out. They've used Biaxin lots of times. Usually after six months on that-if he's still plugged- he has surgery. He has a sinus wash he does daily. It is 1/2 a tsp. of salt and a pinch of baking soda mixed in water. He has a special bottle to squeeze the solution up his nose. You can get big syringes at the pharmacy that do the same job. It really helps. Sometimes he gets lung problems from the infection dripping into his lungs from his sinus.
mimi
what are the drugs of rifampin from first to fourth generations?
mel
Rifampin (rif-AM-pin) is used to treat certain bacterial infections.

In the U.S.—

* Rifadin

* Rifadin IV



* Rimactane

In Canada—

* Rifadin

* Rimactane



* Rofact
matta364...
i just took 2 Rifampin pills a few hours apart, should i call the doctor?
i forgot what time i took the first one, well i actually forgot i took it at all and then i took another one just a few hours ago... so i just need to know if taking 1 extra within a few hours time will hurt me????
Kenny G
that's not much, its shouldn't be too enough to hurt you. you could check the label of the box or tub thing it came in.

if you had taken like 10 it would be bad.
Miracle
Ever heard of treating MRSA with Rifampin and Bactrim?
been struggling with MRSA for about a year now, taken several different antibio. clendamycin, bactrim, Septra, Doxicycline, all of this after an ititial 9 day cleocin via IV. I finally decided to see a different doctor.....maybe he knows what he's doing...you could understand my skepticism at this point...but, he has me on Rifampin, 1200mg. a day and Bactim 1200mg aday....I don't think I have had this high of a dosage as of yet....it's really drained the life out of me....anyway, also concerned after reading about the Rifampin...that its mainly used for treating active TB.....anyway, at this point...nothing really makes sense at all......and of course, im not a doctor or nurse.....sooooo, if anyone has any input on this I would really appreciate it.......I know EVERY case of MRSA is different...but.....I would like to get some info.....anyone had or anyone know someone who has been successfully treated for MRSA, if so, fill me in please. thanks a bunch yall, sincerely.
traceyam...
Can i ask where the MRSA is and how/when you got it, also are you immunocomprimised in any way. I am an RN and i work with MRSA alot, usually vanco is used but i have seen rifampin used, what kind of doctor are you seeing for this, hopefully an infectious disease doc, dont let the name scare ya. have you had your liver , kidney functions tested- bloodwork, etc. there is alot to think of. I hope to help you more once i know more.- Tracey
wywy
i had a positive tb skin test and need to take rifampin but i'm breastfeeding!?
hello

the doctor at infectious desease prescribed me the rifampin and he said it would be ok with breastfeeding. i think that drug is strong so how can it not effect the baby. i don't have TB but a positive skin test and need to take rifampin for 4 months.

please, all those who know about this drug and who tried it please give me feedback.

thank you
starla_o...
I don't think this is too safe. Anything you ingest affects the breat milk and the side effects of rifampacin may be worse in an infant. I would stop breat feeding until you get another opinion.

Oh and the source below has very user friendly info on Rifampacin
redims81
Can "IC sulfamethoxazole/tmp ds tablnt" and "IC rifampin 300 mg capsule eon" turn my urine orange?
I just started taking "IC sulfamethoxazole/tmp ds tablnt" and "IC rifampin 300 mg capsule eon" earlier tonight, and my urine was just bright ornage, like orange soda...is this normal?

Please only answer if you're a docter or pharmacist
Jesse C
I am a pharmacy technician and a paramedic. The sulfamethexazole/trimethoprim, also known as Bactrim DS and Septra DS, is a combination of two antibiotics and is usually used to treat urinary tract infections, lower respiratory tract infections, and sexually transmitted diseases. This particular combination of medicines has no effect on urine color. Rifampin, also known as Rifadin, is most commonly used to treat tuberculosis, MRSA (Methicillin Resistant Streptococcus aureus), and sexually transmitted diseases, among others. It is known to cause an orange color or tint to urine and feces, as referenced by LexiComp in their publication of Drug Information Handbook.
MJD
Is rifampin approved in the U.S. for the treatment of methicillin-resistant Staphylococcus aures infections?
c_schuma...
Yes it is often used in combination with Bactrim, Vanco, and Minocycline for MRSA.
raads r
Difference between rifampin and rifampicin?
Morgan S
Both contain the antibiotic Rifampin..rifampicin includes another drug to make it more effective in treating Tuberculosis...rifampin is used for other bacterial infections.