Rifampicin: Dosage And Indications

Rifampicin is an antibiotic medicine that represents the rifampicin family. It is a semi-synthetic compound used as the first choice in the treatment of tuberculosis.

However, it should not be used in monotherapy, since this fact would favor the development of resistance by bacteria. Therefore, it is administered with other medications that we will explain later.

Rifampicin also has other indications, such as the treatment of carrier patients without symptoms of the Neisseria meningitidis bacteria , as a prophylactic treatment for Haemophilus influenzae type B and for the treatment of leprosy, among other indications.

A little history about rifampin

This antibiotic hit the market in the 1960s. First, a rifampicin metabolite, rifampicin B , was obtained. They tried to make a series of structural modifications on this molecule in order to increase the antibiotic potency, while reducing its rapid elimination via the bile duct. Finally, rifampicin was synthesized.

After its introduction on the market, it has been considered as a first-line treatment for tuberculosis. However, resistance to rifampin appeared on the part of pathogens. This fact made it necessary to administer other medications together with it, such as isonizaide and ethambutol.

Nonetheless, the discovery of rifampin was a breakthrough in medicine, without a doubt. Learn more about this drug in this article.

What is tuberculosis?

What is pulmonary tuberculosis and what are its symptoms?

Tuberculosis is a disease caused by the infection of a bacterium known as Mycobacterium tuberculosis. This microorganism affects, in most cases, the lungs. It is spread through the air, for example, when a person sneezes or coughs. It is enough for another person to breathe in the expelled particles to become infected.

However, it is a disease that can be prevented and that, fortunately, today, has a cure. Specifically, since 2000, more than 49 million patients have been cured thanks to the diagnosis and treatments available to us today.

On the other hand, as for the signs and symptoms of this disease, they depend on the area where the bacteria multiply. Normally, as we have said, it usually affects the lungs , presenting the following symptoms:

  • Weight loss.
  • Chest pain.
  • Intense and long-lasting cough.
  • Fever and chills.
  • Decreased feeling of hunger.
  • Cough accompanied by blood or thick phlegm.

How does rifampicin work in the body?


Rifampicin owes its antibiotic effect to its ability to inhibit RNA synthesis in bacterial cells. To do this, it inhibits the action of RNA polymerase, a DNA-dependent enzyme. Rifampin does not bind to polymerases in eukaryotic cells, such as those in humans, so the synthesis of human RNA is not affected.

On the other hand, it is a bacteriostatic or bactericidal drug, depending on the dose at which it is administered. At lower doses, it will be bacteriostatic, that is, it prevents the development of bacterial cells, and, at higher doses, it will have a bactericidal action or, in other words, it causes the death of the bacteria.

At what dose is rifampin given?

Dosage will vary depending on the patient to be treated. As for the recommended doses in adult patients who are not infected with HIV, it is administered, both orally and intravenously, with a maximum allowable dose of 600 milligrams per day. If the patient has HIV, the dose will be 10 mg / kg, both orally and intravenously.

As for children, the dose for HIV-negative patients is reduced to 10-20 mg / kg per day, the maximum dose being 600 milligrams, always combined with another antituberculous agent. If the child has the human immunodeficiency virus, the dose will be the same.

It is given once a day for two months together with another anti-tuberculosis drug. Then isoniazid and rifampicin will be given at the same dose once a day or 2 or 3 times a week for the next 4 months.

An antibiotic against leprosy

Rifampicin is an antibiotic indicated in the first line of tuberculosis treatment, in combination with other agents. The combination became necessary due to the resistance developed by the bacteria.

You can consult with your doctor or pharmacist any questions you have about this medicine. You should always follow the instructions given by the professionals. Misuse of medicines can lead to serious health problems.

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