Rifampin Recall

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Questions & Answers

Side Effects & Adverse Reactions

Rifampin has been shown to produce liver dysfunction. Fatalities associated with jaundice have occurred in patients with liver disease and in patients taking rifampin with other hepatotoxic agents. Patients with impaired liver function should be given rifampin only in cases of necessity and then with caution and under strict medical supervision. In these patients, careful monitoring of liver function, especially SGPT/ALT and SGOT/AST should be carried out prior to therapy and then every 2 to 4 weeks during therapy. If signs of hepatocellular damage occur, rifampin should be withdrawn.

In some cases, hyperbilirubinemia resulting from competition between rifampin and bilirubin for excretory pathways of the liver at the cell level can occur in the early days of treatment. An isolated report showing a moderate rise in bilirubin and/or transaminase level is not in itself an indication for interrupting treatment; rather, the decision should be made after repeating the tests, noting trends in the levels, and considering them in conjunction with the patient's clinical condition.

Rifampin has enzyme-inducing properties, including induction of delta amino levulinic acid synthetase. Isolated reports have associated porphyria exacerbation with rifampin administration.

The possibility of rapid emergence of resistant meningococci restricts the use of rifampin to short-term treatment of the asymptomatic carrier state.

Rifampin is not to be used for the treatment of meningococcal disease.

Legal Issues

There is currently no legal information available for this drug.

FDA Safety Alerts

There are currently no FDA safety alerts available for this drug.

Manufacturer Warnings

There is currently no manufacturer warning information available for this drug.

FDA Labeling Changes

There are currently no FDA labeling changes available for this drug.


In the treatment of both tuberculosis and the meningococcal carrier state, the small number of resistant cells present within large populations of susceptible cells can rapidly become the predominant type. Bacteriologic cultures should be obtained before the start of therapy to confirm the susceptibility of the organism to rifampin and they should be repeated throughout therapy to monitor the response to treatment. Since resistance can emerge rapidly, susceptibility tests should be performed in the event of persistent positive cultures during the course of treatment. If test results show resistance to rifampin and the patient is not responding to therapy, the drug regimen should be modified.


Rifampin is indicated in the treatment of all forms of tuberculosis. A three-drug regimen consisting of rifampin, isoniazid, and pyrazinamide is recommended in the initial phase of short-course therapy which is usually continued for 2 months. The Advisory Council for the Elimination of Tuberculosis, the American Thoracic Society, and Centers for Disease Control and Prevention recommend that either streptomycin or ethambutol be added as a fourth drug in a regimen containing isoniazid (INH), rifampin, and pyrazinamide for initial treatment of tuberculosis unless the likelihood of INH resistance is very low. The need for a fourth drug should be reassessed when the results of susceptibility testing are known. If community rates of INH resistance are currently less than 4%, an initial treatment regimen with less than four drugs may be considered.

Following the initial phase, treatment should be continued with rifampin and isoniazid for at least 4 months. Treatment should be continued for longer if the patient is still sputum or culture positive, if resistant organisms are present, or if the patient is HIV positive.

Meningococcal Carriers

Rifampin is indicated for the treatment of asymptomatic carriers of Neisseria meningitidis to eliminate meningococci from the nasopharynx. Rifampin is not indicated for the treatment of meningococcal infection because of the possibility of the rapid emergence of resistant organisms. (See WARNINGS.)

Rifampin should not be used indiscriminately, and therefore, diagnostic laboratory procedures, including serotyping and susceptibility testing, should be performed for establishment of the carrier state and the correct treatment. So that the usefulness of rifampin in the treatment of asymptomatic meningococcal carriers is preserved, the drug should be used only when the risk of meningococcal disease is high.

To reduce the development of drug-resistant bacteria and maintain the effectiveness of rifampin and other antibacterial drugs, rifampin should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy.


There is currently no drug history available for this drug.

Other Information

Rifampin capsules, USP contain 150 mg or 300 mg rifampin per capsule. The 150 mg and 300 mg capsules also contain, as inactive ingredients: colloidal silicon dioxide, corn starch, FD&C Blue No. 1, FD&C Red No. 40, gelatin, lactose monohydrate, magnesium stearate, sodium lauryl sulfate, talc, and titanium dioxide.

The printing ink contains ammonium hydroxide, isopropyl alcohol, n-butyl alcohol, pharmaceutical glaze, propylene glycol, simethicone, and titanium dioxide

Rifampin is a semisynthetic antibiotic derivative of rifamycin SV. Rifampin is a red-brown crystalline powder very slightly soluble in water at neutral pH, freely soluble in chloroform, soluble in ethyl acetate and in methanol. Its molecular weight is 822.95 and its chemical formula is C43H58N4O12. The chemical name for rifampin is either 3-[[(4-Methyl-1-piperazinyl)imino]methyl]rifamycin or 5,6,9,17,19,21-hexahydroxy-23-methoxy-2,4,12,16,20,22-heptamethyl-8-[N-(4-methyl-1-piper-azinyl)formimidoyl]-2,7-(epoxypentadeca[1,11,13]trienimino)naphtho[2,1-b]furan-1,11(2H)-dione 21-acetate. Its structural formula is:

Chemical Formula

Rifampin Manufacturers

  • State Of Florida Doh Central Pharmacy
    Rifampin Capsule, Coated [State Of Florida Doh Central Pharmacy]
  • Remedyrepack Inc.
    Rifampin Capsule [Remedyrepack Inc. ]
  • Remedyrepack Inc.
    Rifampin Capsule [Remedyrepack Inc. ]
  • Rebel Distributors Corp
    Rifampin Capsule [Rebel Distributors Corp]
  • Versapharm Incorporated
    Rifampin Capsule, Coated [Versapharm Incorporated]
  • Remedyrepack Inc.
    Rifampin Capsule [Remedyrepack Inc. ]
  • Physicians Total Care, Inc.
    Rifampin Capsule [Physicians Total Care, Inc.]
  • H.j. Harkins Company, Inc.
    Rifampin Capsule, Coated [H.j. Harkins Company, Inc.]
  • Rebel Distributors Corp
    Rifampin Capsule [Rebel Distributors Corp]
  • Akorn Inc.
    Rifampin Injection, Powder, Lyophilized, For Solution [Akorn Inc.]
  • Bryant Ranch Prepack
    Rifampin Capsule [Bryant Ranch Prepack]
  • Mylan Institutional Inc.
    Rifampin Capsule [Mylan Institutional Inc.]
  • Cardinal Health
    Rifampin Capsule [Cardinal Health]
  • Cardinal Health
    Rifampin Capsule, Coated [Cardinal Health]
  • Pfizer Laboratories Div Pfizer Inc
    Rifampin Injection, Powder, Lyophilized, For Solution [Pfizer Laboratories Div Pfizer Inc]
  • Pfizer Laboratories Div Pfizer Inc
    Rifampin Injection, Powder, Lyophilized, For Solution [Pfizer Laboratories Div Pfizer Inc]
  • Lannett Company, Inc.
    Rifampin Capsule [Lannett Company, Inc.]
  • Mckesson Packaging Services A Business Unit Of Mckesson Corporation
    Rifampin Capsule [Mckesson Packaging Services A Business Unit Of Mckesson Corporation]
  • Remedyrepack Inc.
    Rifampin Capsule, Coated [Remedyrepack Inc. ]
  • Lupin Pharmaceuticals, Inc.
    Rifampin Capsule [Lupin Pharmaceuticals, Inc.]
  • Major Pharmaceuticals
    Rifampin Capsule [Major Pharmaceuticals]
  • Mylan Institutional Llc
    Rifampin Injection, Powder, Lyophilized, For Solution [Mylan Institutional Llc ]
  • American Health Packaging
    Rifampin Capsule [American Health Packaging]
  • Eon Labs, Inc.
    Rifampin Capsule [Eon Labs, Inc.]
  • Bedford Laboratories
    Rifampin Injection, Powder, Lyophilized, For Solution [Bedford Laboratories]
  • Carilion Materials Management
    Rifampin Capsule, Coated [Carilion Materials Management]
  • Fresenius Kabi Usa, Llc
    Rifampin Injection, Powder, Lyophilized, For Solution [Fresenius Kabi Usa, Llc]
  • Heritage Pharmaceuticals Inc.
    Rifampin Injection, Powder, Lyophilized, For Solution [Heritage Pharmaceuticals Inc.]

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